Changed Laws and Regulations Impact Reproductive Health Care Providers – JD Supra

Report on Recent Legal Developments in U.S. Reproductive Healthcare and Their Impact on Sustainable Development Goals

Executive Summary

Recent shifts in the United States’ legal framework for reproductive healthcare at both federal and state levels present significant implications for the nation’s progress toward key Sustainable Development Goals (SDGs). Federal policy reversals concerning emergency medical treatment and health information privacy conflict with state-level efforts to protect and expand reproductive rights. This report analyzes these developments through the lens of SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice and Strong Institutions).

Federal Policy Reversals and Challenges to SDG 3 and SDG 10

The federal administration has taken steps that create uncertainty in healthcare access, directly impacting health equity and institutional stability.

Revocation of Emergency Medical Treatment Guidance (EMTALA)

On May 29, 2025, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) rescinded 2022 guidance concerning the Emergency Medical Treatment & Labor Act (EMTALA). This action has direct consequences for SDG 3, particularly Target 3.8, which aims for universal health coverage and access to quality essential health-care services.

• The 2022 guidance affirmed that federal law (EMTALA) supersedes state abortion restrictions when an abortion is deemed a necessary stabilizing treatment for an emergency medical condition.
• The current administration’s revocation is based on the position that HHS lacks the authority to mandate abortion as a stabilizing treatment and that EMTALA should not override state laws.
• This policy change introduces significant ambiguity for healthcare providers in emergency situations, potentially compromising patient health and well-being.

Impact on Health Equity (SDG 10) and Institutional Conflict (SDG 16)

The withdrawal of the EMTALA guidance exacerbates regional disparities in healthcare access, undermining SDG 10 (Reduced Inequalities). The resulting legal landscape creates a system where a patient’s access to emergency care is dependent on geography.

Furthermore, the conflict highlights a challenge to SDG 16 (Peace, Justice and Strong Institutions) through the following events:

1. The 2022 guidance led to significant litigation in states like Texas and Idaho, demonstrating friction between federal directives and state legislation.
2. In response to the 2025 revocation, a coalition of 22 attorneys general, including those from Connecticut, New York, and Massachusetts, asserted that hospitals must continue to comply with EMTALA as interpreted by the 2022 guidance, ensuring abortion care when medically necessary to stabilize a patient.
3. This divergence between federal administrative policy and state-level legal interpretation underscores institutional instability and a lack of cohesive governance on critical health issues.

Judicial Rulings on Health Information Privacy: Setbacks for SDG 5 and SDG 16

A federal court decision has vacated key privacy protections for reproductive health information, impacting gender equality and the rule of law.

Vacation of the HIPAA Reproductive Health Care Privacy Rule

On June 18, 2025, the U.S. District Court for the Northern District of Texas vacated most of the HIPAA Privacy Rule to Support Reproductive Health Care Privacy. This ruling represents a setback for SDG 5 (Gender Equality), as privacy is essential for ensuring individuals can access reproductive healthcare without fear of legal jeopardy.

• The vacated rule prohibited the disclosure of Reproductive Health Care (RHC) information for investigations into legally obtained care.
• The court invalidated the rule, citing that it improperly limited state laws, that HHS exceeded its authority, and that it triggered the major questions doctrine by creating special protections without clear congressional authorization.

This decision weakens the institutional framework (SDG 16) designed to protect sensitive health data, potentially deterring individuals from seeking necessary care and disproportionately affecting women.

State-Level Measures to Uphold Reproductive Health Rights and Advance SDGs

In contrast to federal actions, several states are reinforcing legal protections for reproductive healthcare, demonstrating a sub-national commitment to achieving SDG 3 and SDG 5.

Connecticut’s Legislative Protections

Connecticut has enacted laws that provide robust protections for reproductive health information and access, serving as a model for advancing SDGs at the state level.

1. The Reproductive Freedom Defense Act (RFDA): This state law protects Reproductive Health Care Services (RHCS) information from disclosure in civil, probate, legislative, or administrative proceedings without explicit patient consent. This measure directly supports the principles of privacy and autonomy central to SDG 3 and SDG 5.
2. Public Act 25-168: This act mandates that licensed hospital emergency departments provide necessary and legal reproductive health services, including miscarriage management and treatment for ectopic pregnancies, reinforcing the state’s commitment to SDG 3.
3. Public Act 25-28: This law expands minors’ rights to consent to and have privacy for reproductive health services, such as contraceptive counseling and prenatal care. By removing parental consent barriers, the law improves access to care for a vulnerable population, aligning with the goals of SDG 3 and SDG 5.

These state-level initiatives illustrate how localized governance can be leveraged to protect and advance health and gender equality, even amid conflicting federal policies.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article is fundamentally about health care, specifically focusing on reproductive health services. It discusses access to emergency medical care under the Emergency Medical Treatment & Labor Act (EMTALA), the provision of services like miscarriage management and treatment for ectopic pregnancies, and access to contraception. These topics are central to ensuring healthy lives and promoting well-being for all at all ages.

• SDG 5: Gender Equality

  The issues of reproductive health care, access to abortion, and privacy of health information are intrinsically linked to gender equality. The legal and policy changes discussed in the article directly impact the autonomy of individuals, predominantly women, to make decisions about their own bodies and health. Ensuring access to reproductive health services is a critical component of empowering women and girls and achieving gender equality.

• SDG 16: Peace, Justice and Strong Institutions

  The article extensively details the complex interplay between federal and state laws, administrative guidance from government agencies (HHS, CMS), and judicial rulings (Supreme Court, Federal District Court). It highlights conflicts between different levels of government and legal challenges, such as the letter from 22 attorneys general and the litigation in Texas and Idaho. This relates directly to the development of effective, accountable, and transparent institutions, the promotion of the rule of law, and ensuring access to justice.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3: Good Health and Well-being

  1. Target 3.7: “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.” The article’s entire focus is on the legal landscape affecting access to reproductive health care, including abortion, contraception, and miscarriage management. The discussion of Connecticut’s Public Act 25-28, which expands minors’ rights to access “contraceptive counseling” and “pregnancy prevention services,” directly relates to this target.
  2. Target 3.8: “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…” The debate surrounding EMTALA and whether it compels hospitals to provide abortion as a “stabilizing treatment” for an “emergency medical condition” is a direct reflection of this target’s goal of ensuring access to essential health-care services.

• SDG 5: Gender Equality

  1. Target 5.6: “Ensure universal access to sexual and reproductive health and reproductive rights…” The article details the legal battles following the Supreme Court’s Dobbs decision, which concern the very definition and protection of reproductive rights in the United States. State laws like Connecticut’s Reproductive Freedom Defense Act (RFDA) are described as efforts to protect these rights at a sub-national level, directly aligning with the objective of this target.

• SDG 16: Peace, Justice and Strong Institutions

  1. Target 16.3: “Promote the rule of law at the national and sub-national levels and ensure equal access to justice for all.” The article illustrates a conflict in the rule of law between federal and state authorities. The revocation of federal guidance by the Trump Administration and the subsequent letter from 22 state attorneys general insisting that hospitals “must comply with EMTALA as if the 2022 guidance had never been rescinded” exemplifies the struggle over legal interpretation and enforcement.
  2. Target 16.b: “Promote and enforce non-discriminatory laws and policies for sustainable development.” The vacated HIPAA Final Rule, which aimed to prohibit the disclosure of reproductive health care information for investigations, was an attempt to create a non-discriminatory policy. The article notes the court found HHS was “using HIPAA to set special protections for politically favored medical procedures,” highlighting the ongoing debate about what constitutes non-discriminatory policy in this area.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• For Target 3.7 (Access to reproductive health-care):

  Implied Indicator: Existence and scope of laws and policies governing access to reproductive health services. The article provides concrete examples: Connecticut’s Public Act 25-168, which “requires emergency departments of licensed hospitals to provide reproductive health care services,” and Public Act 25-28, which allows minors to consent to contraceptive services. The legal status of abortion in different states (legal in Connecticut, New York, Massachusetts; restricted in Texas and Idaho) serves as a direct indicator.

• For Target 5.6 (Universal access to reproductive rights):

  Implied Indicator: Legal frameworks protecting reproductive health information privacy. The article discusses two such frameworks: the federal HIPAA Final Rule (now vacated) and Connecticut’s Reproductive Freedom Defense Act (RFDA). The status and enforcement of these laws serve as an indicator of the protection of reproductive rights.

• For Target 16.3 (Rule of law and access to justice):

  Mentioned Indicator: The volume and nature of litigation concerning reproductive rights. The article explicitly states that the 2022 EMTALA guidance “had resulted in significant litigation, particularly in Texas and Idaho,” and that “litigation on this issue is likely to continue.” The mention of the Purl v. United States Department of Health and Human Services case is another specific data point for this indicator.

4. Summary Table of SDGs, Targets, and Indicators

Source: jdsupra.com