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This bulletin is being sent by the Health Care Authority (HCA) on behalf of the Department of Health (DOH).
Access to emergency obstetric care is a top priority for Washington State. On June 3, 2025, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) rescinded federal guidance providing that the Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals to provide abortion care to pregnant patients for whom such care is necessary to stabilize an emergency medical condition they are experiencing, irrespective of any contrary state laws. This decision will negatively impact access to reproductive care in some states, but pregnant patients in Washington state remain protected under state law.
On January 13, 2025, the Washington State Department of Health adopted an emergency rule incorporating the provisions of EMTALA into state law and ensuring protections for emergency obstetric care in hospitals like those in CMS’s now-rescinded EMTALA guidance. On April 29, 2025, Engrossed Substitute Senate Bill (ESSB) 5557 went into effect, codifying the requirement in the department’s emergency rule for hospitals to provide treatment to pregnant people with emergency medical conditions that is consistent with the standard of care, including abortion care, or to make an authorized transfer to another hospital capable of providing the care needed. ESSB 5557 also codified the emergency rule provision prohibiting hospitals from using the continuation of a pregnancy or the health of an embryo or fetus as the basis for withholding care from a pregnant person and from prioritizing the continuation of a pregnancy or the health of any embryo or fetus over the health or safety of a pregnant person without the pregnant person’s informed consent.
After enactment of ESSB 5557, on May 12, 2025, the department readopted an amended emergency rule continuing the incorporation of EMTALA into state law.
With the combination of ESSB 5557 and the department’s current emergency rule, hospitals licensed in Washington are required to continue providing emergency obstetric services, including emergency abortion care, to pregnant persons who need them, regardless of the federal administration’s decision to rescind its EMTALA guidance. The department has authority to enforce compliance with these vital requirements.
Apple Health (Medicaid) and PEBB and SEBB plans will continue to reimburse practices for these services.
The department has commenced rulemaking to incorporate ESSB 5557 and consider other amendments to the requirements for hospital emergency services currently found in WAC 246-320-010 and 246-320-281 and other related rules. Permanent rulemaking workshops will begin July 2025; you can email Tiffani Buck to be added to the interested party list to receive workshop registration information, updates, and meeting materials. You can also find information on the department’s “Rules in Progress” webpage.
For additional information, Washington’s Attorney General Nick Brown issued a statement on the Trump Administration’s rollback of its EMTALA guidance.
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