The Centers for Medicare & Medicaid Services (CMS) has rescinded a 2022 guidance issued by the Biden administration that required hospitals to provide emergency care, including terminating a pregnancy in states with abortion bans. The agency announced this change, stating that the guidance did not reflect the policy of the current administration. This decision has raised concerns among medical experts about the potential risks to pregnant women.
Expert Opinions
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Mary Ziegler, a professor at U.C. Davis who studies reproductive rights law, noted:
"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."
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Lawrence O. Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, expressed his concerns:
"This is not just withdrawing what Biden did — it’s creating a lot of unanswered questions about what hospitals are supposed to do going forward."
Gostin also warned that without clear guidelines, hospitals may refuse emergency care to pregnant women, stating:
"It basically gives a bright green light" for such actions in red states.
Impact on Patients
In recent years, at least three women have died after being denied abortion services due to strict laws that only allow such procedures when necessary to save their lives. One notable case involves Sarah Knight, who has been on life support at Grady Memorial Hospital since February, according to her family.
Federal Law and Emergency Care
The Centers for Medicare & Medicaid Services maintains that it will continue to enforce federal law requiring federally funded hospitals to treat or transfer patients in need of emergency care under the Emergency Medical Treatment and Labor Act (EMTALA), passed in 1986. This law mandates that hospitals provide stabilizing treatment before transferring patients if they cannot be treated locally within an hour. However, it does not require hospitals to perform abortions, even if they would be legal under state law.
Key Points:
- Performing abortions could violate state laws against such procedures outside specific exceptions.
- Federal rules prohibit using funds provided by Congress (including Medicare) for activities prohibited by federal law, including abortion, except when necessary to save the mother’s life or prevent serious harm, as determined by a physician.
Medicare officials clarify that while doctors must stabilize any patient whose condition poses an immediate threat before transferring them, they are not required to perform abortions, even if legal under state law. This situation creates a complex landscape for healthcare providers and patients alike.
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