The Biden Administration Enforces Federal Protections for Patients Seeking Emergency Abortion Care for the First Time Since Dobbs
Mylissa Farmer was going to name her daughter Maeve.
She had already purchased baby clothes, and she was convinced that Maeve would have been a daddy’s girl.
That future was taken from Mylissa at 6:30 a.m. on August 2, 2022, when just short of 18 weeks into her pregnancy, she felt her water break.
Later that morning, at Freeman Hospital West in Joplin, Missouri, doctors informed Mylissa that her pregnancy was no longer viable. And to compound this tragedy, Mylissa herself was now at risk of a serious infection, hemorrhaging, or death.
To preserve her health and life, Mylissa’s doctors developed a plan to provide her with emergency medical treatment. But Freeman overrode the doctors’ medical judgment—because the care Mylissa needed was an abortion. And in the legal chaos that’s been spurred by the Supreme Court taking away our constitutional right to abortion, Freeman, and anyone who might want to deny people abortion care, have now been emboldened to do so.
After learning that she couldn’t get the medical treatment she desperately needed, Mylissa drove for hours to the University of Kansas Health System in Kansas City, Kansas: a state where abortion is still legal. Yet once again—and against medical judgment—the University of Kansas refused to let doctors provide her emergency abortion care.
Mylissa suffered significant pain, terror, and humiliation because these hospitals overrode their doctors’ medical judgment. Filled with grief and fear for her life, she was forced to drive for hours, across three states, before she finally received treatment three days later in Illinois. By the time she received the care she needed, she was in labor, in severe pain, likely suffering an infection, and feeling defeated, hopeless, and humiliated.
We at the National Women’s Law Center (NWLC) want to be crystal clear: What happened to Mylissa is not just horrific. It is illegal.
On November 8, 2022, NWLC filed a complaint with the Centers for Medicare & Medicaid Services (CMS) on behalf of Mylissa Farmer. We asserted that the two hospitals that overrode their medical providers’ judgment to deny Mylissa care violated the Emergency Medical Treatment and Active Labor Act (“EMTALA”), a federal law that ensures patients receive emergency medical care—including emergency abortion care.
And on April 24, 2023, CMS announced that it agrees these hospitals violated federal law!
This is the first time since the Supreme Court overturned Roe v. Wade that the Biden administration is enforcing EMTALA against a hospital that has denied someone emergency abortion care, letting health care providers know:
Any hospital that accepts federal Medicare funds is obligated to follow EMTALA—federal law—regardless of state abortion bans. And if a hospital doesn’t follow the law, the federal government will enforce it against them.
Make no mistake: This decision is a major victory. But this is only the first step in getting justice for Mylissa. Because not only was what happened to her an EMTALA violation—it was also bold-faced sex discrimination.
On January 3022023, NWLC filed another complaint, this time with the U.S. Department of Health and Human Services Office for Civil Rights, asserting that all four hospitals discriminated against Mylissa on the basis of sex in violation of Section 1557 of the Affordable Care Act by denying her the care necessary to preserve her life and health. NWLC also filed similar sex discrimination complaints with state agencies charged with enforcing state civil rights laws.
What happened to Mylissa Farmer was appalling and inexcusable, but sadly we know that the same situation keeps happening, again and again, in the wake of the Supreme Court’s decision to take away the constitutional right to abortion and allow extremist legislators to ban abortion. Across the country, reports continue to surface of patients who are miscarrying or facing life-threatening pregnancy complications being forced to wait until they are on the brink of death before hospitals will let their doctors intervene.
We are living through a public health crisis manufactured by the Supreme Court and anti-abortion extremists. People should not fear being denied treatment for emergency pregnancy complications, but these extremists are pushing agendas which mean that politics, not medicine, control people’s access to health care. Communities of color, particularly Black and Native women, bear particular risk and suffering in this climate.
Even before the federal constitutional right to abortion was taken from us, threatening pregnancy care writ large, Black women of all socioeconomic and educational levels were 3 to 4 times more likely to die from pregnancy-related complications than white women and twice as likely to suffer from severe maternal morbidity. These sobering rates of maternal mortality and morbidity in the U.S. are only going to be exacerbated in this post-Roe landscape.
Mylissa named Maeve after the warrior queen known for her great strength and resilience.
But I think it is Mylissa who is reflecting those incredible qualities, and many more. Because, despite the immense emotional burden and ongoing trauma she is trying to recover from, Mylissa keeps telling her story—because she doesn’t want this horror to keep happening to anyone else.
NWLC applauds the Biden administration’s decision in Mylissa’s case. And we hope, at this critical juncture for abortion access, this decision by the administration serves as a warning that the government will take enforcement action against hospitals that fail to provide emergency abortion care.