In a win for unborn children in Texas, the U.S. Supreme Court declined to hear an appeal from the Biden-Harris administration which seeks to use a federal emergency medical treatment law to force emergency room doctors in the state to perform abortions. In rejecting Becerra et al. v. Texas et al., the High Court’s decision leaves in place a lower court’s ruling from January 2024 which upheld Texas’ pro-life abortion ban and allows doctors to refuse to perform abortions that fall outside the law’s exemption for the life and health of the mother.

Shortly after the Supreme Court overturned Roe v. Wade in July 2022, Secretary Xavier Becerra of the U.S. Department of Health and Human Services issued guidance claiming that the Emergency Medical Treatment and Active Labor Act (EMTALA) required hospitals to provide abortions. This case originated when Texas Attorney General Ken Paxton and two pro-life groups, the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations, sued the Biden administration. They claimed the federal government was attempting to usurp Texas’ abortion law – one of the most protective in the nation – to specifically compel doctors in emergency settings to perform abortions. Secretary Becerra’s guidance stated that abortions “must” be performed when it is deemed “medically necessary” to stabilize a patient, regardless of the state’s abortion restrictions. However, EMTALA never mentions abortion, but rather focuses on public access to emergency medical care for those who cannot afford it. EMTALA only requires hospitals to provide emergency care to pregnant women without discrimination toward any inability to pay for treatment.

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In August 2022 at the lower district court level, U.S. District Judge James Wesley Hendrix originally ruled that Secretary Becerra’s guidance was “unauthorized.”

“[The] Guidance goes well beyond EMTALA’s text, which protects both mothers and unborn children, is silent as to abortion, and preempts state law only when the two directly conflict. Since the statute is silent on the question, the Guidance cannot answer how doctors should weigh risks to both a mother and her unborn child. Nor can it, in doing so, create a conflict with state law where one does not exist,” wrote Judge Hendrix.

Then in January 2024, a three-judge panel at the Fifth Circuit Court of Appeals unanimously upheld that ruling against Secretary Becerra and his guidance. The Fifth Circuit’s ruling underscored that EMTALA does not require doctors to perform abortions respecting both the sanctity of life and state autonomy over the abortion issue. Circuit Judge Kurt Engelhardt determined that EMTALA does not discard the unborn child during a life-threatening medical emergency, and he noted that the law requires hospitals to “stabilize both the pregnant woman and her unborn child.”

“EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law,” stated Judge Engelhardt.

This is not the first time the U.S. Supreme Court has dismissed a case involving the government’s use of EMTALA to force abortions. In June 2024, SCOTUS decided to dismiss a nearly identical case out of Idaho (Idaho v. United States) where the Biden-Harris administration is also using EMTALA in an attempt to trump the state’s abortion law and require doctors to perform abortions under a broader set of health exceptions than the law allows. The High Court also dismissed this case sending it back down to the Ninth Circuit Court of Appeals which had not yet had a chance to hear arguments or decide on the merits of the dispute. The decision, issued without a vote, leaves a preliminary injunction in place that allows emergency abortions in Idaho despite the state’s near-total abortion ban. If the future Ninth Circuit decision conflicts with the Fifth Circuit decision, the Supreme Court will likely need to weigh in and resolve the disputes.

Liberty Counsel Founder and Chairman Mat Staver said, “The Supreme Court was right to dismiss this case and deny a back door attempt by the Biden-Harris administration to advance a pro-death agenda. Hospitals are committed to saving lives, so to say this federal law requires physicians to perform abortions is contrary to the oath they have taken to ‘do no harm.’ The government has no authority to force abortions and has no business telling doctors how to treat their patients.”