### Supreme Court Declines to Mandate Emergency Abortions in Texas Despite Conflicting State Laws

In a pivotal decision, the Supreme Court has declined the Biden administration's plea to compel Texas doctors to perform emergency abortions when it contradicts the state's stringent abortion laws. On the first day of its new term, the justices chose not to overturn a lower-court decision that invalidated the administration's claim that federal law should secure access to emergency abortion care even in states with restrictive abortion bans.

This ruling maintains a prior decision by the U.S. Court of Appeals for the 5th Circuit, which established that Texas law does not conflict with the Emergency Medical Treatment and Labor Act (EMTALA). According to this court's interpretation, the federal law does not impose any specific medical treatments, including abortion services.

The refusal to intervene echoes the Court's earlier involvement in a comparable case in Idaho. In June, the justices momentarily allowed Idaho doctors to perform emergency abortions without risking prosecution under the state's restrictive laws. Despite being seen as a preliminary victory by abortion rights advocates, this decision did not address whether federal law can override stringent state abortion bans.

The Biden administration initially invoked EMTALA in late 2021 to advocate for access to emergency abortions under narrowly defined circumstances. Following the reversal of Roe v. Wade in July 2022, the administration instructed hospitals receiving Medicare funds that emergency room doctors must be willing to perform abortions in certain scenarios, penalizing non-compliance with fines of up to $120,000 per violation.

Solicitor General Elizabeth B. Prelogar had urged the Supreme Court to overturn the 5th Circuit's decision, referencing the Court’s actions in the Idaho case. She contended that the Texas Supreme Court had obfuscated potential conflicts between Texas law and the federal interpretation of EMTALA, emphasizing the absence of a live controversy that needed resolution.

However, Texas Attorney General Ken Paxton asserted that the state's law includes provisions allowing abortions to prevent "substantial impairment of a major bodily function." This stance places Texas' legal framework in apparent yet nuanced opposition to federal guidelines, creating ambiguity for healthcare providers.

Mary Ziegler, a University of California Davis law professor specializing in abortion issues, noted the ongoing uncertainty in interpreting medical exceptions in both Texas and Idaho's abortion bans. She pointed out that the Supreme Court’s refusal to review the Texas case leaves open multiple future outcomes regarding federal and state abortion law conflicts.

Planned Parenthood Federation of America's president, Alexis McGill Johnson, criticized the Court's decision, highlighting its failure to affirm that existing federal laws apply universally, including to pregnant individuals. Conversely, John Seago, president of Texas Right to Life, defended the Texas law's provisions for emergency medical care, faulting the Biden administration for creating what he described as a "vague standard" that adds confusion.

Despite the legal assurances from state officials, women in Texas continue to report being denied critical abortion services. Kelsie Norris-De La Cruz, for instance, was refused urgent care for an ectopic pregnancy at a Dallas-area hospital, forcing her to endure a medically dangerous waiting period before receiving necessary treatment.