Despite the legal implementation of Texas’ Heartbeat Act, which criminalizes abortions once a fetal heartbeat is detected—typically at six weeks—a federal law initially allowed for exceptions. Enacted in 1986, the Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals receiving Medicare funding to provide stabilizing treatment to anyone arriving in an emergency department regardless of insurance status or ability to pay. On July 11, 2022, two weeks after the overturning of Roe v. Wade, the Biden administration issued guidance documents regarding EMTALA through the Department of Health and Human Services. That same year, Texas held the largest population of uninsured residents under 65.
The guidance issued by the Biden administration reaffirmed that under EMTALA, hospitals must provide an abortion if it is necessary to stabilize a patient, regardless of state laws banning or restricting the procedure. Three days later, on July 14, 2022, Texas challenged the guidance, arguing it unlawfully overrode state abortion laws. In December 2022, the U.S. District Court for the Northern District of Texas ruled in favor of Texas and granted a preliminary injunction. The Biden administration appealed, but the Fifth Circuit Court upheld the ruling on January 2, 2024, leaving Texas hospitals exempt from federal requirements to provide emergency abortions, even in life-threatening situations.
The Biden administration has since petitioned the US Supreme Court to review the decision, seeking to overturn it. However, on October 7, 2024, the Supreme Court declined to take the case, allowing the existing ruling to stand. Texas has become the first state in the country where hospitals are not federally required to provide emergency abortions, even when a pregnant person’s life is at risk. Attorney General Ken Paxton hailed the decision as a win for state rights, remarking, “The Supreme Court’s decision reaffirms our right to uphold the values of our state without federal overreach. Texans should have the freedom to protect unborn lives as they see fit.”
By allowing Texas to exempt itself from EMTALA’s emergency abortion requirements, the U.S. Supreme Court has set a precedent, citing state sovereignty as the legal justification. This decision could lead other states to pursue similar legal approaches, limiting the availability of life-saving treatments. For many pregnant Texans, this may result in delayed or denied emergency care, increasing the risk of severe health outcomes or even death.
SOURCES
https://apnews.com/article/supreme-court-emergency-abortion-texas-bf79fafceba4ab9df9df2489e5d43e72
https://www.nytimes.com/2024/10/07/us/politics/supreme-court-texas-abortion-biden.html