In a significant policy shift, the Trump administration announced on Tuesday that it is rescinding a controversial Biden-era guidance that required hospitals to perform emergency abortions under the Emergency Medical Treatment and Labor Act (EMTALA).
This decision marks a reversal of the guidance issued by the Department of Health and Human Services (HHS) in July 2022, which aimed to ensure abortion access in emergency situations.
Background on the Biden Administration’s Guidance
The Biden administration’s guidance was issued in the wake of the U.S. Supreme Court’s decision to overturn Roe v. Wade, which ended federal protections for abortion rights.
Under the guidance, doctors were required to perform abortions in emergency departments if the procedure was deemed necessary to stabilize a patient facing an emergency medical condition. This included conditions such as:
- Ectopic pregnancy
- Complications of pregnancy loss
- Emergent hypertensive disorders, such as preeclampsia with severe features
The goal of the guidance was to preserve access to abortion in cases where it was necessary to protect the life or health of the mother, even in states where abortion was otherwise restricted or banned.
Rescinding the Guidance
However, the Trump administration has now reversed that policy. In a press release, the Centers for Medicare and Medicaid Services (CMS), alongside HHS, announced that they would rescind the guidance issued during the Biden administration.
The statement emphasized that the guidance “do not reflect the policy of this Administration.” The press release continued:
“CMS 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.”
Impact and Reactions
This reversal has sparked criticism from abortion rights advocates, who argue that it undermines access to emergency care for women, particularly those in states with restrictive abortion laws. Alexa Kolbi-Molinas, deputy director of the American Civil Liberties Union’s (ACLU) Reproductive Freedom Project, condemned the move, stating,
“By rescinding this guidance, the Trump administration has sent a clear signal that it is siding not with the majority, but with its anti-abortion allies — and that will come at the expense of women’s lives.”
Kolbi-Molinas further promised that the ACLU would use all available legal means to challenge the decision, emphasizing that it could place women’s health and lives at risk.
Legal Challenges to the Biden Administration’s Guidance
The Biden administration’s guidance had faced legal challenges prior to its rescindment. In January 2024, a federal appeals court ruled that Texas hospitals and doctors were not required to perform emergency abortions, despite the HHS guidance.
This ruling came as part of a broader legal battle over the application of EMTALA in states with restrictive abortion laws.
Earlier in 2024, the Department of Justice (DOJ) dismissed a lawsuit against Idaho, claiming that its near-total abortion ban violated EMTALA by preventing emergency abortion care. This legal setback highlighted the ongoing tension between federal healthcare requirements and state-level abortion restrictions.