Are You Dying? Aww, Still No Abortion for You. Sorry not Sorry.
Not exaggerating, folks. Thanks, Project 2025!
On Tuesday, June 3, amid all the other wild and crazy news we had to deal with, this nugget slipped in almost unnoticed. The Trump administration managed to rescind the Biden administration guidance that made it clear that hospitals could not turn away pregnant patients who were having medical emergencies. They had to treat them, even if that meant terminating a pregnancy to save the life of the mother.
Not. Any. More.
Read that again.
This guidance is EMTALA, or the Emergency Medical Treatment and Labor Act, which requires hospitals to stabilize patients who are experiencing a medical emergency. It provides this for places like Catholic, private hospitals who might not otherwise provide abortive services and requires them to offer the proper care in these instances. States like Texas argued that the guidance, set forth in the Biden administration, had interpreted Emtala too broadly and thus incorrectly.
This all gets very muddy when the “health of the person” means that the “person” can be considered the fetus and not just the mother, see?
Since the reversal of Roe, literal dozens of women have testified that they have been denied treatment thanks to abortion bans, and according to ProPublica several women have died of preventable deaths as a direct result.
Laws requiring hospitals to stabilize patients in labor or active delivery have been on the books since 1986. It’s only now that things are hideously out of whack. Even Idaho, with its notoriously rigid interpretation of abortion law which allows abortion only if a woman’s life is in jeopardy, doesn’t provide cover for stabilizing the patient.
Seriously. Just stabilizing the vessel which is carrying the child, baby, fetus, group of cells. Let that sink in.
A major component of Emtala is that it would protect doctors’ ability to perform abortions as an element of saving peoples’ lives. In states like Idaho and Texas, where they can be held accountable for those actions, and fined, or even jailed, this protection is vital.
Many laypersons can’t envision cases where Emtala protection might need to be invoked. I’ll give you just one and let you go on about your day.
In Tennessee, there is a total abortion ban. Abortions may only be performed to save the life of the mother. This guidance, which would allow doctors and hospitals to stabilize the patient (mother) by performing care such as an abortive service cannot be done in Tennessee even when the mother’s health is at risk unless she is certain to die.
So…
Let’s say that really early in the pregnancy, her water breaks. That is a difficult conversation at best, and a heartbreaking one at worst. Now, without the protection of Emtala, doctors are stuck not knowing whether they will be charged with having performed an abortion or whether the state will understand that many ultra-premature babies simply do not survive. Can a 15, 18, or 20 week old fetus make it? Should they make it? Do the parents have any options? Should they? There are risks galore - infection in the mother, the infant, the bloodstreams of both, and on and on and on. But where once the Emergency Medical Treatment and Labor Act provided a shield so that physicians could use sound judgment based on the individuality and totality of their circumstances - it does no longer.
On page 473 of our lovely Project 2025, this was all laid out for us: “Reverse distorted pro-abortion ‘interpretations’ added to the Emergency Medical Treatment and Active Labor Act.” Their version argues that Emtala is written such that hospitals cannot ‘dump’ Medicare patients and that it preempts pro-life state laws. It states that “HHS should rescind the guidance and end CMS and state agency investigations into cases of alleged refusals to perform abortions.” There are no situations in which doctors use Medicare funds to perform abortion on demand without medical rationale, but conservatives would have us all think that patients waltz into emergency rooms with their CHIP cards and ask for them daily. First, that would be Medicaid, and second, that is not reality, but when has reality been on the Bingo card?
So, today I just wanted to check in with you all to let you know that yet another milestone was quietly, perniciously reached. Now, even when things are really bad but not yet on death’s door, American doctors have their hands tied in many states and risk going to jail to protect pregnant people and their health. Welcome to Gilead, ladies.
Be kind, friends. It’s getting more difficult every day.