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HHS says doctors must provide abortions in emergencies


Physicians must provide abortions in medical emergencies under federal law and can face penalties if they do not want to supply the procedure in these cases, Health and Human Services Secretary Xavier Becerra wrote in a letter to health care providers on Monday.

Becerra said federal law pre-empts state abortion bans in cases where women face medical emergencies related to pregnancy under the Emergency Medical Treatment and Lively Labor Act. If an abortion is vital to treat a girl facing a medical emergency, physicians must offer the procedure, the health secretary wrote.

Hospitals that decline to offer abortions in these cases could have their Medicare provider agreement terminated or face financial penalties, Becerra said. Individual physicians may be cut from Medicare and state health programs in the event that they refuse to supply abortions in medical emergencies, he added. Physicians can even use federal law as a defense in the event that they face state prosecution when providing abortions in emergencies, in keeping with HHS.

Becerra said such medical emergencies include but are usually not limited to ectopic pregnancies, complications from miscarriages and hypertensive disorders resembling preeclampsia that sometimes occurs after 20 weeks of pregnancy. Preeclampsia leads to hypertension, severe headaches and blurred vision. The condition can result in fatal complications if untreated.

“Under the law, regardless of where you reside, women have the correct to emergency care — including abortion care,” Becerra said. “We’re reinforcing that we expect providers to proceed offering these services, and that federal law preempts state abortion bans when needed for emergency care.”

President Joe Biden signed an executive order Friday directing HHS to guard abortion access. At the very least nine states have banned abortion for the reason that Supreme Court overturned Roe v. Wade last month, which protected access to the procedure as a constitutional right for nearly 50 years. Several other states have tried to ban abortion but their laws have been blocked by state courts.

Although state abortion bans generally make exceptions for when the girl’s life is at risk, reproductive rights activists fear the laws can have a chilling effect on patients searching for care in addition to physicians who fear prosecution. U.S. health officials worry that wary doctors could wait too long to treat ectopic pregnancies and complications from miscarriages while awaiting legal guidance.

The entire state abortion bans make performing an abortion a felony that carries prison time, the length of which varies depending on the state. Women who receive abortions are generally exempt from prosecution under the state bans, but reproductive rights group are concerned that states will move to criminalize receiving an abortion as well.

Biden also has directed HHS to take motion to make the abortion pill, mifepristone, as widely available as possible and protect access to contraception.

The Food and Drug Administration approved the abortion pill greater than 20 years ago as a secure and effective approach to end a pregnancy before the tenth week. In December, the FDA permanently allowed the pill to be sent by mail from licensed pharmacies and health care providers. But states banning abortion are also outlawing health care providers from administering the pill.

The Center for Reproductive Rights and Democratic lawmakers have called for the Biden administration to declare a public health emergency in response to states banning abortion.

The president told reporters over the weekend that he has asked health officials within the administration to take a look at whether he has the legal authority to declare such an emergency to guard abortion access and what impact using the powers would have. But Jen Klein, director of the White House Gender Policy Council, said the administration concluded that declaring an emergency was not the very best position to answer states banning abortion.

“After we checked out the general public health emergency, we learned a pair things.  One is that it doesn’t free very many resources. It’s what’s in the general public health emergency fund, and there is little or no money — tens of 1000’s of dollars in it,” Klein told reporters on Friday.  “So that did not seem to be an important option. And it also doesn’t release a major amount of legal authority. And in order that’s why we have not taken that motion.”

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