Attorney General James Affirms Hospitals Must Provide Access to Emergency Abortion Care

NEW YORK – New York Attorney General Letitia James co-led 21 other attorneys general in a letter reminding hospitals of their obligation to provide emergency abortion care under the Emergency Medical Treatment and Active Labor Act (EMTALA). In a letter sent to the American Hospital Association on the third anniversary of the Supreme Court’s decision overturning Roe v. Wade, Attorney General James and the coalition advised hospitals that their obligation to comply with EMTALA’s emergency abortion care requirement has not changed despite the federal administration’s recent decision to revoke a prior guidance document.

“When a pregnant patient shows up at an emergency room in need of help, they should never be turned away,” said Attorney General James. “Our hospitals have a legal responsibility to ensure they are providing life-saving care to all patients in need – including emergency abortion care when necessary. It is critically important that providers be aware of this obligation, so that we avoid further tragedy and save as many lives as possible.”

Since it was enacted in 1986, EMTALA has required Medicare-participating hospitals to provide access to abortion care when it is the treatment necessary to stabilize a pregnant patient with an emergency medical condition. On May 29, 2025, the Centers for Medicare and Medicaid Services (CMS) rescinded guidance that had been issued in 2022 in the wake of the Supreme Court’s decision overturning Roe v. Wade. The 2022 guidance addressed EMTALA’s requirements to provide access to emergency abortion care, but it also did not change EMTALA’s statutory mandates.

In the letter, Attorney General James and the coalition explain that the administration’s rescission of the 2022 guidance in no way alters hospitals’ legal obligations under EMTALA. The attorneys general highlight that EMTALA has always required hospitals to provide access to abortion care if it is the treatment necessary to stabilize pregnant patients with an emergency medical condition, even if the state in which they operate has passed laws limiting abortion access. Emergency medical conditions that require stabilizing abortion treatment can include, but are not limited to, ectopic pregnancy, hemorrhaging, preeclampsia, and other significant life-threatening conditions.

The attorneys general assert that the Trump administration cannot change the law unilaterally through a guidance rescission, and EMTALA continues to remain in full force and effect throughout the country. The attorneys general also explain that continued compliance with EMTALA’s requirements is critical because of the devastating harms that result from denying abortion care to pregnant patients in emergency medical situations. The letter points out that the denial of this essential care increases the risk of death for pregnant patients and can cause irreparable harm, including hysterectomy, fertility loss, kidney failure, brain injury, and limb amputation.

With this letter, Attorney General James and the coalition are reaffirming their commitment to ensuring that hospitals comply with the law and their commitment to protecting pregnant patients across the country.

Joining Attorney General James in sending this letter are the attorneys general of Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.