“This guidance goes far beyond the text of EMTALA, which protects both mothers and unborn children, is silent on abortion, and preempts state law only when the two directly conflict. Since the statute is silent to the question, the Guidance cannot answer how physicians should weigh the risks to both the mother and her unborn child. Nor can it, in doing so, create a conflict with state law where none exists.” Hendrix wrote in his opinion granting a preliminary injunction against HHS enforcing the guidance in Texas or against members of the American Association of Pro-Life Obstetricians & Gynecologists or Christian Medical & Dental Associations. “Under HHS’s reading, if the physician initially determines that the unborn child does not have a medical emergency, the physician must then turn a blind eye to the health of the unborn child for the remainder of treatment. This directly conflicts with the physician’s ongoing treatment duty to provide care for both the mother and the unborn child when stabilizing a pregnant woman,” the judge said. “Because the physician has a duty to both, EMTALA does not require the physician to enter a medical emergency in one to stabilize the other. Again, EMTALA does not say how to balance both interests. It leaves that determination to the physician, who is bound by state law.” Texas’ lawsuit against the Biden administration challenging the guidance was a preemptive strike against one of the few tools the Biden administration sought in its response to Dobbs. Texas already has extreme limits on access to abortion, and Hendrix’s ruling came shortly before the state’s so-called “trigger ban,” a criminal law that bans abortion in most contexts, took effect Thursday. Following the Supreme Court decision striking down the federal right to abortion, HHS, through the Centers for Medicare & Medicaid Services, issued guidance on July 11 on EMTALA, reminding providers of their duty to provide emergency care, including abortion and affirming that the act protects providers who offer legally authorized emergency abortion services. The Texas Attorney General, a Republican, filed suit against HHS on July 14, alleging that the guidance forces hospitals and doctors to commit crimes and risk their licenses under Texas law and that EMTALA does not authorize the federal government compel health care providers to perform abortions. CNN has reached out to HHS and Paxton’s office for comment. In a statement, White House press secretary Karine Jean-Pierre slammed the decision as “a blow to Texans” that “will prevent medical providers from providing life-saving and health-sustaining care.” Separately, the Biden Justice Department cited EMTALA to challenge parts of an Idaho trigger ban that also takes effect Thursday. In that case, the Justice Department is asking a federal judge to block parts of Idaho’s law to the extent it conflicts with EMTALA, threatening to prosecute doctors who provide emergency medical abortions to pregnant women who face serious risks to their health. health. Idaho offers an exemption only for abortions provided when they are “necessary” to prevent death, while the Justice Department maintains that EMTALA requires that emergency abortion care be offered in scenarios where patients face another serious health risk, if not necessarily the threat of death. In that case, the judge said he would issue his order on Wednesday. In oral arguments this week, the judge appeared willing to grant the Justice Department’s request and was not bound by the district court’s decision in Texas. Regardless of how it rules, one or both cases are likely to be appealed — making it possible in the coming weeks for the Supreme Court to be asked again to look at abortion and examine how federal standards interact for emergency care. state abortion bans. This story has been updated with additional reaction.
