When the U.S. Supreme Court overturned Roe v. Wade in 2022, it returned the issue of abortion to the people and their elected lawmakers—allowing states to enact strong pro-life policies.
But the Biden administration attempted to undermine that ruling by misusing federal law to override state law and force doctors to perform abortions.
Representing multiple pro-life medical associations alongside the state of Texas, Alliance Defending Freedom stood up to this abuse of power.
What is the Emergency Medical Treatment and Active Labor Act?
Congress passed the Emergency Medical Treatment and Active 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 uninsured or unable to pay.
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 began attempting to misuse EMTALA to force doctors to perform abortions.
Texas protects life
Currently, Texas law protects every person’s life, including the unborn, allowing abortion only to save the life of the mother.
According to the state’s Human Life Protection Act, which went into effect following the overturning of Roe, “[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.
In this case, ADF attorneys represented doctors around the country 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).
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 proceeded, and the court made that injunction permanent in December 2022. The 5th Circuit upheld this decision in January 2024, and the Biden administration then appealed. In October 2024, the U.S. Supreme Court denied the administration’s request to hear the case, effectively bringing an end to the lawsuit.
In a similar case, Idaho Attorney General Raúl Labrador, together with ADF and Cooper & Kirk, is also challenging the Biden administration’s misuse of EMTALA. That case was heard by the Supreme Court in its 2024 term, and the lawsuit is continuing after the Court declined to rule on the merits of the case.
The government shouldn’t force a doctor or hospital to perform an abortion. The Biden administration’s abortion rule violated the rights of AAPLOG members, CMDA members, and other doctors who have ethical and medical objections to performing abortions.
Becerra v. State of Texas
- July 2022: After the Biden administration issued guidance declaring that 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 ADF’s request to temporarily halt enforcement of the mandate while the lawsuit proceeded. The Biden administration appealed the decision.
- December 2022: The federal district court finalized its injunction to permanently protect Texas and members of AAPLOG and CMDA if the ruling is upheld on appeal.
- November 2023: Oral argument was heard at the U.S. Court of Appeals for the 5th Circuit.
- January 2024: The 5th Circuit ruled that the Biden administration cannot use EMTALA to force emergency room doctors to perform abortions.
- April 2024: The Biden administration asked the U.S. Supreme Court to review the case and reverse the injunction.
- October 2024: The U.S. Supreme Court denied the Biden administration’s request to hear the case.