In Texas case, federal appeals panel says emergency care abortions not required by 1986 law

NEW ORLEANS — The Biden administration cannot use a 1986 emergency care law to require hospitals in Texas hospitals to provide abortions for women whose lives are at risk due to pregnancy, a federal appeals court ruled Tuesday.

It's one of numerous cases involving abortion restrictions that have played out in state and federal courts after the U.S. Supreme Court ended abortion rights in 2022. The administration issued guidance that year saying hospitals "must" provide abortion services if there's a risk to the mother's life, citing the Emergency Medical Treatment and Labor Act of 1986, which requires emergency rooms to provide stabilizing treatment for anyone who arrives at the emergency room.

Texas state courts have also been brought separate cases about when abortion must be allowed there, despite bans on it under most circumstances. The Texas Supreme Court ruled last month against a woman who asked for permission to abort a fetus with a fatal diagnosis. The same court heard arguments in November on behalf of women who were denied abortions despite serious risks to their health if they continued their pregnancies; the justices have not ruled on that case.

Abortion opponents have challenged the emergency care law guidance in multiple jurisdictions. In Texas, the state joined abortion opponents in a lawsuit to stop the guidance from taking effect and won at the district court level. The Biden administration appealed to the 5th U.S. Circuit Court of Appeals, which has jurisdiction in Texas, Louisiana and Mississippi. But the appeal was rejected in Tuesday's ruling by a unanimous three-judge panel.

The ruling said the guidance cannot be used to require emergency care abortions in Texas or by members of two anti-abortion groups that filed suit — the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations. The California-based 9th Circuit has allowed use of the guidance to continue in an Idaho case, which is pending at the U.S. Supreme Court.

Opponents of the guidance said Texas law already allows abortions to save the life of the mother, but that the federal guidance went too far, calling for abortions when an emergency condition is not present and eliminating obligations to treat the unborn child.

The 5th Circuit panel sided with Texas. The opinion said language in the 1986 emergency care law requires hospitals to stabilize the pregnant woman and her fetus.

"We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child especially when EMTALA imposes equal stabilization obligations," said the opinion written by Judge Kurt Engelhardt.

In the appellate hearing last November, a U.S. Justice Department attorney arguing for the administration said the guidance provides needed safeguards for women, and that the district court order blocking the use of the guidance was an error with "potentially devastating consequences for pregnant women within the state of Texas."

The panel that ruled Tuesday included Engelhardt and Cory Wilson, nominated to the court by former President Donald Trump, and Leslie Southwick, nominated by former President George W. Bush.

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