Texas AG sues Biden for telling doctors to perform abortions as needed in emergencies

At issue is the interpretation of a federal law about "stabilizing" patients.

July 14, 2022, 6:58 PM

Texas Attorney General Ken Paxton on Thursday filed the first legal challenge to President Joe Biden’s executive order on abortion -- accusing the administration of turning emergency health care providers into "walk-in abortion clinics" and kicking off what is expected to be a protracted legal battle between the White House and red states.

At issue is Biden’s interpretation of a federal law that requires doctors to treat patients in medical emergencies, even if they do not have insurance, and provide the necessary “stabilizing treatment."

Under guidance issued Monday, the Health and Human Services Department said the law would require doctors to perform abortions in medical emergencies if their clinical judgement finds such a procedure would help stabilize a pregnant patient.

The guidance was the result of a broader executive order signed by the president earlier this month that called on HHS to to protect reproductive services and expand access to medication abortion in the wake of the Supreme Court overturning Roe v. Wade.

On Thursday, Paxton said the administration went too far and filed a complaint in the U.S. District Court for the Northern District of Texas.

“This administration has a hard time following the law, and now they are trying to have their appointed bureaucrats mandate that hospitals and emergency medicine physicians perform abortions,” Paxton said in a statement.

The White House responded by calling Paxton's position "radical."

Texas Attorney General Ken Paxton speaks to anti-abortion supporters outside the U.S. Supreme Court, Nov. 1, 2021, in Washington, D.C.
Evelyn Hockstein/Reuters, FILE

"This is yet another example of an extreme and radical Republican elected official. It is unthinkable that this public official would sue to block women from receiving life-saving care in emergency rooms, a right protected under US law," press secretary Karine Jean-Pierre said.

Biden’s order and the subsequent HHS guidance were not expected to have a major impact on abortion access in states that restrict it as life-threatening medical emergencies facing pregnant patients are relatively rare.

Still, the order was aimed at addressing concerns by many medical experts that state laws allowing abortion to “save the life of a mother” were vague. Doctors said they weren’t sure how imminent death must be before a provider could act.

In guidance to hospitals on Monday, Health Secretary Xavier Becerra said the federal law -- the Emergency Medical Treatment and Active Labor Act -- should empower doctors to use their best clinical judgement. Becerra noted that because EMTALA is a federal statute, it would take precedence over any state laws restricting abortion.

“As frontline health care providers, the federal EMTALA statute protects your clinical judgment and the action that you take to provide stabilizing medical treatment to your pregnant patients, regardless of the restrictions in the state where you practice,” Becerra wrote.

Health and Human Services Secretary Xavier Becerra speaks about actions the Biden administration plans to take in response to the Supreme Court's decision to overturn Roe v. Wade, June 28, 2022, in Washington.
Patrick Semansky/AP, FILE

According to the HHS guidance, emergency medical conditions involving pregnant patients may include “ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features.”

EMTALA is enforced through complaints. If a hospital is found to violate the law through a federal investigation, it could lose access to the Medicare program or face fines.

A major anti-abortion group, Susan B. Anthony Pro-Life America, said Thursday it agreed with Texas on its suit over Biden’s emergency medical guidance.

In a statement provided to ABC News, the organization said the federal law cited by Biden has never specialized a particular method of stabilizing a patient. And if a pregnant person’s health is in danger “every attempt” should be made to stabilize both the mother and child, even if that means premature delivery.

“The new guidance is a complete distortion of [the law] EMTALA and we firmly stand with AG Paxton in Texas,” the group said.