CMS’ rescindment of a 2022 guidance that clarified hospitals’ obligations to provide emergency abortion care is spurring additional confusion amid an already complicated legal landscape, health and legal experts said.
Six things to know:
1. CMS rescinded the EMATALA guidance — first issued by the Biden administration in 2022 upon Roe v. Wade‘s overturning — on June 3. The guidance clarified that clinicians who provided medical treatment, including abortions, to pregnant patients who present to emergency departments were protected under EMTALA, regardless of state law.
2. The move does not change federal law, and EMTALA is still in effect nationally, requiring healthcare providers to provide stabilizing care. However, it is unclear to what extent the Trump administration will enforce the law, as it dropped a Biden-era federal lawsuit in March that sought exceptions for emergency care to Idaho’s strict abortion ban, according to ABC News.
3. CMS said in a June 3 statement it will continue to enforce EMTALA and “work to rectify any perceived legal confusion and instability created by the former administration’s actions.”
4. Some industry experts argue the move will sow more confusion and fear among emergency medicine physicians in states with abortion bans and strict punishments for clinicians who break the law.
“The standard of EMTALA is pretty high,” Katherine Hempstead, PhD, a senior policy adviser at Robert Wood Johnson Foundation, told The Hill. “This kind of takes that layer of reassurance away, and it will make a lot of providers feel very vulnerable.”
5. Physicians and hospitals are stuck between “a rock and a hard place,” trying to navigate differences between state and federal laws, according to Alison Tanner, an attorney at the National Women’s Law Center.
“Doctors and hospitals are being put in an untenable position,” she told ABC News. “On the one hand, they are faced with state laws that would potentially impose severe criminal sanctions for providing necessary emergency abortion care. And on the other hand, they have the federal law, EMTALA, which provides that both the federal government and individual patients can sue the hospital if they do not provide the necessary stabilizing care required under federal law.”
6. Some medical organizations have voiced concerns that rescinding the guidance could threaten patient safety. On June 7, delegates urged the American Medical Association to take a stronger stance against the rescission of the federal guidance, arguing it may lead to more preventable deaths among pregnant women, according to MedPage Today.
The American Hospital Association also weighed in, emphasizing that hospitals take their EMTALA responsibilities seriously and that the law “requires caregivers to exercise their professional judgment about a patient’s care,” in a June 9 statement to Becker’s. Meanwhile, the American College of Obstetricians and Gynecologists released a practice advisory on June 2 underscoring the dangers of delayed abortion care in emergencies.
