On Tuesday, the Trump administration rescinded federal guidance that allowed medical professionals to perform emergency abortions even in states where the procedure is banned. The document had been introduced under President Joe Biden to protect physicians facing legal uncertainty following the overturning of Roe v. Wade.
The guidance clarified the application of the federal EMTALA law, which requires hospitals with emergency departments to provide necessary treatment to all patients—including pregnant women experiencing life-threatening complications. However, the Trump administration stated that the 2022 directive and the accompanying order by then–Health Secretary Xavier Becerra "do not reflect the policies of the current administration."
The Centers for Medicare and Medicaid Services said they will continue to enforce the federal emergency care law and "will work to resolve the legal uncertainty created by actions of the previous administration."
The move aligns with the provisions of Project 2025, a policy blueprint developed by the conservative Heritage Foundation, which calls for reversing Biden-era interpretations of EMTALA as they relate to abortion access.
Human rights and reproductive health organizations strongly condemned the decision. "This move shows a disregard for the law and for human life," said Amy Friedrich-Karnik, federal policy director at the Guttmacher Institute, which supports abortion rights. She noted that EMTALA has become even more critical since the Dobbs v. Jackson ruling, which has created "a chaotic and fragmented system of abortion access."
Alexa Kolbi-Molinas of the ACLU added that the administration is "making it clear it stands with abortion opponents"—a stance that, in her words, "will cost women their lives."
According to the Guttmacher Institute, 13 states currently enforce total abortion bans, while others impose severe restrictions throughout pregnancy. Some laws formally allow exceptions in life-threatening cases, but rights advocates, patients, and doctors have repeatedly turned to the courts, arguing that vague language results in denial of care or dangerous delays. Media reports have documented cases of women dying from complicated miscarriages in states where bans are in effect. Experts say timely emergency abortion care could have saved their lives.
In early 2023, the Fifth Circuit Court of Appeals ruled that EMTALA does not override Texas’s abortion ban. The U.S. Supreme Court declined to hear the Biden administration’s appeal, leaving the lower court’s ruling in place without addressing the merits of the case.
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