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 January 3, 2024

Court blocks Biden administration's federal guidance instructing doctors to ignore state law and provide abortion care

A federal appeals court issued a ruling on Tuesday, declaring that the Biden administration is barred from enforcing federal guidance instructing doctors to offer abortion care during medical emergencies, regardless of state law.

The lawsuit, initiated by the state of Texas in 2022, contends that the Department of Health and Human Services (HHS) cannot reference the Emergency Medical Treatment and Active Labor Act (EMTALA) in its guidance mandating medical providers to deliver abortion care in life-threatening situations.

The ruling

The HHS guidance, crafted shortly after the Supreme Court's 2022 abortion decision overturning Roe v. Wade, stipulates that medical providers must not only offer care when a patient is unable to afford it but also provide abortion care when the patient's life is at risk.

The appellate court ruled that only the first provision, pertaining to patients unable to afford care, is applicable to federal guidance.

"The question before the court is whether EMTALA, according to HHS’s Guidance, mandates physicians to provide abortions when that is the necessary stabilizing treatment for an emergency medical condition. It does not. We, therefore, decline to expand the scope of EMTALA," wrote Judge Kurt Engelhardt in the unanimous ruling.

Engelhardt emphasized that the 1986 law does not specify any medical procedures, undermining the abortion-focused aspect of the guidance.

The previous decision

Initially, a federal judge in Texas blocked the Biden administration's guidance in 2022, a ruling upheld by the appeals court on Tuesday.

HHS initiated an investigation into two hospitals in Kansas and Missouri in May over allegations of violating the guidance.

In November, the Biden administration cited the EMTALA in challenging Idaho's stringent abortion restrictions. Idaho argued similarly that the EMTALA does not encompass abortion, and the state's ban is currently under appeal.

The background

This ruling follows the Texas Supreme Court's decision last month, which denied a pregnant woman's request for an emergency procedure due to the state's abortion ban.

In August 2022, U.S. District Judge James Wesley Hendrix sided with Attorney General Paxton, deeming the HHS rule "unauthorized" and exceeding the text of a related federal law.

The judge acknowledged that EMTALA "protects both mothers and unborn children." However, the federal guidance, being "silent as to abortion," requires doctors to prioritize the mother's well-being in emergency care to stabilize her condition, disregarding the unborn child.

Rather than issuing a nationwide injunction, the judge opted to restrict HHS from enforcing the guidance and its interpretation of the Emergency Medical Treatment and Active Labor Act solely in Texas.

In its lawsuit contesting the guidance, Texas asserted that EMTALA does not grant the federal government the authority to compel healthcare providers to perform abortions.

Written By:
Dillon Burroughs

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