A federal judge in Texas in a Tuesday night ruling blocked guidance issued by the Biden administration that requires doctors to provide abortions in emergency medical situations even if doing so would run afoul of state law. 

In a 67-page ruling, U.S. District Judge James Hendrix halted emergency abortion guidance that the Department of Health and Human Services (HHS) issued last month in the wake of the Supreme Court’s overruling of Roe v. Wade.

The practical effect of the ruling was to halt HHS from enforcing its guidance in Texas, stopping short of a nationwide injunction. Hendrix also blocked the administration from applying its regulation against two co-plaintiffs in the case, a pair of anti-abortion doctors’ associations.

The judge’s ruling dealt a blow to the administration, which had urged the court to find that a 1986 federal law known as the Emergency Medical Treatment and Labor Act (EMTALA) superseded some restrictive state abortion laws passed in the wake of Roe’s demise.

EMTALA requires a hospital to provide stabilizing care to any patient that presents with an emergency medical condition. HHS says abortion qualifies as stabilizing care under the law.

The legal development comes as a patchwork of state abortion laws have emerged as a result of the Supreme Court’s toppling of Roe, which for nearly a half-century recognized a constitutional right to abortion up to the point of fetal viability, around 23 weeks.

Hendrix, a Trump-appointed judge in Lubbock, Texas, ruled that the HHS guidance exceeded the authority that Congress granted to the agency though EMTALA.

“That 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,” Hendrix wrote.

An HHS spokesperson said the administration was weighing its options after the ruling.

“HHS stands unwavering in our commitment to protect a woman’s right to access health and life-saving care under EMTALA,” Sarah Lovenheim, assistant secretary for public affairs at HHS, wrote on Twitter. “We are reviewing the District court’s opinion to determine our next steps.”

Ryan Bangert, a lawyer with the conservative Christian legal advocacy organization Alliance Defending Freedom, which represents the doctors’ groups, hailed the ruling.

“We’re pleased to see the court halt the administration’s attempt to flagrantly disregard the legislative and democratic process, and we’ll continue to defend those in the medical profession who wish to respect and save lives, not take them,” Bangert said.

The decision by the Texas-based judge comes ahead of a ruling in a similar case in which the Biden administration sued the state of Idaho, arguing that EMTALA preempts the state’s strict abortion ban. A ruling in that case, United States v. State of Idaho, is expected by Wednesday.

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