Supreme Court Upholds Texas Abortion Ban, Declines Federal Intervention

Monday, the U.S. Supreme Court declined to intervene in the dispute between Texas' near-total abortion ban and federal guidance, upholding a lower court's ruling that state hospitals cannot be forced to provide emergency abortions.

Without providing reasoning, the justices maintained a 5th Circuit Court of Appeals order from January, which stated that Texas hospitals cannot be required to perform abortions violating state law. Texas' abortion ban only allows abortions when a pregnant person's life is at risk or they face "serious risk of substantial impairment of a major bodily function." Doctors fearing severe penalties have interpreted the law to permit only life-saving abortions.

The Fifth Circuit order also states that hospitals are never obligated to terminate pregnancies, even when a patient's life is at risk.

The Biden administration had asked the Supreme Court to affirm its 2022 guidance, which stated that the federal Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals to terminate pregnancies when a patient's life or health is endangered, overriding state abortion bans with narrower exceptions. EMTALA, enacted in 1986, primarily prevents hospitals from turning away uninsured and indigent patients, particularly women in labor.

U.S. Department of Health and Human Services Director Xavier Becerra enacted the guidance in July 2022, shortly after the Supreme Court reversed the federal right to abortion established in Roe v. Wade.

Texas Attorney General Ken Paxton argued that the federal government exceeded its authority with its interpretation of EMTALA, stating that the law does not mandate specific procedures. Paxton also stated in a news release that the guidance's allowance of abortions to "stabilize" a patient would "transform every emergency room in the country into a walk-in abortion clinic."

American Association of Pro-Life Obstetricians & Gynecologists and Christian Medical & Dental Associations joined Texas as plaintiffs in Paxton's 2022 lawsuit against the Biden administration's guidance.

This decision follows the Supreme Court's action several months ago, when it threw out its own order halting emergency abortions in a similar Idaho case, declining to weigh in before trial. The Idaho case, initiated by the Biden administration, is working its way through lower courts and may return to the justices' docket.

Justice Elena Kagan noted in a concurring opinion in June that Idaho's largest emergency services provider had to airlift pregnant women out of state roughly every other week during the five months the order was in place, compared to just once last year.

OB-GYNs and pregnant Texans have repeatedly stated that the wording of Texas' abortion exceptions lacks sufficient clarity about which health conditions legally permit pregnancy termination.