The U.S. Supreme Court in an Oct. 7 ruling declined to hear an appeal from the Biden administration that sought to enforce federal guidance in Texas that requires hospitals to perform abortions in emergency cases.
The Justice Department had filed an appeal to a lower court's decision that said the Emergency Medical Treatment and Labor Act does not cover emergency abortions in Texas. The Supreme Court's Oct. 7 decision means the lower court's previous ruling stands.
Four notes:
- EMTALA is a decades-old federal law requiring hospitals to provide all patients appropriate emergency care and stabilizing treatment when necessary. It has been at the center of legal disputes over whether it preempts state law where abortion is prohibited and does not make exceptions for the health or life of a mother.
- Texas law permits abortion when necessary to prevent the death of a pregnant woman or to prevent "substantial impairment of a major bodily function."
- In July, HHS sent a letter to hospitals reaffirming they have a "legal duty" under EMTALA to ensure all patients with emergency medical conditions are offered stabilizing treatment, including abortion when deemed necessary. The Biden administration has been firm in its stance that in states with strict laws, EMTALA preempts state law when a pregnant patient's health is at risk.
"If a pregnant patient presenting at an emergency department, including certain labor and delivery departments, is experiencing an emergency medical condition as defined by EMTALA, and that abortion is the stabilizing treatment necessary to resolve that condition, the provider must offer that treatment," HHS and CMS wrote in the letter. "And when a state law prohibits abortion and does not include an exception for the life and health of the pregnant individual — or draws the exception more narrowly than EMTALA's emergency medical condition definition — that state law is preempted."
The Sureme Court has in several rulings dismissed taking up the question of whether EMTALA covers abortion in emergency situations. In June, the court ruled in favor of permitting emergency abortions in Idaho, though did not settle the large question of whether the federal law applies to abortions when deemed necessary by physicians to protect the health of a pregnant woman. The Idaho case has returned to the U.S. Court of Appeals for the 9th Circuit.