White House revokes guidance requiring hospitals to provide emergency abortions

Geoff Bennett:

The Trump administration rescinded federal guidance that required emergency rooms to provide an abortion if the procedure would save a woman's life.

That guidance issued by the Biden administration in 2022 after Roe v. Wade was overturned argued a law known as the Emergency Medical Treatment and Labor Act, or EMTALA, required hospitals to stabilize a patient's health during medical emergencies, even in states with near-total abortion bans.

Yesterday, the administration said the guidance did not reflect President Trump's policy.

For more on how this will affect pregnant women and access to lifesaving medical care at large, we're joined by special correspondent Sarah Varney.

Sarah, thanks for being here.

So why was this law known as EMTALA, why was it implemented in the first place? What problem was it trying to solve?

Sarah Varney:

So, President Ronald Reagan signed this bill in 1986. At the time, hospitals were routinely turning away poor patients, patients without insurance, and turning them away even when they might have life-threatening medical conditions.

So this law was written. It went into effect, and it said that E.R.s across the country that receive Medicare payments, which is essentially every hospital in the United States, has to stabilize a patient with an emergency medical condition before they can transfer them.

Geoff Bennett:

So what did the Biden administration require post-Dobbs? And what is the Trump administration now saying it no longer has to do?

Sarah Varney:

A month or so after the Dobbs decision, the Biden administration issued a memorandum.

It went out to all the hospitals around the country that received these Medicare funds, and it reminded them that EMTALA was in effect, and that, according to the Biden administration's reading of EMTALA, it meant that even in states that had very strict abortion bans, that women who presented in emergency rooms with life-threatening medical conditions, if an abortion was the procedure that was needed to stabilize her, that those hospitals had to provide that treatment.

What the Trump administration is essentially saying is, we're rescinding that letter and leaving it open to interpretation from the different hospitals about whether or not certain emergency medical conditions meet their state ban.

Geoff Bennett:

And what state, Sarah, would be most affected by this?

Sarah Varney:

There's certain states where there's really no exception for the health of the pregnant woman. That includes Arkansas, Idaho, Mississippi, Oklahoma, and South Dakota.

So these are some places where a pregnant person could go into the emergency room, and there would be some debate about whether or not they could have an abortion if that was necessary to stabilize their health. Just as an example, for instance, in South Dakota, they released a report last year that showed that there were — according to their records, that there were zero abortions that happened in South Dakota hospitals in 2023.

Geoff Bennett:

Sarah, how would this affect a pregnant woman in a red state versus a blue state?

Sarah Varney:

So there's already — even with the Biden guidance in effect, there has been pretty significant differences between the types of care that pregnant women have gotten in states with abortion bans and states without abortion bans.

The Associated Press did an investigation that found dozens of women who were turned away from emergency rooms, including when they needed an abortion to stabilize their health care. ProPublica has also done pretty extraordinary investigative reporting, finding that women have been turned away from emergency rooms or not received the care that they needed.

They were either harmed or, in some cases, they died. So we already have seen this divide, really, and this patchwork of care emerging across the United States.

Geoff Bennett:

And how are anti-abortion groups responding to this announcement?

Sarah Varney:

Anti-abortion groups are celebrating the rescission of this Biden-era guidance.

They say it's actually not necessary. They point to these induced termination of pregnancy reports that I was just mentioning about South Dakota in places like Texas, where you had 14 abortions mostly due to emergency situations in Texas in January of 2025.

So the anti-abortion groups and lawmakers, anti-abortion lawmakers say that these laws are working as they were intended and that women can, in fact, get emergency room care when it's necessary.

Geoff Bennett:

As I understand it, this decision was outlined in Project 2025, that conservative blueprint for a second Trump term. Tell us more about that.

Sarah Varney:

Well, the EMTALA rescission was actually included in Project 2025, so we're seeing that checked off the list. It also calls for the administration to stop defending existing EMTALA lawsuits that were held over from the Biden administration. They have also done that.

And then there's many, many things in Project 2025 that have to do with abortion, including calls for a national abortion surveillance program so that there would be national data about the number of abortions that are happening in the United States. It calls for the reversal of FDA approval of the abortion pill and for the enforcement of what's called the Comstock Act, which would essentially cease the mailing of abortion pills around the country.

Geoff Bennett:

Special correspondent Sarah Varney.

Sarah, thanks again for your time this evening.

Sarah Varney:

Thank you, Geoff.