HOUSTON — Days after the Biden administration moved to provide access to abortion in certain emergency situations, Texas Attorney General Ken Paxton on Thursday filed a lawsuit challenging the federal guidelines, saying they would “force abortion” on state hospitals.
The case was the opening salvo in what is likely to be a lengthy legal tug-of-war between the administration and states like Texas, which have moved quickly to ban abortions in nearly all cases after the Supreme Court’s recent decision to overturn Roe v. Wade.
The lawsuit, which names Mr. Biden’s health minister, Xavier Becerra, as the lead defendant, stems from guidelines issued Monday by the federal Department of Health and Human Services. The agency has instructed hospitals that even in states where abortion is illegal, federal law requires doctors to perform abortions on pregnant women who show up in their emergency rooms if they believe it is the “stabilizing treatment necessary” to resolve an emergency. medical condition.
“President Biden is flagrantly flouting the legislative and democratic process — and ignoring a Supreme Court decision before the ink is dry — by having his bureaucrat-appointed bureaucrats force hospitals and emergency physicians to perform abortions,” Mr. Paxton wrote in the complaint. , filed Thursday in United States District Court in Lubbock, Texas.
White House press secretary Karin Jean-Pierre responded in a statement, citing “yet another example of an extreme and radical Republican elected official.” Without naming Mr. Paxton, the statement said it was “unthinkable that this public official would sue to block women from receiving life-saving care in emergency rooms, a right protected by US law.”
Read more about the end of Roe v. Wade
The suit comes amid an active debate between doctors and hospital advocates in Texas — and other states that have banned all or most abortions — over when the procedure can be authorized in emergencies. Texas law allows exceptions when an abortion would save the pregnant patient’s life or prevent “substantial impairment of essential bodily functions” — the types of situations the federal guidelines focus on, though they leave room for interpretation.
Mr. Paxton has often turned to the courts to voice his opposition to Mr. Biden’s policies; The Texas Tribune reported in April that he had filed 11 immigration-related lawsuits against the administration. He has also filed or joined a series of lawsuits related to Covid-19 policies, including the administration’s efforts to mandate mask-wearing and vaccination.
For Mr. Biden, the legal challenge underscores the pressure he has been under from all sides since the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health, the case that overturned Roe. Abortion rights activists and some liberal lawmakers criticized the president for not acting quickly and decisively enough on the decision.
Under pressure, Mr. Biden issued an executive order last week directing the Department of Health and Human Services and other federal agencies to take all possible steps to do so. But Mr Becerra admitted there was no “magic bullet” to preserve or restore access to abortion.
Monday’s guidance to hospitals was accompanied by a letter from Mr. Becerra to health care providers outlining their responsibilities under the Emergency Medical Treatment and Active Labor Act, known as EMTALA, a 1986 law that requires anyone arriving in emergency department, to be stabilized and treated regardless of their insurance status or ability to pay.
Abortion opponents, including Roger Severino, who led the Health Department’s Office for Civil Rights under former President Donald Trump, said the leadership itself violates the law, which specifies that both a pregnant woman and her unborn child must be stabilized. Mr. Paxton presented this argument in his file.
“No federal law authorizes abortion,” he wrote. “EMTALA is no different. It does not guarantee access to abortion. Rather, EMTALA considers a medical emergency to be one that threatens the life of the unborn child.
But Lawrence O. Gostin, an expert on public health law who has advised the administration, said the new guidelines are on “solid legal ground” in arguing that when federal and state laws conflict, federal law takes precedence. that of the state.
“EMTALA was not designed specifically for abortion access or miscarriage management, but it absolutely includes both,” Mr. Gostin said. He said the law would allow abortion “as long as it is based on the need to prevent serious consequences to the health or life of a pregnant woman due to the pregnancy.”
The guidance to hospitals was the first of two abortion-related actions the Department of Health and Human Services took this week. On Wednesday, she warned the nation’s 60,000 retail pharmacies that they risk violating federal civil rights laws if they refuse to fill prescriptions for pills that can induce abortion.
This guide mentions three drugs – mifepristone, misoprostol and methotrexate – which are often prescribed for other conditions but can also cause abortions. But the guidelines were carefully written, avoiding telling pharmacies that they were required to provide the drugs for abortion purposes.
Experts said the administration was reacting to reports that women of childbearing age were being denied the drugs after the Supreme Court ruling.
“They are doing what they can to clarify what the federal protections are; I think there’s a lot of pressure on them to do that,” said Alina Salganikoff, director of women’s health policy at the Kaiser Family Foundation, adding, “Advocates across America are very busy right now trying to advise employers, hospitals and clinicians about what their responsibilities and potential liability are when it comes to abortion.
Michael D. Shear contributed reporting from Washington.
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