Project 2025: A Blueprint for Attacking EMTALA Protections and Denying Emergency Abortion Care

Project 2025 – the right-wing playbook for a new, anti-democratic presidential administration — proposes an all-out attack on health care for pregnant people. Among the many horrific proposals, drafters want to enact policies that undermine, and effectively remove, long-standing federal protections guaranteeing a right to emergency abortion care under the Emergency Medical Treatment and Labor Act (EMTALA). 

Congress passed the Emergency Medical Treatment and Labor Act in 1986 to address the crisis of patients being turned away from emergency rooms and denied emergency care. This federal law provides straightforward protections: when any person experiencing an emergency medical condition seeks care at a Medicare-funded hospital, the hospital is required to offer necessary stabilizing treatment, regardless of the patient’s ability to pay. EMTALA requires hospitals to provide stabilizing care. In some situations, emergency abortion care is the only treatment that can stabilize a pregnant patient and is thus required by EMTALA. These protections have become even more essential in the years since the Supreme Court wrongly struck down Roe v. Wade, as extremist state lawmakers have passed laws that seek to deny abortion care even in emergencies. 

As part of their crusade to entirely dismantle our federal civil rights protections and to ban abortion for everyone, everywhere, under every circumstance, the drafters of Project 2025 aim to undermine EMTALA’s crucial and common–sense protections for pregnant people. They falsely claim that EMTALA does not require emergency abortion care. Since the executive branch cannot change the underlying law—which clearly requires emergency abortion care—they have formed a plan to undermine this crucial protection by halting enforcement. Under their plan, federal agencies would no longer enforce EMTALA when pregnant people are denied life- or health-saving abortion care. The folks behind Project 2025 are working toward a country where a person can show up at an emergency room suffering from a dangerous pregnancy complication that requires an abortion to protect their health or life, and the hospital can deny treatment and jeopardize the person’s health, without fear of the federal government coming after them for violating EMTALA. Instead, in a true perversion of Congress’ original intent behind the law, the drafters propose using EMTALA to harass and investigate hospitals and providers who provide emergency care to pregnant patients who need it.   

Changing policies to try to exclude pregnant people from EMTALA’s federal protection would contradict the law’s purpose. It would also be discriminatory—singling pregnant people out for denial of care while everyone else is protected. And it would have catastrophic results for people across the country. 

We know what would happen if a new presidential administration adopts Project 2025’s plans and refuses to enforce EMTALA’s protections, because we are seeing it play out across the country as patients are being denied care even as they risk infection, blood loss, organ loss, and even death. In Idaho, after the Supreme Court allowed its abortion ban which conflicts with EMTALA to go into effect, chaos and suffering ensued. Women had to be airlifted out of the state to get emergency abortion care. OB-GYNs, fearing felony charges for providing emergency care, fled the state, forcing labor and delivery units in Idaho to close and worsening the maternal health care crisis. The drafters of Project 2025 want this to be the reality across the United States. They want to do this even though it would disproportionately harm pregnant patients who live in rural areas, have low incomes, are Latina, Black or Indigenous, or are immigrants—communities already facing high maternal mortality rates and barriers to care.  

In the America of Project 2025, people are stripped of health insurance coverage, affordable prescription drugs, and access to IVF and contraception, and pregnant people can be callously denied treatment at the doors of an emergency room. In that world, the federal government does not exist to help or protect people, only to harass and oppress them, and to implement policies that enshrine rigid gender roles and remove individuals’ autonomy. This sounds like a dystopian nightmare, but it’s the plan of the Project’s drafters, and we must do everything we can to fight against it.