Maryland guarantees emergency abortion care regardless of federal rules

It took three years, but a bill that would enshrine emergency abortion protections in state law won final approval in the House Thursday and is headed to the governor for his signature.

The House voted 96-37, with no debate, for Senate Bill 169 Thursday. The Senate had approved the bill 32-11 on Feb. 12. If signed as expected, it would ensure that Marylanders could get emergency abortion care now guaranteed under the federal Emergency Medical Treatment and Labor Act (EMTALA).

Abortion-rights advocates have been pushing for a state bill because they feared EMTALA, broadened under the Biden administration, would be reversed under President Donald Trump.

“We had seen the potential for this standard of care to be ripped away from women at the end of the Biden administration,” said Sen. Clarence Lam (D-Howard and Anne Arundel), who has been introducing the bill since 2024.

Under SB 372, a hospital treating a patient with an emergency pregnancy-related medical condition would have to do what’s needed to stabilize the patient, including the termination of the pregnancy, if needed. Or the hospital would have to transfer the patient to another facility, so long as the transfer does not worsen the patient’s condition. Gov. Wes Moore, seen here in a 2023 file photo, will sign SB 372, a bill guaranteeing access to abortion in emergency medical situations, his aides said Thursday. (Photo by Danielle E. Gaines/Maryland Matters)

Passed in 1986, EMTALA ensures “public access to emergency services regardless of ability to pay,” according to the Centers for Medicare and Medicaid Services (CMS).

Under the Biden administration, CMS issued guidance to hospitals that said doctors can perform an emergency abortion if it is necessary to “stabilize” the patient’s medical condition, as obligated under EMTALA.

People in crisis are often taken to the nearest hospital or emergency department. Abortion-rights advocates said the EMTALA guidance ensured pregnant people in need of immediate health care could get an emergency abortion, even if the patient was taken to a religiously affiliated hospital with moral objections to abortions.

Lam first introduced his bill during the 2024 legislative session, Biden’s last year in office, but that bill was filed late in the session, so it languished in the Senate Rules Committee and died for the 2024 session. In 2025, it passed the Senate, but never got out of the former House Health and Government Operations Committee.

In the meantime, fears of Lam and other abortion-rights advocates came true. The Trump administration last year revoked the Biden-era CMS guidance, muddying the waters of what is required under EMTALA, particularly regarding abortion services at faith-based institutions or in states with strict abortion bans. Sen. Clarence Lam (D-Anne Arundel and Howard) in a Senate Finance committee hearing. (Photo by Danielle J. Brown/Maryland Matters)

SB 169 will restore the protections of the Biden-era EMTALA rules, in Maryland at least, reaffirming that Marylanders in a medical crisis needing an emergency abortion would be able to get it, regardless of federal protections or lack thereof.

A version of the bill, House Bill 372, sponsored by Del. Lesley Lopez (D-Montgomery), was passed by the House in late February and have been sitting in the Senate Finance Committee since without a hearing.

Anti-abortion advocates have argued that the proposed EMTALA legislation would infringe on the religious rights of physicians or hospital facilities that disagree with abortions in most settings.

But Lam called the bill’s passage a “real victory for women across the state.”

“I think after three years and after, I think, a lot of angst that people felt based on the posture of the current Trump administration in fighting women’s reproductive rights, this is a significant win to restore a basic expectation and necessary care for women in our state,” he said Thursday afternoon.

Maryland Matters is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Maryland Matters maintains editorial independence. Contact Editor Steve Crane for questions: editor@marylandmatters.org.