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The Trump administration announced on Tuesday that it is rescinding a Biden-era guidance requiring emergency rooms across the country to provide abortion services to people facing health emergencies relating to pregnancy complications.
That guidance, issued in 2022 shortly after the Supreme Court upended federal abortion protections established in Roe v. Wade, was based on a federal law that applies to U.S. hospitals with ERs that rely on Medicare funds. The law, entitled the Emergency Medical Treatment and Active Labor Act (EMTALA), requires those hospitals to provide stabilizing treatment to patients in all emergency situations.
While many believe EMTALA inherently applies to abortion care, the Biden administration’s guidance attempted to make that clearer, stating that, where a person’s health or life could be jeopardized due to issues relating to their pregnancy, hospitals must provide patients with abortions, where applicable — including in states with complete bans on the procedure.
Over the past few years, several abortion-restrictive states have attempted to challenge the guidance. A lawsuit in Texas, for example, was successful at doing so after lower courts deemed the state in compliance with EMTALA exceptions and the U.S. Supreme Court refused to hear a challenge from the Biden administration in late 2024.
On Tuesday, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced they were rescinding the 2022 guidance, stating that it does “not reflect the policy” of the Trump administration. CMS said that it would still adhere to EMTALA standards, with abortion rights advocates noting that, under the stipulations of the law itself, those should still include emergency abortions where they are necessary.
“The obligation to provide emergency care comes from a federal statute … and as much as they might like to, President Trump and [HHS] Secretary Kennedy can not erase 40 years of law with this press release,” said Alexa Kolbi-Molinas, deputy director of the American Civil Liberties Union’s (ACLU) Reproductive Freedom Project, speaking to The Hill about the administration’s action.
Other abortion rights advocates and organizations spoke out against the Trump White House’s decision to make it less clear whether EMTALA includes emergencies relating to reproductive health.
The move “shows a callous disregard for the law and people’s lives,” said Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute.
Nancy Northup, president and CEO of the Center for Reproductive Rights, noted that the move would make things more perplexing for doctors (and thus, more dangerous for patients), stating:
In pulling back guidance, this administration is feeding the fear and confusion that already exists at hospitals in every state where abortion is banned. Hospitals need more guidance right now, not less.
Jamila Perritt, a Washington, D.C.-based OB/GYN and president and CEO of Physicians for Reproductive Health, also criticized the move.
“This action sends a clear message: the lives and health of pregnant people are not worth protecting,” Perritt said. “Complying with this law can mean the difference between life and death for pregnant people, forcing providers like me to choose between caring for someone in their time of need and turning my back on them to comply with cruel and dangerous laws.”
Perritt emphasized that EMTALA should still be interpreted as covering emergency abortions.
“It is important to remember that EMTALA is still the law of the land,” Perritt added. “As a doctor, I have a moral and ethical obligation to provide emergency care to those in need, including EMTALA’s mandate to provide abortion care when it is necessary and stabilizing treatment.”
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