FederalHealthcareJudicialFederal Court Rules in Favor of Texas, Enjoining Health and Human Services Guidelines on ‘Emergency Abortions’

Health and Human services Secretary claimed that a federal law mandating emergency medical care preempts state laws banning abortion.
August 25, 2022
On August 23, a federal court granted the State of Texas a preliminary injunction against the U.S. Health and Human Services Department (HHS) guidelines aimed at protecting “emergency abortions” in Texas under the Emergency Medical Treatment and Labor Act (EMTALA). 

The State of Texas is joined by the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) and the Christian Medical and Dental Association (CMDA) in the lawsuit. 

EMTALA ensures that individuals who exhibit “emergency medical conditions” are treated for said conditions or transferred to another facility where the condition can be adequately treated. 

In the guidelines, HHS Secretary Xavier Becerra wrote that if an individual is “experiencing an emergency medical condition as defined by EMTALA, and that abortion is the stabilizing treatment necessary to resolve that condition, the physician must provide that treatment.”

“And when a state law prohibits abortion… That state law is preempted.” 

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In their complaint, the State of Texas argues, “The EMTALA Guidance purports to simply remind hospitals of their existing obligations under federal law. But it does not: it includes a number of new requirements related to the provision of abortions that do not exist under federal law.” 

The plaintiffs assert that abortion is not listed as an official treatment to stabilize medical conditions in the EMTALA, and thus the HHS order cannot be fulfilled.

The remaining plaintiffs, AAPLOG and CMDA, also claim in their supporting brief, “[The guidance] requires doctors and hospitals to choose between performing abortions in violation of State law, their consciences, and their medical licenses, or complying with State law and caring for women as they always have.”

They also remind the court that EMTALA prioritizes the health of both the unborn child and the mother.

The AAPLOG and the CMDA are represented by the Alliance for Defending Freedom (ADF), a conservative Christian legal advocacy firm. 

In a press release following the injunction, ADF attorney Denise Harle wrote, “Emergency room physicians can, and do, treat ectopic pregnancies and other life-threatening conditions. Elective abortion is not life-saving care — it ends the life of the unborn.” 

The court agreed with and expanded on this sentiment, arguing that the definition of “emergency medical condition” was too broad as described in the guidance, and that it incorrectly included conditions that could “become emergent.” 

“Both Texas civil and criminal laws prohibit abortion unless there is a threat to the life of the pregnant woman. And HLPA’s language indicates that the life-threatening physical condition must be present, rather than likely to be emergent,” the court wrote.

The Human Life Protection Act (HLPA), which passed in Texas last year, makes elective abortions criminally illegal. 

All states with laws banning abortion allow the procedure if the mother’s life is threatened.

Following the decision, Texas Attorney General Ken Paxton tweeted, “Another win against Biden. I recently sued Biden to block his attempt to use HHS regs to transform every emergency room in the country into a walk-in abortion clinic. Last night, the court ruled in favor of Texas!” 

In a press release, Texas Rep. Brian Harrison (R-Midlothian) said, “Biden has instructed HHS, where I served as Chief of Staff under President Trump, to preempt Texas’s pro-life laws. This defeat is one of many more to come, and I am excited to defeat their unconstitutional efforts next session in the Texas Legislature.”

While Republicans believe that the guidelines represent an effort by the Biden administration to override the Supreme Court and state legislatures, Democrats argue the guidance simply clarifies the duties of physicians to provide emergency medical care to patients.  

In an amicus brief filed on behalf of four prominent medical organizations, the amici curiae argue, “The State’s challenge in this case misunderstands both EMTALA and the on-the-ground practice of emergency medicine.”

“The Guidance is not an ‘Abortion Mandate,’ nor does it turn emergency rooms into ‘walk-in abortion clinics,’” the brief reads. “It merely restates physicians’ obligations under federal law and medical ethics, and explains how those obligations may manifest themselves in real-world emergency situations involving pregnant patients.”


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Hudson Callender

Hudson Callender is a reporter for The Texan and a lifelong resident of San Antonio, Texas. Hudson recently graduated cum laude from Trinity University with majors in Economics and Political Science, and loves to study ancient history. Hudson is also an avid mountaineer, backpacker, and paddler, often leading trips to remote wilderness areas. Outside of his love for nature, history, and Lone Star beer, Hudson spends his weekends arguing with his friends about football, and will always stick up for the Baylor Bears, Dallas Cowboys, and San Antonio Spurs.