'Incredibly scary': Trump admin takes a huge step that could endanger lives of pregnant women

The Donald Trump administration announced on Tuesday it is rescinding Biden-era guidance that uses a federal law to require hospitals to stabilize patients in need of emergency care -- including by providing an abortion. In July 2022, the Department of Health and Human Services (HHS) issued guidance that, under the Emergency Medical Treatment and Labor Act (EMTALA), doctors must perform abortions in emergency departments -- even in states where the procedure is illegal -- particularly if it serves as a "stabilizing medical treatment" for an emergency medical condition.

In 2022, shortly after the US Supreme Court overturned nationwide abortion protections, the Biden administration issued guidance aimed at safeguarding abortion access in critical medical situations. The guidance sought to ensure that women facing life-threatening emergencies—such as severe hemorrhaging or the risk of organ failure—could still receive necessary abortion care.

The administration contended that, even in states with near-total abortion bans, hospitals were obligated to perform emergency abortions under the Emergency Medical Treatment and Active Labor Act (EMTALA). This federal law mandates that emergency rooms accepting Medicare funds must provide medical examinations and stabilizing treatment to all patients. Since nearly every ER in the US depends on Medicare, the rule effectively applied nationwide.


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Trump revokes emergency abortion policy

With Tuesday’s announcement, the Trump administration declared it will stop enforcing the requirement, prompting huge concern among doctors and abortion rights advocates over the potential impact on access to emergency care. Even under the Biden administration’s federal guidance, an AP investigation last year revealed that dozens of pregnant women were already being denied urgent medical treatment, including emergency abortions.

The Biden administration had previously filed a lawsuit against Idaho, arguing that the state's restrictive abortion law—which only permits the procedure to save the mother’s life—violated the Emergency Medical Treatment and Labor Act (EMTALA). While the US Supreme Court issued a procedural decision in the case, it left unresolved key legal questions, such as whether doctors in states with abortion bans can legally perform emergency abortions when a patient faces severe health risks.

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How will Trump's move impact guidance impact care?

Skye Perryman, the president and CEO of Democracy Forward, a legal group that defended Biden’s interpretation of EMTALA in court, said that erasing the guidance would prove dangerous for pregnant women seeking reproductive healthcare in states with abortion bans on the books.

“The Trump administration’s decision to withdraw EMTALA guidance guaranteeing pregnant people medical care in emergency situations will sow confusion for providers and endanger the lives and health of pregnant people,” she said, in a written statement. “Every American deserves the right to access the necessary care in emergency scenarios, including pregnant people, without political interference.”

Despite the change in the guidance, EMTALA remains in place, reports the Times. The Trump Administration did not directly instruct hospitals to deny abortions in emergency situations. However, in a memo announcing the policy reversal, the Centers for Medicare and Medicaid Services (CMS) clarified that the Department of Health and Human Services cannot enforce the Biden Administration’s interpretation of EMTALA—which states that federal law overrides Texas’ near-total abortion ban—citing court decisions that have temporarily blocked this guidance in Texas.

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Abortion-rights advocates condemned the move, arguing that it puts the health and lives of pregnant individuals at serious risk.

Nancy Northup, president and CEO of the Center for Reproductive Rights, strongly criticized the move. “The Trump administration would rather see women die in emergency rooms than allow them to receive life-saving abortion care,” she said. “In pulling back guidance, this administration is feeding the fear and confusion that already exists at hospitals in every state where abortion is banned. Hospitals need more guidance right now, not less.”

“It’s making it incredibly scary for the American people and pregnant folks who would need access to emergency services,” Simpson says. “People’s lives are at stake.”

“We’re making our health care professionals have to operate in a gray area when their work really needs to be clear,” Monica Simpson, executive director of SisterSong, a reproductive justice collective, told Times. “They’re in the business of providing life-saving care to people on a daily basis, and they don’t need to be put in a position where their decision making is compromised.”

When that confusion happens, she said, “people die.” Simpson says that, for states that have banned or restricted abortion, like her home state of Georgia, rescinding the Biden-era guidance is “just going to make things worse.”