Former President Joe Biden made clear to hospitals in 2022 that under the Emergency Medical Treatment and Labor Act (EMTALA), they were obligated to provide abortion care if it was medically necessary, even in states that ban abortions. Medical emergencies that required abortion care included "ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features," according to Biden's guidance.
The 1986 law requires hospitals that receive federal funding to treat or stabilize patients experiencing medical emergencies even if they lack health insurance or cannot pay for health services, or to transfer them to another facility for care. EMTALA has been interpreted to include abortion care by both Republican and Democratic administrations going back to former President George W. Bush, but the CMS statement suggested President Donald Trump will not require hospitals to protect women's health or lives by providing abortions.
While rescinding Biden's guidance, CMS said it would continue to enforce EMTALA, "including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy."
"CMS will work to rectify any perceived legal confusion and instability created by the former administration's actions," the agency added—an apparent reference to a lawsuit filed by the Biden administration against Idaho, which claimed its near-total abortion ban superseded EMTALA.
That case went to the Supreme Court in 2024 and was dismissed, leaving in tact a federal court ruling that required Idaho hospitals to provide emergency abortion care.
Fatima Goss Graves, president and CEO of the National Women's Law Center, emphasized that the CMS action "doesn't change hospitals' legal obligations, but it does add to the fear, confusion, and dangerous delays patients and providers have faced since the fall of Roe v. Wade."
"Stripping away federal guidance affirming what the law requires will put lives at risk," said Goss Graves. "At the same time, this administration claims it is considering ways to support 'population growth,' but it is actively dismantling the systems that protect pregnant people's health and lives. The hypocrisy is staggering. No matter what political games the administration wants to play, we will continue to stand with the patients, doctors, and hospitals fighting every day to do what is right."
Mary Ziegler, a professor at University of California, Davis, toldThe New York Times that the CMS guidance creates "a lot of unanswered questions about what hospitals are supposed to do going forward. So more confusion means more risk."
"We've already seen since the overturn of Roe that uncertainty and confusion tends to mean physicians are unwilling to intervene, and the more unwilling physicians are to intervene, the more risk there is in pregnancy," said Ziegler.
The Center for Reproductive Rights said that "confusion is the point" of the new policy statement.
"The Trump administration would rather women die in emergency rooms than receive lifesaving abortions," said Nancy Northup, the group's president and CEO.
The deaths of at least five women as the result of abortion bans in Texas and Georgia have been reported since Roe v. Wade was overturned, with doctors avoiding providing abortion care even in cases of nonviable pregnancies, for fear of being prosecuted.
Mini Timmaraju, president and CEO of Reproductive Freedom for All, said in a statement that rescinding Biden's guidance "means women will die."
"The Trump administration is clearly refusing to protect pregnant people in crisis," said Timmaraju. "It's another calculated step in Trump's war on reproductive freedom—siding with extremists who want to punish doctors and abandon patients. No one should be denied emergency care, and we'll hold every official who enables this cruelty accountable."
Alexa Kolbi-Molinas, deputy director of the ACLU's Reproductive Freedom Project, said the organization "will use every lever we have to keep President Trump and his administration from endangering our health and lives."
"The Trump administration cannot simply erase four decades of law protecting patients' lives with the stroke of a pen," said Kolbi-Molinas. "Regardless of where they live, pregnant patients have a right to emergency abortion care that will save their health or lives. By rescinding this guidance, the Trump administration has sent a clear signal that it is siding not with the majority, but with its anti-abortion allies—and that will come at the expense of women's lives."
U.S. Sen. Patty Murray (D-Wash.) also sought to provide clarification.
"Once again, the Trump administration is sending a clear message that they do not care about women's lives," said Murray. "Make no mistake: EMTALA is still the law, and Trump rescinding this guidance does not change the fact that pregnant women who need emergency abortion care to save their life or health are still legally entitled to this care."
