Trump Administration Rolls Back Biden Rule on Emergency Abortions

On Tuesday, the Trump administration announced the rescission of federal guidance that had outlined hospitals' responsibilities to deliver emergency abortion care per the Emergency Medical Treatment and Labor Act (EMTALA). This decision has raised alarms among abortion rights advocates, who caution that it may jeopardize the lives of pregnant patients.

The guidance established during the Biden administration, released following the 2022 overturning of Roe v. Wade, directed hospitals to consider abortion as a necessary option in medical emergencies, regardless of stringent abortion restrictions in certain states. The interpretation, now rescinded, played a pivotal role in legal disputes in states such as Idaho and Texas, where officials contended that it inappropriately expanded the scope of EMTALA.

The Centers for Medicare and Medicaid Services (CMS) has issued a letter reversing its previous policy under the Trump administration. The agency confirmed it will continue to enforce EMTALA protections while committing to "rectify any perceived legal confusion" stemming from the prior administration's stance.

Abortion rights organizations expressed significant concern.

Dr. Jamila Perritt, an OB-GYN and president of Physicians for Reproductive Health, stated, “This action sends a clear message: the lives and health of pregnant people are not worth protecting.” “Adhering to this legislation could be a matter of survival.”

In the wake of the overturning of Roe v. Wade, numerous women have come forward with accounts of being denied or experiencing delays in emergency medical care in states with abortion bans. Reports indicate that at least five fatalities have been associated with these delays, as highlighted by reproductive health advocacy organizations.

The withdrawn guidance played a pivotal role in a U.S. Supreme Court case from the previous year concerning Idaho’s near-total abortion ban, which permitted abortions solely when a woman's life was in jeopardy, excluding health considerations. The Biden administration contended that these restrictions contravened EMTALA, a law mandating hospitals to stabilize all patients in emergencies.

In a decisive 6–3 ruling, the Court dismissed the case on procedural grounds, thereby sidestepping a determination on the substantive issues at hand. Justice Ketanji Brown Jackson delivered a powerful dissent, stating, “This court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it…” Pregnant patients in Idaho, Texas, and other regions are set to face significant financial burdens.

Critics argue that the decision to rescind the guidance will create confusion among hospitals, expose physicians to legal vulnerabilities, and increase risks for patients.