Texas hospitals not required to provide emergency abortions, federal appeals court rules

Texas hospitals are not required to perform emergency abortions despite federal guidance to the contrary, a federal appeals court in Louisiana ruled Tuesday.

The opinion grants Texas Attorney General Ken Paxton’s request to block a Biden administration order that said hospitals must treat pregnant patients facing medical emergencies, including by terminating a pregnancy if necessary. Those emergencies include ectopic pregnancy, complications from loss of pregnancy and preeclampsia, per the letter.

In the July 11, 2022 letter, Department of Health and Human Services head Xavier Becerra said hospitals held this obligation under the Emergency Medical Treatment and Active Labor Act, a law requiring hospitals to treat patients facing health crises regardless of their ability to pay. The letter said that the order would preempt state law that "does not include an exception for the life and health of the pregnant person."

More: Paxton sues Biden administration over emergency rooms performing abortion to save a life

The DHS issued the guidance just days after the U.S. Supreme Court struck down Roe v. Wade, the landmark case establishing the right to abortion. Texas law currently prohibits abortion entirely except to save the life of the mother.

Paxton initially filed the suit against Becerra, the HHS and the Centers for Medicare and Medicaid Services in a U.S. district court in Lubbock on July 14, 2022.

In the complaint, Paxton argued that the EMTALA "does not authorize—and has never authorized—the federal government to compel healthcare providers to perform abortion." He called the order "The Abortion Mandate," writing "the Biden Administration seeks to transform every emergency room in the country into a walk-in abortion clinic" in a press release.

More: 'Emotional torture': Austin woman's story of a doomed pregnancy amid abortion ban

Judge James Wesley Hendrix of a U.S. district court in Lubbock sided with Paxton and his co-plaintiffs, two anti-abortion medical associations, ruling that the federal government had overstepped its authority in issuing the guidance on abortions.

A three-judge panel heard the Justice Department's appeal of that decision at the 5th Circuit Court of Appeals in New Orleans on Nov. 7. Judges Kurt Engelhardt and Cory Wilson were appointed by former President Donald Trump and the third, Judge Leslie H. Southwick, was appointed by President George W. Bush.

The court's Tuesday opinion affirms the Lubbock ruling, stating that the EMTALA "does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law."

The decision seems unlikely to change practices in Texas hospitals, where record-low abortion numbers indicate physicians' compliance with state bans. However, the ruling in Paxton's favor adds momentum to his campaign to crack down on abortion in the state, coming just weeks after he successfully appealed a state district judge’s order blocking enforcement of Texas' abortion ban against a Dallas woman, Kate Cox, who sought to terminate a nonviable pregnancy.

The next test of Texas' post-Roe abortion laws is currently pending before the Texas Supreme Court in Zurawski v. Texas, with a decision expected before June. Brought by 20 women and two OB-GYNs, the lawsuit alleges that the state's lack of guidance on abortion ban exceptions has caused providers to delay or deny necessary medical care.

This article originally appeared on Austin American-Statesman: Texas can ban emergency abortions despite federal guidance, court rules