Democratic Doctors Caucus Reaffirms EMTALA Amid Trump's CMS Policy Reversal on Abortion Care

Prompted by the Trump administration's revocation of federal guidance from CMS related to the Emergency Medical Treatment and Labor Act (EMTALA), Whip Katherine Clark (D, Massachusetts) and the Democratic Doctors Caucus held a press conference to reaffirm that despite the administration's actions to remove the guidance, “EMTALA is still the law of the land.”¹

In 2022, CMS established the “Reinforcement of EMTALA Obligations specific to Patients who are Pregnant or are Experiencing Pregnancy Loss,” which has now been removed because it does “not reflect the policy of this Administration,” according to the June 3 CMS announcement.²

It also stated that “CMS will continue to enforce EMTALA, which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy. CMS will work to rectify any perceived legal confusion and instability created by the former administration’s actions.”

However, Clark and the 6 physicians serving in the Democratic Caucus sounded a warning in the June 11 conference, aiming to offer clarity by emphasizing that the EMTALA law remains the same.¹ “EMTALA doesn't carve out exceptions,” Maxine Dexter, MD (D, Oregon), said. “It is not based on the political whims of a White House.”

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“Donald Trump does not have the power to change that law,” Clark emphasized. “His callous action did not change women's rights under the law. It did not change doctors' responsibilities to their patients under the law. What it did do is sow confusion.”

Since the Supreme Court ruled on the Dobbs decision to overturn Roe v Wade, outcomes for women have worsened in states that responded with bans or heavy restrictions on abortion care.³ Simultaneously, the infant mortality rate saw a steep increase of an estimated 478 excess infant deaths, with Black infants facing the highest increase.⁴

“The Republican Party has stopped at nothing to roll back more freedoms, to strip away more health services, and take more steps towards their ultimate goal: a nationwide abortion ban," Clark said, referencing actions aimed at defunding Planned Parenthood and challenges to abortion coverage through private health plans.¹

From left: Maxine Dexter (OR), Ami Bera (CA), Kim Schrier (WA), Katherine Clark (MA), Kelly Morrison (MN), Raul Ruiz (CA), Herb Conaway Jr (NJ; not pictured)

Kelly Morrison, MD (D, Minnesota), the first pro-choice obstetrician-gynecologist (ob-gyn) to serve in Congress, stated that by revoking the guidance, the administration is "inserting politics into emergency care protocols,” saying that the move aimed to intentionally confuse doctors, hospitals, and patients, while “stoking fear and putting lives at risk.”

This action is not the first time conservative efforts directed at restricting access to abortion care have been labeled “intentional” or “confusing.” Legal penalties and lawsuits aimed at abortion care providers erupted with the Dobbs decision, and momentum has continued in the years since, varying by state.⁵

However, concerns around the vague wording across such legislation have been consistently raised. Notably, Houston ob-gyn Richard Todd Ivey, MD, of Baylor College of Medicine, described the design of Texas abortion laws as intentional. “The vague wording of the law with detailed, severe penalties for physicians is deliberate,” he wrote in a JAMA viewpoint article. “The chilling effect in health care is the desired outcome. The culture of fear among patients and physicians is real.”

Echoing that sentiment, Raul Ruiz, MD (D, California), warned that ignoring or weakening EMTALA could lead to "paralysis and delay" in emergency departments, with potentially fatal consequences.¹

To the members of the Democratic Doctors Caucus, the withdrawal of EMTALA guidance by the Trump administration reinforces alarms physicians have been ringing around the perception of a political agenda to instill ambiguity in medicine.

“Because the administration can't actually change the law, as you've heard, they're now creating enough uncertainty and confusion that hospitals and physicians might think twice about providing that life-saving care,” Kim Schrier, MD (D, Washington) said at the press conference.

Emergency physician Herb Conaway Jr, MD (D, New Jersey), described the action as “nothing but a continuation of the administration's war on the poor, the dispossessed, those who don't have ready access to the highest quality care because they live in a rural area, or they live in an area that doesn't have a great tax base.”

In a contrasting statement, antiabortion advocate Marjorie Dannenfelser, president of SBA Pro-Life America, saw the removal of the guidance as a corrective measure to the Biden-era policy, saying, “Democrats have created confusion” by using the guidance to expand abortion access in restrictive states, “to justify their extremely unpopular agenda for all-trimester abortion.”⁶

Ami Bera, MD (D, California), rounded out the Democratic Doctors Caucus by reminiscing on the foundational experience all doctors share as they take the Hippocratic Oath, and its importance in times that are challenging for physicians.¹

“When we entered the profession, we took an oath to put our patients first, to do no harm, to do good, to make these decisions with our patients, patient autonomy,” he said, emphasizing that in the emergency department “we don't see a Democratic patient or Republican patient; we see someone who is in need.”

The Democratic Doctors Caucus concluded the press conference by reiterating their unwavering commitment to protecting EMTALA and ensuring that all Americans have access to the emergency medical care they need, regardless of their location or the political climate.

“To the doctors of America, we've got your back,” Bera said. “We're going to fight this, and we're going to honor and uphold EMTALA and take care of the patients that are in front of us.”

References

1. Whip Clark: “EMTALA Is Still the Law of the Land.” June 11, 2025. Accessed June 18, 2025. https://democraticwhip.house.gov/newsroom/press-releases/whip-clark-emtala-still-law-land

2. CMS statement on Emergency Medical Treatment and Labor Act (EMTALA). News release. CMS. June 3, 2025. Accessed June 18, 2025. https://www.cms.gov/newsroom/press-releases/cms-statement-emergency-medical-treatment-and-labor-act-emtala

3. Grossi G. New report shows worsening health outcomes for women in states with abortion bans. AJMC^®. July 18, 2024. Accessed June 18, 2025. https://www.ajmc.com/view/new-report-shows-worsening-health-outcomes-for-women-in-states-with-abortion-bans

4. Steinzor P. Abortion bans linked to higher infant mortality, disproportionately impact Black infants. AJMC^®. February 13, 2025. Accessed June 18, 2025. https://www.ajmc.com/view/abortion-bans-linked-to-higher-infant-mortality-disproportionately-impact-black-infants

5. Grossi G. Abortion in 2025: access, fertility, and infant mortality updates. AJMC^®. February 20, 2025. Accessed June 18, 2025. https://www.ajmc.com/view/abortion-in-2025-access-fertility-and-infant-mortality-updates

6. CMS ends Biden’s EMTALA attack on unborn children. News release. Susan B. Anthony Pro-Life America. June 3, 2025. Accessed June 18, 2025. https://sbaprolife.org/newsroom/press-releases/cms-ends-bidens-emtala-attack-on-unborn-children