Federal judge in Texas blocks Biden administration’s emergency abortion care guidance

A federal judge in Texas has blocked enforcement of a federal health rule that mandates medical providers must be able to provide emergency abortion care, regardless of state-level bans on abortion.

US District Judge James Wesley Hendrix late on 23 August determined that guidance issued by President Joe Biden’s administration under the Emergency Medical Treatment and Active Labor Act was “unauthorised” and “well beyond” the text of the law, which is “silent on abortion”.

“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 wrote in the opinion.

The ruling from Judge Hendrix, who was ppointed by Donald Trump, grants a preliminary injunction against the US Department of Health and Human Services from enforcing the guidance in Texas and against members of two anti-abortion health systems – the American Association of Pro-Life Obstetricians & Gynecologists and Christian Medical & Dental Associations.

The guidance follows the president’s executive order in July – weeks after the US Supreme Court struck down the constitutional right to abortion care – reminding medical providers of their duty to provide emergency abortion care under the Emergency Medical Treatment and Labor Act, which grants public access to emergency services regardless of a patient’s ability to pay.

Texas Republican Attorney General Ken Paxton sued HHS on 14 July, arguing that providers would be in conflict with the state’s severely restrictive anti-abortion laws.

The state is among at least 10 where abortion is outlawed in nearly all instances. A “trigger” law designed to take effect without constitutional protections affirmed by the Supreme Court’s decision in Roe v Wade will take effect on 25 August – that law could punish providers with fines of no less than $100,000 and potentially life in prison.

The US Department of Justice also has sued the state of Idaho, arguing that the state’s anti-abortion law – which outlaws abortion care in nearly all instances, including in emergency medical situtations – violates the federal Emergency Medical Treatment and Labor Act.

Guidance from HHS asserts that “if a physician believes that a pregnant patient presenting at an emergency department is experiencing an emergency medical condition as defined by [federal law], and that abortion is the stabilizing treatment necessary to resolve that condition, the physician must provide that treatment.”

“When a state law prohibits abortion and does not include an exception for the life of the pregnant person – or draws the exception more narrowly than [federal law’s] emergency medical condition definition – that state law is preempted,” according to federal guidance.

Idaho’s law makes exceptions for abortion care when “necessary” to prevent death, which the Justice Department argues puts abortion patients who face other serious health risks or potentially life-threatening complications in jeopardy, in violation of federal law.

A ruling from a separate judge is also expected in that case this week.

White House press secretary Karine Jean-Pierre said the Texas decision “is a blow to Texans”.

“Texas filed this suit to ensure that it can block medical providers from providing life-saving and health-preserving care,” she said in a statement. “Because of this decision, women in Texas may now be denied this vital care – even for conditions like severe hemorrhaging or life-threatening hypertension. It’s wrong, it’s backwards, and women may die as a result.”