Texas can ban emergency abortions despite federal guidance, court rules

[January 03, 2024]  By Brendan Pierson

(Reuters) - The U.S. government cannot enforce federal guidance in Texas requiring emergency room doctors to perform abortions if necessary to stabilize emergency room patients, a federal appeals court ruled on Tuesday, siding with the state in a lawsuit accusing President Joe Biden's administration of overstepping its authority.

The ruling by a unanimous panel of the 5th U.S. Circuit Court of Appeals comes amid a wave of lawsuits focusing on when abortions can be provided in states whose abortion bans have exceptions for medical emergencies.

The U.S. Department of Justice declined to comment. The office of Texas Attorney General Ken Paxton and two anti-abortion medical associations that challenged the guidance - the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations - did not immediately respond to requests for comment.

The Biden administration in July 2022 issued guidance stating that the Emergency Medical Treatment and Active Labor Act (EMTALA), a federal law governing emergency rooms, can require abortion when necessary to stabilize a patient with a medical emergency, even in states where it is banned. The guidance came soon after the U.S. Supreme Court overturned its landmark Roe v. Wade ruling, which since 1973 had guaranteed a right to abortion nationwide.

Texas and the associations immediately sued the administration, saying the guidance interfered with the state's right to restrict abortion. A lower court judge in August 2022 agreed, finding that EMTALA was silent as to what a doctor should do when there is a conflict between the health of the mother and the unborn child and that the Texas abortion ban "fills that void" by including narrow exceptions to save the mother's life or prevent serious bodily injury in some cases.

An operating room sits empty at Alamo Women's Reproductive Services, an abortion clinic that closed its doors following the overturn of Roe v. Wade and plans to reopen in New Mexico and Illinois, in San Antonio, Texas, August 16, 2022. REUTERS/Callaghan O'Hare/File Photo

Circuit Judge Kurt Engelhardt, writing for the 5th Circuit panel, agreed, writing that EMTALA also includes a requirement to deliver an unborn child and it was up to doctors to balance the medical needs of the mother and fetus, while complying with any state abortion laws.

The law "does not provide an unqualified right for the pregnant mother to abort her child," he wrote.

The ruling upheld a lower court order that blocked enforcement of the guidance in Texas and also blocked the administration from enforcing it against members of two anti-abortion medical associations anywhere in the country.

The federal court's decision comes a month after Texas's highest state court ruled against a woman seeking an emergency abortion of her non-viable pregnancy. That court is currently considering a separate lawsuit by 22 women about the scope of the emergency medical exception to Texas's abortion ban.

A federal judge last year reached the opposite conclusion in a similar lawsuit in Idaho, blocking that state's abortion ban after finding it conflicted with EMTALA. The 9th U.S. Circuit Court of Appeals is expected to hear the state's appeal of that ruling later this month.

(Reporting By Brendan Pierson in New York; Editing by Alexia Garamfalvi and David Gregorio)

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