Texas sues HHS over emergency abortion access
Physicians in many states are reporting chaos and confusion over appropriate care, AMA president tells House committee.
Photo: Studio642/Getty Images
The State of Texas has sued the Department of Health and Human Services over its mandate issued earlier this month that emergency medical care must include abortion access.
The Biden Administration's response to Dobbs v. Jackson Women's Health Organization is to "attempt to use federal law to transform every emergency room in the country into a walk-in abortion clinic," according to the complaint filed on July 14. President Biden is flagrantly disregarding the legislative and democratic process – and flouting the Supreme Court's ruling before the ink is dry – by having his appointed bureaucrats mandate that hospitals and emergency medicine physicians must perform abortions."
The federal court has given HHS and other federal agencies listed on the complaint 60 days to respond.
WHY THIS MATTERS
The Supreme Court ruling in June striking down Roe v. Wade and leaving abortion decisions up to the states has created a quagmire for hospitals and physicians looking for clarity on what services they may legally perform. This particularly affects emergency room doctors.
Today, the American Medical Association president Dr. Jack Resneck Jr. testified at a House committee hearing about the impact of the Roe reversal on patients and physicians.
"The recent Dobbs decision overturned nearly a half century of precedent, ending patients' rights to comprehensive reproductive healthcare, allowing government intrusion into the medical exam room, and criminalizing medical care. And now physicians in many states are reporting chaos and confusion," Resneck told the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations.
"Physicians have been placed in an impossible situation, trying to meet their ethical duties to place patients' health and wellbeing first, while attempting to comply with vague, restrictive, complex and conflicting state laws that interfere in the practice of medicine and jeopardize the health of our patients. Physicians are worried about prosecution of their patients and themselves in the midst of significant legal uncertainty, and this is dangerous for our patients."
A woman with a life-threatening ectopic pregnancy sought emergency care at the University of Michigan Hospital after a doctor in her home state worried that the presence of a fetal heartbeat meant treating her might run afoul of new restrictions on abortion, according to The Washington Post. The same report said that at a Kansas City, Missouri, hospital, administrators temporarily required "pharmacist approval" before dispensing medications used to stop postpartum hemorrhages, because they can also be also used for abortions. In Wisconsin, a woman bled for more than 10 days from an incomplete miscarriage after emergency room staff would not remove the fetal tissue.
Earlier this month, HHS Secretary Xavier Becerra evoked the Emergency Medical Treatment and Labor Act, which since 1986 has required that Medicare hospitals provide patients with ER care regardless of what state laws are in effect. If a state bans abortions and doesn't make exceptions in cases of the health or life of a pregnant person, the Act supersede state law, Becerra said in a July 11 letter to healthcare providers.
Becerra told providers that pregnant women and those experiencing the loss of a pregnancy must have access to "full rights and protections" for emergency care under federal law. This includes care for ectopic pregnancies, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features.
The course of treatment is up to the physician or other medical personnel, Becerra said. Stabilizing treatment could include abortion.
The Texas complaint against this mandate contends that the Emergency Medical Treatment and Labor Act mandate forces hospitals and doctors to commit crimes and risk their licensure under Texas law. It further complicates liability issues for physicians and hospitals.
The Texas Hospital Association declined comment, but said its legal team is currently working to review the matter.
THE LARGER TREND
HHS issued the guidance after the Supreme Court struck down Roe v. Wade, the 49-year old law that gave women the right to an abortion. The court also sided with Mississippi's abortion restrictions in Dobbs v. Jackson Women's Health Organization.
Many states had "trigger laws," ones restricting abortion access or banning abortions that were ready to take effect when Roe v. Wade was abolished.
Texas Hospital Association President and CEO John Hawkins said by statement of the Dobbs v. Jackson Women's Health decision: "Today's decision will dramatically impact the issue of women's reproductive health, as the Texas trigger law is now set to take effect next month according to language in the authorizing bill. While the vast majority of abortions do not happen in Texas hospitals, hospitals will stay abreast of the new laws and work with their patients to promote the healthiest outcomes."
Twitter: @SusanJMorse
mail the writer: SMorse@HIMSS.org
