‘This is not a matter of opinion:’ State AGs instruct hospitals to continue providing emergency abortions despite state law

Democratic state attorneys general issued an urgent warning to hospitals across the U.S. that they must continue to provide emergency abortions despite state laws.

The 21 attorneys general issued the letter on the anniversary of the reversal of Roe v Wade and after the U.S. Centers for Medicare and Medicaid Services rescinded guidance to hospitals about how to follow federal law on emergency reproductive care.

Last month the agency backpedaled on guidance issued in 2022 on the federal Emergency Medical Treatment and Active Labor Act, which it said “[does] not reflect the policy of this Administration.”

North Carolina Attorney General Jeff Jackson urged hospitals in the state to keep providing life-saving emergency abortion care to patients. Abortion is banned in North Carolina after 12 weeks, with certain exceptions for medical emergencies, and pregnancies a result of rape or incest.

“This is not a matter of opinion,” Jackson said. “North Carolina hospitals must obey the law and work to save their patients.”

“Under the law, all hospitals participating in the Medicare program must provide abortion care when that care is necessary to treat a medical emergency, regardless of state laws that limit abortion access,” Jackson’s office said in the news release.

On June 3, the agency said it would “continue to enforce EMTALA” despite rescinding the 2022 guidance, but the attorneys general were compelled to write to the American Hospital Association on June 24.

“The law is clear: Hospitals subject to EMTALA have an obligation to provide timely abortion care when necessary to stabilize a patient experiencing an emergency medical condition,” they wrote.

The letter pointed to the “real-world consequences” of hospitals denying or delaying abortion care for patients in a medical emergency.

“In Texas, a young mother experiencing a miscarriage died of an infection after being forced to delay abortion care for 40 hours until doctors, fearful of prosecution under Texas’s abortion ban, could no longer detect a heartbeat in her unborn child,” they said.

“And HHS found as recently as May 2025 that a hospital violated EMTALA when a pregnant woman nearly died after being denied abortion care for her ectopic pregnancy, resulting in permanent damage to her reproductive organs,” the letter continued.

Attorneys general Rob Bonta of California, Letitia James of New York and Matthew J. Plantkin of New Jersey were among the signatories.

In addition to North Carolina, the attorneys general of Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia also signed.