Health Law

Federal judges issue conflicting rulings on emergency abortions when health of mothers is at risk

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Federal judges in Idaho and Texas have issued conflicting decisions on whether a federal law requiring stabilizing emergency care conflicts with abortion bans.

The federal law at issue is the Emergency Medical Treatment and Active Labor Act. The law, known as the EMTALA, requires hospitals that receive federal Medicare funds to provide necessary stabilizing treatment to arriving emergency room patients with medical conditions that pose a risk to their lives, put their health in serious jeopardy, or create a risk of serious impairment.

The judges in both cases considered state abortion bans that have exceptions to prevent the death of the mother but not to protect the health of the mother.

Senior U.S. District Judge B. Lynn Winmill of the District of Idaho on Wednesday blocked Idaho from enforcing its abortion ban in emergency situations covered by the EMTALA, report Reuters, the Washington Post and Law.com. The injunction remains in place during litigation.

Winmill ruled in a lawsuit filed Aug. 2 by the U.S. Department of Justice. The federal government had argued that the Idaho law puts emergency doctors at risk of criminal liability for performing abortions unless they can show that the procedure was necessary to prevent the death of the pregnant woman.

Idaho law prevents abortions but allows doctors to assert an affirmative defense that they performed an abortion to save the pregnant woman’s life.

U.S. Attorney General Merrick Garland praised the Idaho decision in an Aug. 24 press release.

“Today’s decision by the district court for the District of Idaho ensures that women in the state of Idaho can obtain the emergency medical treatment to which they are entitled under federal law,” Garland said. “This includes abortion when that is the necessary treatment. As the district court ruled, a state law that attempts to prevent a hospital from fulfilling its obligations under EMTALA violates federal law and the supremacy clause of the U.S. Constitution.”

A different federal judge, Judge James Wesley Hendrix of the Northern District of Texas, ruled against the federal government Tuesday in a different lawsuit filed by the state of Texas. Hendrix barred the Biden administration from enforcing its emergency room guidance in the state.

Texas law bans abortions, except when necessary to protect the mother’s life or to avoid a risk of substantial impairment to a major bodily function. The federal guidance is broader partly because it says abortions may be needed for emergency medical conditions that are likely to become emergent and for situations in which the health of a pregnant woman is in serious jeopardy.

Hendrix said the guidance “goes well beyond EMTALA’s text, which protects both mothers and unborn children” and is “silent as to abortion.”

Federal law doesn’t specify how a doctor should act when there is a conflict between the health of the mother and the unborn child, Hendrix said. The Texas law “fills this void.”

Texas Attorney General Ken Paxton praised the decision in an Aug. 24 press release.

“We’re not going to allow left-wing bureaucrats in Washington to transform our hospitals and emergency rooms into walk-in abortion clinics,” Paxton said.

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