Revoking EMTALA guidance on abortions will only further confuse doctors, experts say
The guidance required emergency, life-saving abortions despite bans.
In revoking federal guidance requiring emergency, life-saving abortions to protect the lives of pregnant women, the Trump Administration has added confusion to an already impossible situation for doctors, possibly putting women's lives at risk, experts told ABC News.
"The rescission of this guidance is, contrary to its own statement, only further lending into the confusion that exists in emergency departments around the country, and it will put women's lives at risk," Alison Tanner, an attorney at the National Women's Law Center, told ABC News.
"There have been countless stories of people across the country being denied emergency care, forced to wait in their cars in parking lots while they are actively bleeding, or being sent to different hospitals with a bucket and told to leave the state that they're in in order to get the care that they need," Tanner said.
Earlier this week, the Trump administration revoked Biden-era federal guidance reminding hospitals that they are required to provide life-saving care, including abortions, in emergency situations under a federal law -- the Emergency Medical Treatment and Active Labor Act -- regardless of state law.
The guidance was issued after Roe v. Wade was overturned in 2022, ending federal protections for abortion rights. At least 13 states have total abortion bans in effect, according to the Guttmacher Institute.
As the administration rolled back the guidance this week, a government agency also found that a Texas hospital "failed to ensure ... [Kyleigh Thurman] received an appropriate medical screening," when she presented to the emergency department in early 2023, the Centers for Medicare and Medicaid Services said in a deficiency letter shared with ABC News.
Thurman ultimately needed to have a fallopian tube removed after it ruptured due to an ectopic pregnancy.
Thurman said she was turned away twice from a local emergency room, without treatment. Another facility also denied her care twice, before her OB-GYN traveled to the hospital and convinced staff to end the pregnancy. She was rushed to surgery days later after the tube ruptured.
Ectopic pregnancies are a dangerous complication that occurs when a fertilized egg implants and grows outside the uterus, in this case, in her fallopian tube. The treatment for an ectopic pregnancy is an abortion to prevent life-threatening complications.
The hospital "did not appropriately screen [Thurman] for known risks associated with presenting signs, symptoms and test results including those which would constitute an [emergency medical condition], such as, but not limited to, ectopic pregnancy," the deficiency letter stated.
"The hospital's failure to provide an appropriate medical screening examination, within the capability of the hospital's emergency department ... and consistent with the hospital's screening process, placed the patient at risk for deterioration of her health and wellbeing as a result of an untreated medical condition," the letter said.
The determination was made after Thurman submitted an administrative complaint to the Centers for Medicare and Medicaid Services, an office within the Department of Health and Human Services, in August 2024.
"I know how incredibly horrible and how hard it was for me, and I didn't want anyone else to ever have to go through what I had to go through," Thurman told ABC News.
Thurman said she did not know how Texas' near-total abortion ban could impact her health or even what an ectopic pregnancy is before she learned she was pregnant.
"I never imagined myself being caught in the crosshairs, but I don't think that many people ever do. It only highlights how this can happen to anyone," Thurman said.
"I really didn't have a thought on it, and it really didn't become evident to me how negatively [abortion bans] would impact women until it was impacting my life," Thurman said. "I didn't know what it all meant."
Thurman said she wants to try for a family despite her experience.
"A lot of people are like 'just move' and I'm like, 'it's not that simple when you have deep roots in a place.' This is my home. I am not leaving. I'd rather fight back than leave," Thurman said.
The new guidance will only create more confusion around what is already "muddy and very confusing," Thurman said. It is now more of an environment where "mistakes can happen," Thurman said.
Despite the rescinding of the guidance, hospitals and physicians are still required to provide stabilizing care, experts said.
"EMTALA is still the law of the land. Hospitals and doctors must still comply with EMTALA," Astrid Ackerman, a staff attorney at the Center for Reproductive Rights who worked on filing EMTALA complaints, told ABC News.
"What we're really concerned about is that this trend of that pregnant people cannot get the care that they need in this country, and more importantly, the care that hospitals and doctors want to provide," Ackerman said.
Tanner said there is a real concern about whether the Trump administration will enforce EMTALA, especially after it dropped a federal lawsuit over Idaho's abortion ban, which does not allow abortions to save the life of the mother.
An injunction in a separate EMTALA lawsuit by a hospital system in the state has blocked the ban.
Doctors and hospitals are now stuck between "a rock and a hard place," trying to figure out what care they can provide, Tanner said.
"Doctors and hospitals are being put in an untenable position. On the one hand, they are faced with state laws that would potentially impose severe criminal sanctions for providing necessary emergency abortion care," Tanner said.
"And on the other hand, they have the federal law, EMTALA, which provides that both the federal government and individual patients can sue the hospital if they do not provide the necessary stabilizing care required under federal law," Tanner said.
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