Coalition of 22 State Attorneys General Confirms Abortion is Still Covered Under EMTALA
A coalition of 22 state attorneys general has written to the American Hospital Association (AHA) to remind hospitals that they are obliged to provide emergency abortion care to patients under the Emergency Medical Treatment and Active Labor Act (EMTALA). Earlier this month, the Trump administration rescinded guidance issued by the Centers for Medicare and Medicaid Services (CMS) in 2022 – Reinforcement of EMTALA Obligations specific to Patients who are Pregnant or are Experiencing Pregnancy Loss – as it did not reflect the policy of the Trump administration.
That guidance specifically stated that abortion is covered under EMTALA, such as when pregnant patients visit hospitals seeking emergency care for conditions such as ectopic pregnancy, hemorrhaging, preeclampsia, placental abruption, or amniotic fluid embolism. The failure to provide abortion for these conditions could have grave consequences for the patient, including infertility or even death.
Announcing the decision to rescind the guidance, the CMS said it will continue to enforce EMTALA, “which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy.” The CMS did not specifically mention abortion care, and neither did HHS Secretary Robert F. Kennedy Jr. in his June 13 letter to healthcare providers about the rescission of the guidance, only confirming that stabilizing care must be provided to a person who is pregnant and having a medical emergency. Kennedy explained in the letter that the 2022 guidance was causing confusion; however, some doctors claim that the uncertainty remains, especially in states with abortion bans, where doctors could potentially be jailed for providing an emergency abortion.
California Attorney General Rob Bonta, New Jersey Attorney General Matthew J. Platkin, and New York Attorney General Letitia James co-led the group of 22 attorneys general in clarifying that under EMTALA, abortion care should be provided in emergencies, irrespective of the rescission of the 2022 guidance. “Nothing about CMS’s rescission of its 2022 guidance changes the statutory text of EMTALA, which requires abortion care in specified circumstances. Nor does the rescission of the guidance supersede numerous judicial opinions interpreting EMTALA to require the provision of emergency abortion care,” wrote the Attorneys General.
They referenced the letter sent to healthcare providers by Robert F. Kennedy, Jr., in which he confirmed that EMTALA has not been changed. “That letter needlessly attempts to sow confusion by focusing on protections for a pregnant patient’s unborn child,” explained the Attorneys General. “Nothing about the rescission of the guidance changes the fact that EMTALA’s requirement to provide stabilizing care is based on the medical condition of the pregnant patient, not the fetus.”
The Attorneys General warned of the devastating consequences of denying medically necessary abortion care to pregnant patients, including permanent damage to reproductive organs and death. “The law is clear: Hospitals subject to EMTALA have an obligation to provide timely abortion care when necessary to stabilize a patient experiencing an emergency medical condition,” wrote the Attorneys General. “We remain steadfast in our commitment to ensuring that every hospital continues to follow the law, and we stand ready to work together to ensure that every pregnant patient across the country receives the necessary and lifesaving health care that federal and state law require.”
