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Appeals court blocks Biden from forcing emergency room doctors to perform abortions

BRENDAN SMIALOWSKI/AFP via Getty Images
BRENDAN SMIALOWSKI/AFP via Getty Images

An appeals court has rejected the Biden administration’s effort to use a federal law to force emergency room doctors to perform abortions in Texas, upholding a lower court decision.

A three-judge panel of the United States Court of Appeals for the Fifth Circuit unanimously ruled Tuesday to continue an injunction against the Biden administration’s federal guidance requiring emergency room medical staff to perform abortions.

Circuit Judge Kurt D. Englehardt, a Trump appointee, authored the panel opinion, concluding that the federal Emergency Medical Treatment and Labor Act does not require hospitals to provide abortions.

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“EMTALA does not govern the practice of medicine,” wrote Englehardt. “While EMTALA directs physicians to stabilize patients once an emergency medical condition has been diagnosed … the practice of medicine is to be governed by the states.”

“EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law. The injunction squarely enjoins HHS from enforcing the Guidance and Letter regarding these two issues within the State of Texas and against the plaintiff organizations.”

Chelsey Youman, national legislative advisor with the pro-life group Human Coalition Action, celebrated the decision in an emailed statement shared with The Christian Post. 

“We are grateful that the court recognized the authority of states to protect human life and refused to classify abortion as necessary health care,” said Youman. “Texas has led the way in protecting innocent human life, and we are grateful to Attorney General Paxton for upholding the transformative pro-life laws of the state.”

Senior Staff Attorney Rabia Muqaddam of the pro-choice group the Center for Reproductive Rights, said in a statement to Time magazine that she believed the ruling “shows a complete disregard for the lives of pregnant people.”

EMTALA was passed in 1986 and focuses on "public access to emergency services regardless of ability to pay," requiring hospitals participating in Medicare to provide medical services to all people.

"Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented," explains an EMTALA information page.

In July 2022, shortly after the United States Supreme Court overturned Roe v. Wade, the U.S. Department of Health and Human Services issued guidance claiming that EMTALA required hospital emergency staff to provide abortions.

In response to the guidance, the office of Texas Attorney General Ken Paxton filed suit against the Biden administration, being joined by the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations.

U.S. District Judge James Wesley Hendrix in Lubbock granted a preliminary injunction against the guidance in August 2022, arguing in part that EMTALA “protects both mothers and unborn children, is silent as to abortion, and preempts state law only when the two directly conflict.”

“Since the statute is silent on the question, the Guidance cannot answer how doctors should weigh risks to both a mother and her unborn child. Nor can it, in doing so, create a conflict with state law where one does not exist,” he added.

“Texas law already overlaps with EMTALA to a significant degree, allowing abortions in life-threatening conditions and for the removal of an ectopic or miscarried pregnancy.”   

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