When the United States Supreme Court overturned Roe v. Wade in its Dobbs v. Jackson Women’s Health Organization decision, it returned the issue of abortion to the people and their elected lawmakers—once again allowing states to enact strong pro-life policies, for the first time in nearly 50 years.
Now, the Biden administration is attempting to undermine that ruling by misinterpreting federal law to unilaterally create a new abortion mandate within hospital settings. Thankfully, the state of Texas and two pro-life physician organizations are standing up to this abuse of power.
What is the Emergency Medical Treatment and Labor Act?
The U.S. Congress passed the Emergency Medical Treatment and Labor Act (EMTALA) in 1986. It requires all hospitals that participate in Medicare to provide medical screening and stabilizing treatment for emergency medical conditions, even if the patient is not able to pay.
The primary purpose of EMTALA was to prevent ”patient dumping,” which is the practice of refusing to treat patients who are unable to pay. It ensured that hospitals could not turn away patients who required immediate medical assistance but might not be insured.
EMTALA explicitly states that hospitals are required to provide treatment to stabilize emergency medical conditions for both a pregnant mother and her “unborn child.” The act clearly outlines the need to protect unborn children, not harm them.
But following the Supreme Court’s decision to overturn Roe, the Biden administration is attempting to redefine EMTALA to mandate the performance of abortions.
Currently, abortion is against the law in the state of Texas.
According to the state’s Human Life Protection Act, which went into effect following the overturning of Roe v. Wade, “[a] person may not knowingly perform, induce, or attempt an abortion.” Texas also has several laws predating Roe that prohibit anyone in the state from causing an abortion or acting as an accomplice to an abortion or attempted abortion.
All these laws include exceptions in cases where the life of the mother is at risk. And doctors in Texas, as in every other state, can and do treat ectopic pregnancies and other life-threatening conditions in the emergency room. But that is not enough for the Biden administration.
In July 2022, the Centers for Medicare and Medicaid Services issued guidance purporting to remind states about their duties under EMTALA. In reality, the guidance created new requirements that have never existed in federal law.
Instead of requiring a doctor to provide treatment for both mothers and unborn children, this new guidance said doctors must perform abortions if “abortion is the stabilizing treatment necessary to resolve [an emergency medical condition].” And it did not limit the definition of an “emergency medical condition” to cases where the mother’s life is in danger, but rather included “incomplete medical abortions” and undefined “health” conditions.
The federal government has previously defined “health” conditions for pregnant women to include social and emotional health, and the term “incomplete medical abortions” refers to chemical abortions that could have been initiated elsewhere. In other words, this new guidance effectively forces doctors to perform elective abortions in a variety of circumstances even when both the mother and the unborn child could be saved.
Alliance Defending Freedom attorneys are representing doctors who are members of two pro-life organizations—the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) and the Christian Medical and Dental Associations (CMDA). If the new abortion rule from the Biden administration stands, these doctors will be forced to perform abortions in violation of their deeply held beliefs.
If hospitals do not comply with the Biden administration’s abortion rule, the administration threatens to revoke all federal funding from them. At the same time, since Texas law prohibits elective abortion, the hospitals face criminal penalties if they perform the elective abortions that the Biden administration is attempting to mandate.
In addition to their own ethical concerns, AAPLOG members, CMDA members, and other doctors in Texas would be forced to choose between violating the federal abortion mandate or violating state law. Either choice would come with the threat of significant punishment.
The state of Texas, AAPLOG, and CMDA filed a lawsuit in July 2022 seeking to have the unconstitutional abortion mandate struck down. Less than a month later, a federal district court in Texas granted our request to temporarily halt the mandate while the lawsuit proceeds.
What’s at stake?
The Biden administration is attempting to circumvent Congress by twisting an existing federal law into a new mandate to perform abortions. It is gravely overstepping its authority and trying to preempt decisions made by the people of Texas through their elected representatives.
In addition, the Biden abortion rule would violate the rights of AAPLOG members, CMDA members, and other doctors who have ethical and medical objections to elective abortions.
- July 2022: After the Biden administration issued guidance declaring EMTALA mandates the performance of some elective abortions, the state of Texas, AAPLOG, and CMDA filed a lawsuit seeking to have the Biden administration’s unconstitutional abortion mandate struck down.
- August 2022: A federal district court in Texas granted our request to temporarily halt enforcement of the mandate while the lawsuit proceeds.
The bottom line
The Biden administration cannot be allowed to twist a longstanding federal law into an unprecedented mandate to perform abortions.