CMS Rescinds July 2022 Guidance on EMTALA and Emergency Abortions
Last week, the Trump administration rescinded guidance issued by the CMS in July 2022 regarding hospitals’ obligations under the Emergency Medical Treatment and Labor Act (EMTALA) with respect to patients who are pregnant or are experiencing pregnancy loss. The guidance was issued under the Biden administration following the overturning of Roe v. Wade. The guidance required hospital emergency departments to provide abortion services as stabilizing care, even in states with abortion bans.
Under EMTALA, individuals presenting at a Medicare-funded hospital seeking medical care must be screened by qualified medical personnel to determine the presence of a medical condition. If an emergency medical condition is identified, the patient must be provided with stabilizing treatment before the patient is discharged or transferred to another facility. EMTALA applies regardless of the individual’s ability to pay.
The 2022 CMS guidance titled “Reinforcement of EMTALA Obligations Specific to Patients who are Pregnant or are Experiencing Pregnancy Loss,” concerned pregnant patients with an emergency medical condition such as an ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders such as preeclampsia with severe features. In such cases, stabilizing treatment could include medical and/or surgical treatments, such as abortion, irrespective of any state law or mandate that applies to specific procedures.
The CMS has now rescinded that guidance and the accompanying letter from then-HHS Secretary, Xavier Becerra, stating “the guidance does not reflect the policy of this administration.” The new guidance took effect on May 29, 2025. Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services (CMS), explained the decision in a post on X. “The Biden Administration created confusion, but EMTALA is clear, and the law has not changed: women will receive care for miscarriage, ectopic pregnancy, and medical emergencies in all fifty states—this has not and will never change in the Trump Administration.”
The CMS stated that it will continue to enforce EMTALA, including cases where a pregnant patient or unborn child is in serious jeopardy, and explained that “CMS will work to rectify any perceived legal confusion and instability created by the former administration’s actions.”
