Trump Administration Rescinds Emergency Abortion Guidance

By Paul J. Giancola, Claudia E. Stedman, and Savannah Wix

On June 3, 2025, the Trump administration announced (the Announcement) that it would no longer follow Biden-era guidance (the Guidance) that directed hospitals to provide emergency abortions to pregnant women in emergency situations, including in states where abortion is restricted. The Guidance,¹ issued in 2022, followed the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade. The stated purpose of the Guidance was to preserve access to abortions in extreme medical emergencies, particularly in states where near-total abortion bans had gone into effect.

Through this Guidance, the Biden administration reminded hospitals of their obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA is a federal law that requires hospitals that receive Medicare funding to provide stabilizing treatments to patients experiencing an emergency medical condition (acute symptoms that without immediate treatment poses a serious risk to life or health), as defined by the statute, or if the hospital does not have the capacity or capability to treat the condition, to transfer that patient to a hospital that can provide stabilizing treatment. With respect to pregnant women, EMTALA would kick in where the health of the woman or her unborn child is in serious jeopardy.

The Biden administration issued this Guidance as state laws restricting or banning abortion began going into effect. Virtually all hospitals in the U.S. receive Medicare funds. Accordingly, the Guidance would apply nationwide to pregnant women who may be experiencing emergency medical conditions such as organ failure, ectopic pregnancy, or life-threatening hemorrhage. In these instances, the Guidance directed hospitals receiving Medicare funding to provide stabilizing treatment to these patients, which in some instances may include abortion.

The Guidance further provided that in states with abortion bans, EMTALA would preempt state law supporting an action taken against a physician who provides an abortion to a pregnant woman in need of stabilizing treatment. EMTALA also contains a whistle-blower provision that prevents retaliation by the hospital against any employee or physician who refuses to transfer a patient with an emergency medical condition that has not been stabilized by the hospital.

Despite the Trump administration’s announcement, the Centers for Medicare and Medicaid Services (CMS) stated they would continue to enforce EMTALA, including in cases where the health of a pregnant woman or her unborn child is in serious jeopardy.² However, CMS has also indicated they would take steps to “rectify any perceived legal confusion and instability” created by the Biden-era Guidance, signaling a potential reinterpretation of how EMTALA is applied in pregnancy-related emergencies. The Announcement may increase confusion over whether doctors can provide emergency abortions for their patients and whether EMTALA will protect providers who do.

The legal uncertainty surrounding the issue is far from settled. The Biden administration previously sued Idaho over its restrictive abortion law, arguing it conflicted with EMTALA’s requirement to provide stabilizing emergency care.³ The case reached the U.S. Supreme Court, which issued a procedural ruling that left unresolved whether federal law protects emergency abortions in states with bans.⁴ It is likely that additional lawsuits by providers, industry groups, and others will follow.

As courts and policymakers continue to grapple with the implications, physicians, hospitals, and health systems should consider engaging legal counsel to navigate the new federal landscape. Snell & Wilmer will continue to monitor any developments in this area.

*Any opinions expressed are those of the authors, and not necessarily the firm or their colleagues.