Federal appeals court blocks Biden administration guidance protecting abortion access in Texas

A federal appeals court ruled Tuesday that the Biden administration cannot enforce federal guidance instructing doctors to provide abortion care in medical emergencies, no matter state law.

The suit, brought by the state of Texas in 2022, argues that the Department of Health and Human Services (HHS) cannot cite the Emergency Medical Treatment and Active Labor Act (EMTALA) in its guidance that medical providers must provide abortion care in life-saving situations.

The HHS guidance, written just after the Supreme Court’s 2022 abortion decision that overturned Roe v. Wade, said that medical providers must both provide care when a patient cannot afford it and provide abortion care when the life of the patient is at risk. 

The appellate court ruled that only the first provision, regarding patients who cannot afford care, is relevant for federal guidance.

“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. It does not. We therefore decline to expand the scope of EMTALA,” Judge Kurt Engelhardt wrote in the unanimous ruling. 

Engelhardt ruled that the 1986 law does not specify any medical procedures, making the abortion-focused aspect of the guidance unfounded.

A federal judge in Texas first blocked the Biden administration guidance in 2022, with the appeals court upholding that ruling Tuesday.

HHS launched an investigation into two hospitals in Kansas and Missouri in May over allegations that they violated the guidance. 

The Biden administration also cited the EMTALA in a challenge to Idaho’s strict abortion restrictions in November. Idaho similarly argued that the EMTALA does not regard abortion. The state’s ban is under appeal.