On June 3, 2025, the Trump administration rolled back guidance that directed hospitals to provide abortions in emergency situations, including in states with abortion bans and restrictions.

EMTALA (Emergency Medical Treatment and Labor Act) has been on the books since 1986. It requires that anyone who arrives at a Medicare-participating hospital (which is most hospitals) with a medical emergency, including active labor,be stabilized.

After Roe v. Wade was overturned in 2022, the Biden administration issued guidance making it clear that if a pregnant person faced a medical emergency, EMTALA obligated doctors to perform an abortion—even in states with bans—if that was the safest course of action.

The Biden administration’s guidance states that, “When a state law prohibits abortion and does not include an exception for the life of the pregnant person — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted.” 

The Trump administration has rolled back that guidance, claiming it "misused" federal law to override state abortion restrictions.

While the Trump administration’s press release said that it will “continue to enforce EMTALA,” the press release also stated that the administration “will work to rectify any perceived legal confusion and instability created by the former administration’s actions.”

However, this means that there is no longer a clear federal mandate protecting doctors who perform emergency abortions, even if a patient’s life is on the line, in states with abortion bans or severe restrictions. Instead, states now have more leeway to limit what kind of emergency care is allowed, even when delaying treatment could be dangerous or deadly.

Advocates for reproductive rights are sounding the alarm, warning that this rollback puts lives at risk. Many OB/GYN practitioners are concerned that they will have to choose between providing life-saving care and avoiding potential criminal charges, and are further concerned that the confusion and risk surrounding emergency abortions will dissuade medical students from specializing in obstetrics.

This isn’t the first time EMTALA has clashed with state abortion bans. It’s already been at the center of courtroom battles in states like Texas and Idaho, where doctors found themselves torn between federal guidance and state law.

In Texas, the Biden administration sued the state after it enforced abortion restrictions that doctors said prevented them from providing care in life-threatening pregnancy-related situations. A judge initially sided with the federal government, saying EMTALA overrides state bans in emergency cases. But the 5th Circuit Court of Appeals later overturned that decision, effectively telling doctors to follow state abortion law first.

In Idaho, where a near-total abortion ban includes only narrow exceptions, another lawsuit raised the same issue: What happens when federal emergency care laws say “yes,” but state bans say “no”? The Biden administration argued that federal law should protect doctors who perform emergency abortions, while Idaho said its ban should stand.

The tension between these two cases led the U.S. Supreme Court to step in, agreeing to hear arguments in 2024. While the Court hasn’t issued a final ruling yet, it temporarily allowed Idaho’s ban to take effect, signaling that the justices may lean toward giving states more power to prevent abortions, even in emergencies.

For now, if you live in a state with severe abortion restrictions, emergency care just got a lot more uncertain.