Supreme Court Declines To Weigh In On Texas Emergency Abortion Case

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Dive Brief:

• Doctors and hospitals in Texas will not be required to provide abortions for emergency care if the procedure violates the state’s abortion ban, the Supreme Court said Monday.
• Justices refused to review a lower court’s decision that said hospitals in the state are not federally required to provide abortions if they violate Texas law, which has one of the strictest abortion bans in the country.
• It’s a loss for the Biden administration, which has tried to require states to provide abortions for emergency care after the court overturned Roe v. Wade in 2022, ending the federal right to abortion.

Dive Insight:

Since Roe v. Wade was overturned, the Biden administration has attempted to assert that federal law mandates abortions in certain emergency scenarios, even when the procedure is at odds with state abortion bans.

Federal law dubbed the Emergency Medical Treatment and Labor Act, or EMTALA, says hospitals that receive Medicare funds — nearly all hospitals in the country — must provide emergency care to patients before transferring or discharging them.

The Biden administration has argued EMTALA mandates abortions when an emergency procedure would save the life of a pregnant person or prevent serious harm.

Shortly after Roe v. Wade was overturned in 2022, the Biden administration told states they could face fines and legal action if they attempted to prohibit doctors from providing emergency abortions.

States with strict abortion bans have pushed back. In July 2022, Texas Attorney General Ken Paxton filed a lawsuit countering the guidance, arguing the Biden administration’s interpretation of EMTALA would “transform every emergency room in the country into a walk-in abortion clinic.” Paxton also argued the state’s abortion ban already included exceptions to save the life of the mother.

Both a district and appellate court sided with Texas and blocked enforcement of the federal law in the state. The Department of Justice then asked the Supreme Court to intervene.

The justices did not explain why they declined to hear the case, and there were no noted dissents.

Paxton called SCOTUS’ decision a “major win,” but abortion rights groups were dismayed.

“Texas has taken extreme measures to try to evade federal law that requires hospitals to provide emergency abortion care while simultaneously refusing to clarify what the medical emergency exception to its own abortion ban means,” said Beth Brinkmann, senior director of U.S. litigation at the Center for Reproductive Rights, in a statement. “Pregnant people need these protections —it’s a matter of life or death.”

The Texas abortion ban has been the target of multiple lawsuits and federal complaints. In August, two women filed complaints with the HHS alleging hospitals in Texas denied them emergency abortion care.

The Supreme Court’s decision not to hear the Texas case comes months after the court ruled in a similar case. In June, the court said that doctors in Idaho were allowed to perform emergency abortions in contrast with the state’s near-total abortion ban. 

In a 6-3 decision, justices ruled that doctors could perform abortions for life-saving instances in Idaho, but declined to extend its ruling to other states with similar abortion bans, leaving the door open for future litigation and refusing to answer the broader question of whether doctors must adhere to EMTALA or state abortion bans concerning emergency care.

Doctors have reported confusion regarding which laws and guidelines to follow in the more than 20 states that currently restrict abortion.