Biden administration clarifies protections for doctors making emergency abortion decisions

The Biden administration wants doctors to know that their clinical judgment is protected by federal law when it comes to “life-saving or health-saving abortion services” in emergency situations — regardless of the circumstances. state abortion restrictions.

The Department of Health and Human Services issued a memo on Monday reiterating existing guidelines found in the 1986 Emergency Medical Treatment and Labor Act. The EMTALA statute requires that all patients receive appropriate medical care and stabilization treatment in an emergency situation, including patients who require abortion care when the life or health of the pregnant person is in danger.

Senior HHS officials told reporters Monday that EMTALA will protect physicians’ clinical judgment, as well as their choices to provide medical or procedural abortions to pregnant patients with emergency medical conditions, including but not limited to limit, complications due to miscarriage, ectopic pregnancy and emergency hypertensive disorders such as pre-eclampsia. This applies regardless of the restrictions on abortion care in the state where the physician practices.

The vital exceptions included in some abortion bans, such as those in Missouri and Texas, are deliberately vague. Many state lawmakers have refused to define basic terms like “medical emergency” or “substantial risk of death.” This creates a powerful incentive for providers ― a historically risk-adverse group ― not to provide life-saving care. until the pregnant person is near death, for fear of consequences such as the loss of their license or facing prosecution and criminal penalties.

HHS says it will enforce EMTALA through a complaints process that may require hospitals or physicians to pay civil fines. Fines vary depending on the size of the hospital, but can be up to approximately $120,000 per hospital or physician that violates a provision of the EMTALA. Hospital staff, doctors and patients can file a EMTALA Complaint with the Centers for Medicare and Medicaid Services.

The reaffirmation of those guidelines is part of a broader push by the Biden administration in recent weeks to protect access to abortion care. HHS announced that it is distributing nearly $3 million in grants to strengthen training and other support for its Title X family planning providers, as well as releasing new guidelines to help protect the privacy of patients seeking reproductive health care services.

“It is essential that providers know that the professional and legal obligation of a physician or other qualified medical personnel to provide stabilizing medical treatment to a patient who presents to the emergency department and is found to be suffers from an emergency medical condition prevails over any directly conflicting law or state mandate that may otherwise prohibit such treatment,” Health and Human Services Secretary Xavier Becerra wrote in a statement Monday. a letter to health care providers.

None of the EMTALA regulations have changed, senior HHS officials noted. The guidelines included in Monday’s memo simply state that in specific circumstances where state laws restricting or prohibiting abortion directly conflict with EMTALA, federal law prevails over those state laws over the abortion. The law only applies to hospitals that accept Medicare patients, which the vast majority of hospitals do.

A senior HHS official noted that EMTALA can expand the reach of some state laws because it includes any situation that threatens a patient’s life or health. “It’s the key not just to emergencies, but to situations that could become an emergency if left untreated,” the official said.

The department highlights these requirements in light of the Supreme Court’s recent decision to overturn Roe v. Wade, the 1973 decision that established federal abortion protections. Since Roe fell just over two weeks ago, more than a dozen states have banned or severely restricted the procedure, with more expected to follow in the coming weeks.

Many state abortion bans or restrictions that have come into effect since the fall of Roe include no exceptions unless the pregnant person’s life is in danger. And while reaffirming existing EMTALA status may seem redundant, it is in fact of crucial importance.

HHS memo comes just days after President Joe Biden signed a decree to address abortion access in the wake of Roe’s repeal. The administration has promised to protect access to drugs, abortion, birth control and emergency contraceptives like Plan B. More recently, Biden said he was considering declare a public health emergency in order to make some federal resources available, although the administration has said that is unlikely to happen.


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