ACOG Statement on Clarification Regarding EMTALA Protections

The following is a statement from Iffath Abbasi Hoskins, MD, FACOG, president of the American College of Obstetricians and Gynecologists (ACOG), regarding the clarification from Department of Health and Human Services (HHS) Secretary Xavier Becerra about the Emergency Medical Treatment and Active Labor Act (EMTALA):

“ACOG is grateful to HHS Secretary Becerra for providing explicit guidance regarding the federal preemption of EMTALA over state laws banning abortion care. This guidance reaffirms the responsibility of health care systems across the country to provide appropriate evidence-based medical care—including medically necessary, lifesaving medical intervention, such as abortion—despite laws that may exist forbidding that care in any particular state. Health care professionals all over the country have been seeking this type of reassurance since the Supreme Court’s decision put basic medical decision-making into question more than two weeks ago. This guidance is one step toward reassuring clinicians of the critical role of their independent evidence-based medical judgement when treating a pregnant patient with an emergency condition, even in states where abortion care is banned or restricted. 

“In declaring and reaffirming that treatment in emergency medical situations must be under the purview of the health care professional who is caring for the individual patient, HHS is acknowledging that the practice of medicine and the progression of pregnancy are both incredibly complex and that quality care must reflect a medical expert’s clinical judgment rather than the limits imposed by restrictive state laws. As implicitly recognized in Secretary Becerra’s letter, any attempt to delineate specific exemptions will not take into account an individual patient’s unique needs, especially in crisis scenarios. All medical institutions should be encouraged by this letter to empower their medical experts to make decisions consistent with their ethical obligations and in the best interests of patients without threats or fear due to state bans on abortion care.

“ACOG hopes that this guidance from HHS will help all clinicians, including obstetrician–gynecologists and emergency physicians, feel more confident in being able to provide patients with the evidence-based medical care they need in emergency settings. We applaud the administration’s swift action to put meaningful guidance into the hands of our clinicians and institutions related to EMTALA, and we look forward to additional action and guidance that will be critical to protecting care and access outside of emergency departments.”