Nearly three years after Roe v. Wade was overturned, the Centers for Medicare and Medicaid (CMS) announced in a statement it would rescind 2022 guidance from the Biden administration that allowed patients to have abortions in emergency situations.
Former President Joe Biden sought to override state laws banning abortion and ensure pregnant people had access to reproductive care in emergencies, like if their life was at risk.
Biden’s guidance cited the Emergency Medical Treatment and Active Labor Act (EMTALA), a national law that requires hospitals to examine and treat all patients even if they can’t pay for their care. Under CMS’s new directive, EMTALA is still in place as federal law and encompasses treating “identified emergency medical conditions” for a pregnant person and/or an unborn child, but the federal government is no longer directly asking states to provide abortions during emergencies.
As a result, some experts worry a lack of directive could lead to more confusion and fear around how best to provide care.
Melissa Simon, an ob-gyn at Northwestern Medicine in Chicago, told us she is “deeply concerned” about CMS’s decision.
“The current administration is trying to rescind this but is not changing the EMTALA law, which still obligates hospitals to provide emergency care,” she said. “However, what this will do is promote more confusion, which leads to a dangerous climate of legal uncertainty under which physicians and health professionals should not operate.”
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Oath vs. law. Even with Biden’s guidance in place, the Associated Press reported last August “dozens” of pregnant people have been turned away from emergency rooms since the Dobbs ruling, including patients with life-threatening pregnancy complications. In some cases, patients have died.
In the June 3 announcement, CMS said it would enforce EMTALA, which protects patients who show up to emergency departments seeking treatment, including cases where a pregnant person and/or their unborn child is “in serious jeopardy.”
At the same time though, CMS also rescinded a letter from former Department of Health and Human Services Secretary Xavier Becerra that explicitly directed clinicians to provide abortions if “stabilizing treatment” is required to resolve a medical issue.
Simons said the new CMS’s guidance “undermines” clinicians ability to provide “evidence-based life-saving care without delay or discrimination,” and that patients will now be exposed to higher pregnancy health risks. She also said this may erode trust between patients and their providers.
“No patient should be forced to suffer, and no healthcare provider should be forced to choose between their oath and the law,” she said.