~ The Trump Administration’s rescission of EMTALA guidance that reaffirmed nationwide access to emergency abortion care puts patients’ lives in jeopardy and sows chaos for hospitals and providers across the country ~
WASHINGTON, D.C. – Today, on the three-year anniversary of the Dobbs decision overturning Roe v. Wade, U.S. Senators Mazie K. Hirono (D-HI) and Ron Wyden (D-OR) led eight of their colleagues in a letter condemning the Trump Administration’s recent rescission of guidance that reaffirmed hospitals and providers’ obligations under the Emergency Medical Treatment and Labor Act (EMTALA) to provide medically necessary emergency abortion care, regardless of where the patient lives. The letter, sent to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz, urges HHS to immediately reverse its decision to rescind this lifesaving guidance.
In 1986, Congress enacted EMTALA to require Medicare-participating hospitals to provide necessary stabilizing treatment for any individuals—including pregnant women—experiencing emergency medical conditions. The federal law clearly requires hospitals to offer abortion care in cases where it was deemed medically necessary to prevent serious harm to patients’ health and life. However, since the conservative majority on the Supreme Court handed down the Dobbs decision, more than twenty states have passed laws to ban or severely restrict access to abortion, disrupting decades of certainty for hospitals regarding their legal obligation to provide necessary emergency abortion care under federal law.
“While EMTALA remains binding federal law, the rescission will create further confusion for hospitals and providers, especially in states with abortion bans, and will result in medically-necessary care being withheld from pregnant patients in crisis,” wrote the lawmakers. “When doctors are forced to navigate the complex legal interplay of state abortion bans and federal EMTALA protections, pregnant people experience care delays and may receive substandard care.”
In their letter, the senators assert that by rescinding this guidance—accompanied by the ensuing fear and confusion for hospitals and providers—HHS has needlessly put pregnant patients at severe risk of harm, medical complications, lasting health consequences, and preventable death.
“This abrupt decision will further the chaos and confusion that hospitals, physicians, and patients have experienced since the Dobbs decision and will result in negative and deadly consequences for women and families across the United States,” the lawmakers concluded.
In addition to Senators Hirono and Wyden, the letter was signed by Senators Amy Klobuchar (D-MN), Lisa Blunt Rochester (D-DE), Tammy Duckworth (D-IL), Elizabeth Warren (D-MA), Angela Alsobrooks (D-MD), Maria Cantwell (D-WA), Tina Smith (D-MN), and Jacky Rosen (D-NV).
The full text of the letter is available here and below.
Dear Secretary Kennedy and Administrator Oz:
We write to express our strong disapproval of your recent rescission of guidance that reaffirmed hospitals and providers’ obligations under the Emergency Medical Treatment and Labor Act (EMTALA) to provide life-saving abortion care to patients experiencing medical crises. On June 3, 2025, the U.S. Department of Health and Human Services (“HHS” or “the Department”) and the Centers for Medicare & Medicaid Services (“CMS” or “the Agency”) rescinded July 2022 guidance that reminds hospitals of their longstanding obligation under EMTALA and that protects pregnant women’s access to emergency abortion care, regardless of where they live. While EMTALA remains binding federal law, the rescission will create further confusion for hospitals and providers, especially in states with abortion bans, and will result in medically-necessary care being withheld from pregnant patients in crisis.
In 1986, Congress enacted EMTALA to require Medicare-participating hospitals to provide necessary stabilizing screening and treatment for any individuals—including pregnant women—experiencing emergency medical conditions. Under the law, hospitals are required to treat conditions determined by health care providers that, absent immediate medical attention, could reasonably result in placing the patient’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ. EMTALA clearly requires hospitals to offer abortion care for cases in which their health care providers determine it medically necessary to prevent serious harm to their patients’ health and life, including in, but not limited to, cases of ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features. Since enacting EMTALA, Congress and administrations of both parties have consistently recognized that stabilizing care under the statute includes abortion. As a result, up until a few years ago, medical providers have not had to worry about the government interfering with their clinical judgement to provide necessary stabilizing medical care to pregnant women in emergencies.
Following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health (Dobbs) in June 2022, 22 states passed laws to ban or severely restrict access to abortion, including 6 states with no exception for the health of the pregnant person. This has disrupted decades of certainty that hospitals are required to provide access to emergency abortion care under federal law, sowing chaos for patients and providers alike, and forcing doctors to play lawyers and lawyers to play doctors. When doctors are forced to navigate the complex legal interplay of state abortion bans and federal EMTALA protections, pregnant people experience care delays and may receive substandard care. In response to the confusion caused by these restrictive abortion bans, HHS Secretary Becerra issued guidance in July 2022 restating hospitals’ legal obligation under federal law to provide stabilizing treatment, including necessary abortion care, to pregnant patients in emergency situations. Even with such guidance in place, physicians across the country report that hospitals fail to meet the challenge of supporting doctors in navigating this extraordinary legal environment and, in many cases, hospitals continue to rely on guidance developed pre-Dobbs. While Republican-led states and anti-abortion groups have tried to challenge proper meaning and scope of the federal law, EMTALA has always and will continue to protect emergency abortion care and preempt all state laws to the contrary.
The Trump administration’s decision to rescind this guidance will create more confusion, fear, and stress for hospitals and their staffs about what care they are legally required to provide pregnant patients whose lives are or could be in danger. Moreover, it will undermine patients’ faith that their doctor will be able to act in their best interest in the event of an emergency. State abortion laws with vague medical exceptions and criminal penalties force hospitals and physicians to delay and deny emergency abortion care for pregnant patients, placing patients at higher risk for medical complications, lasting health consequences, and avoidable death.
By rescinding the guidance, HHS has needlessly put pregnant patients at severe risk of harm and preventable death. Given the threat to women’s lives following the rescission of this guidance, we request information and responses to the following questions by July 3, 2025, at 5:00pm ET.
This abrupt decision will further the chaos and confusion that hospitals, physicians, and patients have experienced since the Dobbs decision and will result in negative and deadly consequences for women and families across the United States. HHS should immediately reverse its decision to rescind the guidance.
Sincerely,
###