(NEW YORK) — A federal appeals court ruled this week that Texas hospitals and doctors are not required to perform emergency abortions despite guidance from the Biden administration.
The U.S. Court of Appeals for the 5th Circuit, in a unanimous decision on Tuesday, said the federal government had misinterpreted the Emergency Medical Treatment and Labor Act (EMTALA) and that the law “does not mandate any specific type of medical treatment, let alone abortion.”
Here’s what it means when it comes to abortion access in Texas:
In July 2022, the U.S. Department of Health & Human Services (HHS) issued guidance that under EMTALA, which was passed in 1986, doctors must perform abortions in emergency departments — even in states where the procedure is illegal — if the patient needs “stabilizing medical treatment” for an emergency medical condition.
The move was one of the attempts of the Biden administration to preserve abortion access in Texas since the U.S. Supreme Court overturned Roe v. Wade in June 2022, ending federal protections for abortion rights.
In response, Texas Attorney Gen. Ken Paxton and two anti-abortion groups — the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations — filed a lawsuit arguing that the guidance would “force abortion” from the federal government despite the state’s laws.
EMTALA ensures that emergency patients receive services and treatment regardless of ability to pay. Hospitals that refuse to provide “necessary stabilizing care” or “an appropriate transfer” can face civil monetary penalties.
“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,” Judge Kurt Engelhardt of the 5th Circuit wrote in the ruling. “It does not. We therefore decline to expand the scope of EMTALA.”
Engelhardt also wrote that EMTALA “does not provide an unqualified right for the pregnant mother to abort her child.”
The federal court upheld a lower court order preventing enforcement statewide and against members of either of the two anti-abortion groups anywhere in the United States.
Texas has multiple abortion bans in place and is one of at least 16 states that has ceased nearly all abortion services since Roe was overturned, according to an ABC News review.
Texas’ bans include exceptions that allow abortions in cases of medical emergencies and fatal fetal diagnoses, but doctors and patients have claimed, in a separate lawsuit filed in March, that they are unable to provide care or have been denied care, respectively, under the laws.
Under state law, it is a second-degree felony to perform or attempt an abortion, punishable by up to life in prison and a fine of up to $10,000. The law also allows private citizens to sue anyone who “aids or abets” an abortion.
In the limited cases when abortion is allowed, a person is required to make two trips, one for in-person counseling and another 24 hours later or longer for the abortion, according to the Guttmacher Institute, a research group that focuses on sexual and reproductive health.
Only a physician is allowed to perform an abortion and medication abortion must be given in person because the use of telemedicine for abortion services is banned.
Recently, the Texas Supreme Court ruled against a woman, Kate Cox, who sued the state for an emergency abortion after she was denied despite the fetus having a fetal anomaly and being told that continuing the pregnancy would impact her fertility.
Last month, the state high court ruled that those two aspects did not “pose the heightened risks to the mother the exception encompasses.”
The court is also considering a lawsuit brought by 20 women and two doctors on behalf of their patients asking the Court to clarify what conditions qualify under the “medical emergency” exceptions of the state’s abortion bans and allow doctors to use their medical judgement to decide if a patient needs an abortion without fear of being prosecuted.
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