HHS: Emergency medical care includes access to abortion


The federal government under the Biden administration has made efforts to ensure access to abortion as part of emergency medical care, with Health and Human Services Secretary Xavier Becerra telling providers this week that pregnant women and others experiencing pregnancy loss have access to “full rights and protections”. for emergency care under federal law.

The advice comes in light of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which effectively overturned the precedent Roe v. Wade who had protected access to abortion for 49 years.

In a 5-4 vote in June, the judges decided to overturn Roe v. Wade, the 1973 Act, and Planned Parenthood v. Casey, who reaffirmed the right to abortion in 1992.

In a letter To providers this week, Becerra referred to the Emergency Medical Treatment and Labor Act, which since 1986 has required Medicare hospitals to provide patients with appropriate emergency care, regardless of applicable laws or mandates. If a state prohibits abortion by law and does not make exceptions for the health or life of a pregnant person, EMTALA supersedes the state law.

According to Becerra, “Determination of an emergency medical condition is the responsibility of the medical examiner or other qualified medical personnel. Emergency medical conditions involving pregnant patients may include, but are not limited to, an ectopic pregnancy, pregnancy loss complications or an emergency hypertensive disorder, such as preeclampsia with severe features.”

The treatment needed to stabilize these emergency conditions is also within the physician’s purview, Becerra said, and could include medical or surgical interventions including abortion, antihypertensive therapy, removal of one or both fallopian, or methotrexate therapy, regardless of state law. or mandates that apply to proceedings.

“Thus, if a physician determines that a pregnant patient presenting to an emergency department, including some labor and delivery departments, has an emergency medical condition as defined by the EMTALA, and that abortion is the stabilizing treatment necessary to resolve this condition, the physician must provide that treatment,” Becerra wrote. “And where a state law prohibits abortion and does not include an exception for life and the health of the pregnant person – or establishes the exception more narrowly than EMTALA’s definition of emergency medical conditions – this state law is preempted.”

There are penalties for not following EMTALA, he said. A complaint against a hospital may trigger an investigation, and if the investigation indicates that a hospital has violated one or more of the EMTALA terms, that hospital may be subject to termination of its health insurance provider agreement. . It may also incur civil monetary penalties, which may also be imposed on individual physicians. Physicians may also be excluded from health insurance and state health care programs.


Following the Supreme Court’s decision, HHS announced an action plan to protect access to reproductive care, including abortion.

Five priorities have been defined, including:

  • Increase access to abortion drugs.
  • Protect patients and providers from discrimination and ensure patient and provider confidentiality.
  • Protect emergency abortion care.
  • Ensure providers have family planning training and resources.
  • Reinforcement of family planning care, including emergency contraception.

Since announcing the plan, HHS has taken a number of steps. The agency called a meeting with health insurers and sent them a letter calling on the industry to commit to its obligations to provide coverage for contraceptive services at no cost, as required by the Care Act affordable. He has also published guidance for patients and providers that addresses the extent to which federal law and regulation protect individuals’ private medical information when seeking abortions and other forms of health care. reproductive health, as well as when it comes to using health information apps on smartphones. .

Additionally, HHS announced nearly $3 million in new funding to strengthen training and technical assistance for the nationwide network of Title X family planning providers, and met with Michigan Governor Gretchen Whitmer, Governor of Oregon Kate Brown and Maine Governor Janet Mills and state attorneys. general to discuss state-specific concerns.


The Supreme Court’s decision overturning Roe v. Wade has implications for health insurance coverage, according to healthinsurance.org.

The ruling that overturns nearly 50 years of a woman’s right to an abortion now leaves that decision up to each state. It is estimated that half of them have already put in place restrictions on abortion or should put restrictions in place.

“With the overturning of Roe v. Wade, access to abortion will vary more widely from state to state,” Louise Norris, analyst at healthinsurance.org, said in a statement. “State-level variations were already the norm for health insurance abortion coverage, especially for health plans purchased by individuals and small groups. The states that will now ban abortions were generally the same states that already banned abortion coverage on health plans purchased on the exchange or even on all state-regulated private health plans.”

For now, she said, most state health plans will continue to cover FDA-approved female contraception, including sterilization, long-acting contraception (IUDs and implants) and emergency contraception.

Twitter: @JELagasse
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