Emergency Rooms or Abortion Clinics? Texas Faces Off with Biden 

In 2022, a Texas federal court blocked an attempt by the Biden administration to compel the state’s emergency room physicians to perform abortions, irrespective of their religious convictions.

Judge James W. Hendrix of the federal district court predicted that Texas and two pro-life physician groups would likely win their lawsuit against the Department of Health and Human Services (HHS). The case was titled Texas et al. v. Xavier Becerra, et al.

Two groups challenge the mandate: 

  • Christian Medical and Dental Associations
  • American Association of Pro-Life Obstetricians and Gynecologists. 

They argued that the Biden administration’s directive misapplied the Emergency Medical Treatment and Labor Act (EMTALA) to enforce abortion provisions in situations where Texas law, through the Texas Human Life Protection Act, prohibits them.

The lawyers representing the Biden administration have taken legal action to compel Texas to permit abortions, which goes against the state’s laws. The matter is set to be discussed during oral arguments at the U.S. Court of Appeals for the 5th Circuit regarding the case of State of Texas v. Becerra, where the lawyers representing the Biden administration will face off against those representing the state.

Alliance Defending Freedom (ADF) attorneys representing the two medical associations have stated that the case addresses the improper use of federal law to coerce emergency physicians into performing abortions. They have requested the appeals court to maintain the district court’s decision.

Ryan Bangert, ADF Senior Vice President, will argue that emergency rooms, intended as life-preserving institutions, should not be converted into facilities for elective abortions. He emphasized that while emergency room physicians can treat conditions like ectopic pregnancies, elective abortions are not considered life-saving and should not be mandated by the government.

EMTALA, enacted in 1986, mandates that public access to emergency services be provided without regard to ability to pay. It requires government-funded hospitals to offer necessary stabilizing treatment for emergency medical conditions.

HHS Secretary Xavier Becerra in July issued guidance interpreting EMTALA to mean that if a physician determines that an abortion is needed to stabilize a pregnant patient’s emergency medical condition, the treatment must be provided even if state law restricts abortions.

This interpretation suggests that in cases where state laws do not align with EMTALA’s definition of an emergency medical condition, the federal law would take precedence, potentially classifying elective abortions as emergency medical conditions.

Critics argue that this is an inappropriate application of EMTALA. Judge Hendrix pointed out that the act, which aims to protect both mother and unborn child, does not specifically address abortion. Thus, the HHS’s guidance was deemed unauthorized.

In a related case in Idaho, U.S. District Judge B. Lynn Winmill ruled that the state’s restrictive abortion law conflicts with federal law because it nearly entirely prohibits abortion. He noted that physicians could not comply with both federal and state laws, indicating that federal law would supersede state law. Idaho is expected to appeal Judge Winmill’s decision to the 9th Circuit Court of Appeals.