Appeals court rules Texas can ban emergency abortions in spite of federal guidance

A federal appeals court ruled Tuesday that Texas can ban emergency abortions even though the U.S. Department of Health and Human Services says a federal statute takes priority over state laws prohibiting the procedure.

The 5th U.S. Circuit Court of Appeals affirmed a district court’s ruling that sided with Texas Attorney General Ken Paxton. The appeal was heard by Judge Leslie Southwick, an appointee of President George W. Bush, and Trump appointees Kurt Engelhardt and Cory Wilson.

“The Texas plaintiffs argument that medical treatment is historically subject to police power of the States, not to be superseded unless that was the clear and manifest purpose of Congress, is convincing,” Engelhardt wrote.

Spokespeople for the Justice Department and the Texas attorney general did not immediately respond to requests for comment Tuesday evening.

The Texas Supreme Court last month denied a request for an emergency court order allowing Kate Cox, a pregnant woman who learned her fetus had a fatal diagnosis, to have an abortion in the state. Cox ended up leaving the state to get the procedure.

Protesters hold signs at a rally at the Texas Capitol in Austin. (Montinique Monroe / Getty Images)

Paxton, a Republican, had sued to block guidance from the Department of Health and Human Services in 2022 that said medical providers should offer abortions in emergency situations, in accordance with a 1986 federal law that requires doctors to provide the emergency services needed to stabilize any person who comes into an emergency room regardless of the patient’s ability to pay.

The Biden administration had appealed a ruling by U.S. District Judge James Wesley Hendrix, who in 2022 barred the federal agency from enforcing the guidance in Texas and against two anti-abortion groups of doctors.

In his ruling, Hendrix found that the department’s guidance went “well beyond” the text of the law known as the Emergency Medical Treatment and Labor Act.

The appeals court agreed with the district court’s finding that the federal statute, known as EMTALA, “does not provide an unqualified right for the pregnant mother to abort her child especially when EMTALA imposes equal stabilization obligations,” Engelhardt wrote in Tuesday’s opinion.

“We therefore decline to expand the scope of EMTALA,” he added.

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