A recent study suggests that restrictive state abortion laws in the United States may impact emergency care for pregnant patients, despite federal requirements that hospitals provide lifesaving treatment. The research, published in JAMA Health Forum, examined the effects of state abortion bans on compliance with the Emergency Medical Treatment and Labor Act (EMTALA), a 1986 law mandating all Medicare-participating hospitals to screen and stabilize emergency department patients.
"For pregnant patients, stabilization may mean ending a pregnancy when it presents a serious threat to the patient's health," said lead researcher Woskie. "When state laws narrow the circumstances in which clinicians feel safe intervening, it can delay essential care, which directly conflicts with Americans' right to timely emergency care."
The study analyzed EMTALA violation records from 2018 through early 2023, focusing on six states—Idaho, Kentucky, Louisiana, Mississippi, Oklahoma, and Texas—that have abortion bans without exceptions for patient health. These were compared to a control group of 34 states plus Washington D.C., where broader health exceptions exist.
Researchers found an average increase of 1.18 pregnancy-related EMTALA violations per quarter in states with strict abortion bans after those policies took effect. According to Woskie: "This works out to roughly five extra EMTALA violations per state per year. Each violation represents a hospital formally breaking federal law. And even though the cases are rare, each reflects a confirmed case in which a patient did not receive the emergency care they were entitled to."
The increase was not uniform across all states studied; Texas showed the most pronounced rise in violations following its earlier adoption of restrictive abortion policies. The other five states exhibited more modest increases after Roe v. Wade was overturned in June 2022.
Complaints leading to these violations are typically filed by healthcare workers who witness failures in delivering appropriate emergency care or by patients and their families who believe they were denied lawful treatment. Investigations are conducted jointly by CMS and state officials.
The study also noted that many post-ban violations involved failures during initial medical screening and compliance processes within emergency departments. This suggests potential breakdowns at early stages of patient evaluation and triage.
"When doctors hesitate, diagnosis may be delayed, conditions can worsen, and the very harms EMTALA was designed to prevent become more likely," Woskie added.
These findings indicate that stricter abortion laws without health exceptions may contribute to delays or denials of necessary emergency care for pregnant patients.
