The Biden administration sent a letter to hospitals July 2, reaffirming they have a "legal duty" under federal law to ensure all patients with emergency medical conditions are offered stabilizing treatment, including abortion when deemed necessary.
The letter follows a recent Supreme Court decision that ruled in favor of permitting emergency abortions in Idaho — for now. In the June 27 decision, the justices dismissed the question of whether the Emergency Medical Treatment and Labor Act covers abortion when deemed necessary by physicians to protect the health of a pregnant woman, and ruled that abortions in emergency cases may resume in Idaho. The case now returns to the U.S. Court of Appeals for the 9th Circuit.
"While this litigation continues in the lower courts, we write to you to reaffirm our view that EMTALA's protections remain in place — as they have for the last 40 years — and to share that CMS remains committed, to the fullest extent of the law, to ensuring compliance with EMTALA's protections," HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, wrote in the letter.
In states with strict abortion bans, physicians and hospital administrators have expressed concern and confusion regarding under which circumstances abortions are permitted. The agencies addressed those concerns in the letter, aiming to offer some clarity:
"If a pregnant patient presenting at an emergency department, including certain labor and delivery departments, is experiencing an emergency medical condition as defined by EMTALA, and that abortion is the stabilizing treatment necessary to resolve that condition, the provider must offer that treatment. And when a state law prohibits abortion and does not include an exception for the life and health of the pregnant individual — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted."
Three more EMTALA updates:
- In May, CMS launched a web portal that allows patients to file EMTALA complaints directly with the federal government. Patient complaints were previously funneled through state health agencies first, with the new process aiming to expedite the federal government's ability to investigate complaints. In the July 2 letter to hospitals, CMS said it was launching a Spanish version of the web form.
- In June, Cincinnati-based Bon Secours Health System issued a statement affirming its support for physicians who perform medically necessary abortions in emergent situations, saying it supports physician compliance with EMTALA. The Catholic nonprofit system operates 49 hospitals in Ohio, Kentucky, Virginia and South Carolina.
"While the legislative environment is complex, our mission compels us to provide compassionate care for all," a health system spokesperson previously told Becker's. "In emergent patient care situations, when providers and medical teams prioritize patient care and follow hospital policies and medical standards of care in good faith, they can expect the support of Bon Secours Mercy Health."
- In January, HHS and CMS began sharing training materials with hospitals on providers' obligations under EMTALA. HHS also said it organized a dedicated team to help hospitals comply with the law.