Medical Emergencies & Access to Abortion Care

On June 27, the US Supreme Court issued its opinion in an Idaho case concerning the Emergency Medical Treatment and Labor Act (EMTALA). While the Court did not rule on the merits of the case, this order ensures that — for now — clinicians in Idaho will continue to receive federal protections guaranteeing access to necessary and life-saving care for pregnant people experiencing medical emergencies, regardless of the state’s restrictive abortion ban.

Signed into law in 1986, EMTALA requires hospitals that receive Medicare funds to treat and stabilize anyone who presents with an emergency medical condition, regardless of their ability to pay and regardless of the type of care required. If the hospital is not equipped to provide treatment, it must arrange a transfer. EMTALA requires hospitals to offer abortion care to stabilize a pregnant person in an emergent situation and the US Department of Health and Human Services (HHS) has reaffirmed this position and offers several resources for providers.

 SMFM members with questions regarding EMTALA should consult with counsel or contact the Abortion Defense Network, a coalition of attorneys and legal organizations that can provide legal advice, resources, and assistance in evaluating a range of legal issues for providers in a post-Roe landscape.
Case Updates and SMFM Judicial Advocacy

SMFM has provided expert input in court filings supporting efforts to protect clinicians’ ability to provide necessary and life-saving health care to patients experiencing obstetric emergencies. Learn more about this work below.

  • In advance of oral arguments heard by the US Supreme Court on April 24, 2024, SMFM joined partners in an amicus brief and public statement urging the Supreme Court to maintain EMTALA protections. SMFM members and staff also attended a rally in front of the Supreme Court during oral arguments.
  • In August 2022, the US Department of Justice filed a lawsuit challenging Idaho's abortion law, claiming that state law conflicts with and is preempted by EMTALA. SMFM joined the American College of Obstetricians and Gynecologists (ACOG), the American College of Emergency Physicians (ACEP), and several other medical societies to file an amicus brief  that detailed the life-saving nature of abortion care. 
  • In July 2022, Texas filed a lawsuit against HHS asserting that the HHS EMTALA guidance did not provide a basis for the federal government to compel clinicians to offer abortion care. In response, SMFM joined ACOG, ACEP, and the American Medical Association to file an amicus brief explaining the importance of the federal law requiring clinicians to provide stabilizing medical care, including abortion care, to patients experiencing medical emergencies. In August 2022, a federal judge agreed with the State of Texas and temporarily blocked the HHS EMTALA guidance. HHS appealed the ruling, and again, SMFM joined partner organizations in filing an amicus brief detailing how Texas and the lower court misunderstood EMTALA and the realities of emergency medical care.
Federal Agency Activities
  • The Centers for Medicare and Medicaid Services (CMS) provides guidance on EMTALA including a 2022 letter from Secretary Becerra reaffirming that EMTALA requires clinicians to offer necessary stabilizing care for patients suffering emergency medical conditions, including abortion care. Some portions of this guidance are now unenforceable in Texas and for members of certain anti-abortion organizations due to a court injunction.

  • In May 2024, HHS launched a new online portal to make it easier for individuals to file an EMTALA complaint if they believe a patient was denied stabilizing treatment at a Medicare-funded facility. The new web resource aims to both educate consumers about EMTALA’s protections and ease the filing process. Complaints can be filed anonymously using the form.

  • An investigation led by CMS found that hospitals in Missouri and Kansas violated EMTALA for failing to provide emergency abortion care to a patient following preterm premature rupture of membranes (PPROM). HHS can penalize both hospitals and individual clinicians who are found to have violated EMTALA. Following the investigation, Secretary Becerra issued an open letter to hospitals and healthcare providers reinforcing EMTALA obligations under federal law.