New Online Portal Allows Patients To Report Potential EMTALA Violations

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Dive Brief:

• The Biden administration is opening an online portal where patients and healthcare workers can lodge complaints against hospital emergency departments that they believe improperly deny care in order to better safeguard patients’ access to federally protected emergency care.
• The right to receive medical care during life threatening emergencies has been enshrined in law since 1986 under the Emergency Medical Treatment and Active Labor Act. However, EMTALA has taken on increased importance since Roe v. Wade was overturned by the U.S. Supreme Court in 2022.
• In a statement Tuesday, HHS Secretary Xavier Becerra said the agency wanted to ensure patients know their rights and that the new web resource was designed to make filing complaints easier.

Dive Insight:

States looking to restrict access to abortion, particularly those who do not include exceptions for the life and health of a pregnant person, have sparred with HHS over whether emergency care protections ought to extend to abortion care access.

The Department of Justice is currently defending its interpretation in front of the Supreme Court that hospitals’ obligations to provide emergency medical care under EMTALA preempts state-level abortion restrictions, such as those passed in Idaho and Texas.

Immediately after Roe v. Wade was struck down, HHS Secretary Xavier Becerra issued a statement strongly supporting EMTALA’s coverage of abortion services. 

“Under the law, no matter where you live, women have the right to emergency care — including abortion care,” Becerra said in July 2022.

EMTALA stipulates hospitals must provide medical screening exams to determine if a patient is experiencing an emergency. If an emergency is confirmed, hospitals must provide stabilizing medical treatment or, if they are unable to do so,  appropriately transfer the patient.

In August 2022 Becerra sent a letter to state governors warning his agency would not hesitate to take legal action against states that sought to ban providers from providing such care. 

However, the courts’ response to legal fights has been mixed, leaving providers — and patients — with some ambiguity about the future of care guarantees.

An Idaho district court and the Ninth Circuit Court of Appeals were at odds over whether Idaho’s ban — which has exceptions for the life of the mother but no exceptions for her health — violated EMTALA. The case moved to the Supreme Court this January.

In Texas, a district judge blocked HHS guidance in 2022, calling it an “unauthorized” reach from the federal agency. A preliminary injunction remains in place blocking the HHS from enforcing its guidance in Texas or against members of the American Association of Pro Life Obstetricians and Gynecologists and the Christian Medical and Dental Association.

As providers and patients await the Supreme Court’s judgment, patients and providers are opting to receive and give care in states with less restrictive abortion policies.

Interstate abortion travel doubled between 2020 and the first six months of 2023, the Guttmacher Institute reported.

Meanwhile, medical students have been less likely to apply to residencies in states with restrictive abortion policies, according to a recent analysis from the AAMC Research and Action Institute.