Attorney General Bonta Launches Statewide Survey to Ensure Hospitals Follow Emergency Reproductive Healthcare Laws

OAKLAND – California Attorney General Rob Bonta today announced the launch of a statewide survey to assess how hospital emergency departments are complying with reproductive healthcare laws, particularly when abortion care is the medically necessary emergency treatment.

The survey is being conducted by the California Department of Justice’s Healthcare Rights and Access Section as part of an ongoing effort to identify and address gaps in emergency care across the state. The findings will help determine whether hospitals are meeting their legal obligations under California’s Emergency Services Law (ESL) and will ensure patients are receiving the care they are entitled to without delay or denial.

“Access to emergency abortion care is not optional. It’s the law,” said Attorney General Bonta. “No patient should need to wonder whether they will receive the care they need in a medical emergency. We’re letting the facts and data lead the way to ensure every hospital in California is fulfilling its responsibility to protect patients’ health and dignity.”

California’s Emergency Services Law (ESL)

California’s Emergency Services Law requires every general acute care hospital with an emergency department to treat all patients experiencing a medical emergency regardless of insurance, ethnicity, citizenship, age, preexisting medical condition, immigration status, or ability to pay, among other protected characteristics.

Patients have the right to receive the emergency healthcare needed to determine if they have an emergency medical condition, as well as the emergency healthcare needed to relieve or eliminate that emergency medical condition, provided the hospital has the personnel and facilities to provide such healthcare. Under the law, hospitals must act not only when a person’s life is in danger, but also when a patient is experiencing acute symptoms and, without immediate medical attention, the patient could reasonably be expected to face serious:

•  Jeopardy to their health 
•  Impairment to bodily functions
•  Dysfunction to any organ or body part

Despite these clear legal protections, the Department has received alarming reports of hospitals refusing to provide emergency abortion care, including delaying treatment and placing patients at risk of infection, hemorrhage, or permanent harm. This practice fails to meet the standard of care required by California law.

Providence St. Joseph's Lawsuit Highlights Dangers of Delayed Reproductive Care

In September 2024, Attorney General Bonta filed a lawsuit against Providence St. Joseph Hospital (Providence) alleging it violated multiple California laws due to its refusal to provide emergency abortion care to people experiencing obstetric emergencies. One particular patient, Anna Nusslock, had her water break when she was 15 weeks pregnant with twins on February 23, 2024. Despite the immediate threat to her life and health, and despite the fact her pregnancy was no longer viable, Providence refused to treat her with the necessary abortion or induction. She had to travel to a small critical access hospital called Mad River, 12 miles away, where she was actively hemorrhaging by the time she was on the operating table.

Emergency Reproductive Health Laws

The survey also seeks to ensure that designated hospitals offer Sexual Assault Forensic Exams (SAFE), which are designed to gather evidence of sexual assault and provide healthcare services, including medical and mental health treatment. Victims of sexual assault are entitled to a SAFE exam from a trained medical professional free of charge. Sexual assault victims shall be provided with the option of emergency contraception at no cost. All patients are entitled to obtain a prescription for emergency contraception, where medically appropriate. 

Statewide Survey Will Evaluate Hospital Compliance

The survey will reach approximately 333 hospitals across California, gathering detailed information about how emergency departments administer reproductive healthcare and how they respond when abortion care is the required emergency treatment. Results from the survey will inform oversight, guide enforcement efforts, and ensure hospitals are fully complying with the Emergency Services Law.