After two years of struggling to get over the finish line, advocates hope this is the year they pass legislation ensuring Marylanders have access to emergency abortions during severe, life-threatening medical complications.
Senate bills to enshrine the protections of the federal EMTALA rule in state law have failed in each of the past two years, but Senate Bill 169 and new House Bill 327 have been approved by their respective chambers this year. There are just two weeks to go in the session, but supporters are hopeful that the bills can win final approval — helped along, ironically, by Trump administration plans to reverse the federal protections.
“Last year we were only a few months into the Trump administration,” said Sen. Clarence Lam (D-Anne Arundel and Howard), sponsor of SB169. “We have certainly seen a lot of changes in the health care space.
“One of those is obviously a concern with access to emergency abortion care for women. And this (Trump) administration, since last year, has taken further steps to be able to limit the access for women to emergency abortion care in our emergency rooms,” he said.
SB 169 and HB 372 would require that a hospital that treats a patient with an emergency pregnancy-related medical condition, stabilize that patient, including the termination of a pregnancy if needed, or transfer that patient to another facility, so long as the patient’s risk would not be worsened by the transfer.
This is the third year Lam has sponsored legislation that would codify federal protections under the Emergency Medical Treatment and Labor Act (EMTALA) into state statute.
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 across the United States outlining that doctors can conduct an emergency abortion if it is necessary to “stabilize” patient’s medical condition, as obligated under EMTALA.
Lam first tried in 2024, but that bill never got out of the Senate Rules Committee. Last year’s attempt managed to get Senate approval, but then got gummed up in a House committee in the final days of the 2025 session.
But with the Trump administration chipping away at federal emergency abortion policy, Del. Lesley Lopez (D-Montgomery) decided to join forces with Lam. She sponsored a House version of the bill to improve its chances of getting through both House and Senate to become law.
“It’s clear where we’re going with reproductive rights in this country, and we need to take every opportunity we can to protect people in that aspect,” Lopez said.
The strategy appears to be working. The House passed Lopez’s House Bill 372 on Feb. 26 by a 97-37 vote. Lam’s third attempt at the legislation, Senate Bill 169, won Senate approval on a 32-11 vote on Feb. 12.
The lawmakers pushing the bill said that a year under the second term of the Trump administration, which softened Biden-era interpretation of EMTALA, has made the issue “a very real concern” this year.
But the legislation may run up against faith-based hospitals that are morally opposed to abortions in most cases, and could even result in legal action if the legislation becomes law, according to some anti-abortion advocates.
“It seeks to codify the Biden’s administration of emergency care, which doesn’t just merely focus on protecting the life of the pregnant woman, but expands to protect the ‘health’ of the pregnant woman,” said Jeffrey S. Trimbath, president of the Maryland Family Institute. “Going from ‘life’ to ‘health’ is a Mack-truck-sized expansion through which you can drive all kinds of subjective notions that we think are a problem.”
The Biden-era guidance from CMS told hospitals that, “If qualified medical personnel determine that the patient’s condition, such as an ectopic pregnancy, requires stabilizing treatment to prevent serious jeopardy to the patient’s health (including a serious impairment or dysfunction of bodily functions or any bodily organ or a threat to life), the qualified medical personnel is required by EMTALA to provide the treatment,” the letter says.
State laws that ban or severely restrict abortion care are preempted by the EMTALA statute, according to the letter.
But last year, the Trump administration revoked that CMS guidance, which could muddy the water of what is required under EMTALA regarding abortion services, particularly at faith-based institutions or in states with strict abortion bans.
Which is why abortion rights advocates like Karen J. Nelson, president and CEO of Planned Parenthood of Maryland, said that even in an abortion-friendly state like Maryland, state-level EMTALA protections are needed.
“Maryland is known for its strong and expansive state-level protections of abortion care. However, we rely on enforcement of the federal EMTALA law to protect Marylanders during times of crisis,” Nelson said in a statement. “This bill ensures that there is state-level protection for life-saving care regardless of what occurs outside of Maryland’s boundaries.”
Lam agrees.
“They (the Trump administration) are no longer enforcing prior provisions that were enforced under the Biden administration to require all hospitals, regardless of whether they’re religiously affiliated or not, to offer emergency abortion care to any woman coming through their doors,” Lam said. “And with that protection ripped away, we have a very real concern.
He noted that people needing emergency medical treatment are often taken to the closest hospital or emergency department that can treat them. Many of those facilities are run by religiously affiliated institutions.
“A woman, by no choice of her own, is just transported by the ambulance to the nearest emergency department, might end up in a facility where she may not be able to get the life-saving emergency abortion that she needs,” Lam said of the consequences of a loss of EMTALA protections.
“This protection has become very real for Maryland women across the state,” Lam said, “and I think that’s why, in the face of the new developments and further tearing away of these protections by the Trump administration, this bill became even more clear why we need to pass it this year.”
Lopez said she was “hopeful” that bills succeed, now that the same bills have passed the House and Senate and crossed over to the other chamber.
“Now it comes down to procedure, but it is the will of both bodies to put these protections in place,” Lopez said.
But if it passes, anti-abortion advocates are likely to challenge the issue in court as a violation of the First Amendment and religious freedom under the Maryland State Constitution, Trimbath said.
“This is part of a broader trend during this session to pass legislation that tries to challenge federal policy on these issues,” he said. “If this does pass, we think it is a blatant violation of the First Amendment. Litigation is sure to follow. So it will be unwise for them to pass this.”