The Biden administration has instructed emergency room doctors to perform emergency abortions when necessary to save a pregnant woman’s health. This directive follows the recent Supreme Court ruling that did not resolve the legal dispute over whether state abortion bans supersede a federal law mandating hospitals to provide stabilizing treatment.
In a letter sent to doctor and hospital associations, Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services Director Chiquita Brooks-LaSure reminded hospitals of their legal obligation to offer stabilizing treatment, which may include abortions. The Associated Press obtained a copy of the letter.
The letter emphasized the importance of ensuring that pregnant women receive the necessary treatment to stabilize their emergency medical condition in the emergency room. It highlighted instances where pregnant women were turned away from hospital emergency departments due to uncertainty among medical providers about the treatment they could provide.
CMS will resume investigations into complaints against emergency rooms in Idaho, following the Supreme Court ruling that hospitals in the state must be allowed to perform emergency abortions. However, enforcement in Texas will remain on hold due to a lower court ruling.
The letter is the Biden administration’s effort to raise awareness about a 40-year-old federal law requiring nearly all emergency rooms that receive Medicare funding to provide stabilizing treatment for patients in a medical emergency. Hospitals that fail to provide this care are subject to federal investigations, fines, and loss of Medicare funding.
The Texas Alliance for Life disputed the administration’s claims, stating that state pro-life laws, including those in Texas and Idaho, already have provisions allowing for abortions in life-threatening emergencies during pregnancy.
The emergency room is the battleground where the administration is asserting its authority to require emergency abortions in rare circumstances, despite strict state abortion laws. After the overturning of Roe v. Wade in 2022, HHS informed doctors that they must perform abortions in emergency medical situations to keep women stable.
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An AP investigation revealed a surge in complaints about pregnant women being denied care in emergency rooms in 2022 after the Roe decision was overturned, raising concerns about emergency pregnancy care in states with strict abortion laws.
Enforcement of the federal law in emergency abortion cases in Idaho was halted when the state’s abortion ban went into effect. Idaho’s law only allows abortion if a pregnant woman’s life, not health, is at risk.
HHS argues that this conflicts with the federal Emergency Medical Treatment and Active Labor Act (EMTALA). Each year, around 50,000 women face serious pregnancy complications, and in severe cases where the fetus is unlikely to survive, doctors may recommend a termination.
For example, in cases like preterm premature rupture of membranes during the second trimester, continuing the pregnancy may endanger the patient, necessitating a termination to prevent sepsis. Texas is challenging the administration’s guidance on the law.
Related story: Supreme Court rules to allow emergency abortions in Idaho
HHS has made it easier for patients turned away or not properly transferred to file complaints against hospitals. A new webpage allows individuals to report violations of EMTALA in a simple three-step process.
The department announced that the complaint webpage will now be available in Spanish, recognizing the need for accessibility among Latinas and people of color, who may face challenges in states with abortion bans.
Lupe Rodriguez of the National Latina Institute for Reproductive Justice highlighted the importance of centering Latinas and people of color in these discussions, given their disproportionate impact from abortion restrictions and limits on emergency care.
