The Biden administration has informed emergency room doctors that they are required to perform emergency abortions when necessary to save the health of a pregnant woman. This follows the Supreme Court ruling last week that did not resolve a 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 emphasized the legal obligation of hospitals to offer stabilizing treatment, which could include abortions. The Associated Press obtained a copy of the letter.
The letter stated, “No pregnant woman or her family should have to worry about being denied the treatment needed to stabilize her emergency medical condition in the emergency room.” It continued, “Despite this, there have been numerous incidents where pregnant women with emergency medical conditions were turned away from hospital emergency departments due to uncertainty from medical providers about the treatment they could provide.”
CMS will resume investigations into complaints against emergency rooms in Idaho following the Supreme Court decision that hospitals must be allowed to perform emergency abortions despite the state’s abortion ban. However, enforcement in Texas, which has a strict six-week abortion ban, will remain on hold due to a lower court ruling.
This letter is part of the Biden administration’s efforts to bring attention to a 40-year-old federal law that mandates almost all emergency rooms receiving Medicare funds to provide stabilizing treatment for patients in a medical emergency. Hospitals that fail to offer this care are subject to federal investigations, significant fines, and loss of Medicare funding.
The Texas Alliance for Life countered the letter, stating that the Biden administration falsely implies that Idaho and other state pro-life laws do not protect women facing life-threatening pregnancy emergencies. The group asserted that all state pro-life laws have an abortion exception for situations where a pregnancy poses a threat to a mother’s life.
The emergency room is the only place where the Biden administration argues it can federally mandate rare emergency abortions despite strict state abortion bans. After the overturning of Roe v. Wade in 2022, HHS sent letters to doctors requiring them to provide abortions in emergency medical situations necessary to maintain a woman’s medical stability.
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An investigation by AP found a significant increase in complaints about pregnant women being turned away from emergency rooms in 2022 after the Supreme Court’s ruling on Roe, raising concerns about emergency pregnancy care in states with strict abortion laws.
Enforcement of the federal law in emergency abortion cases in Idaho had been paused since January due to the state’s strict abortion ban. Idaho’s law threatens doctors with prison time for performing abortions, except in cases where a pregnant woman’s life, not just health, is at risk.
The Biden administration argues that this conflicts with the federal law known as the Emergency Medical Treatment and Active Labor Act (EMTALA). Each year, about 50,000 women develop severe pregnancy complications requiring emergency care. In the most critical cases where a fetus is unlikely to survive, doctors may recommend terminating the pregnancy to protect the woman’s health.
For instance, in a situation where a woman’s water breaks during the second trimester, putting her at risk of sepsis, terminating the pregnancy may be necessary to prevent a potentially deadly infection.
Texas is suing the Biden administration over its guidance on the law. The Department of Justice has appealed a lower court ruling allowing the enforcement of the law to the Supreme Court, which may decide to take up the case later this year.
In recent months, HHS has made it easier for patients turned away from hospitals to file complaints. CMS launched a new webpage for submitting complaints in a simple, three-step process. The department also announced that the complaint webpage will now be available in Spanish.
Lupe Rodriguez, executive director of the National Latina Institute for Reproductive Justice, highlighted the importance of making tools available in Spanish to support Latinas and people of color who are disproportionately impacted by abortion bans and restrictions on emergency care.
Related story: Supreme Court rules to allow emergency abortions in Idaho
