Attorney General Bonta Co-Leads 22 States to Protect Patients Against Texas’ Attempt to Exclude Abortion from Emergency Healthcare

OAKLAND — California Attorney General Rob Bonta today co-led a multistate coalition in a legal fight to protect Americans’ access to abortions during life-threatening medical emergencies. In an amicus brief, the coalition supported the Biden Administration’s defense of its Emergency Medical Treatment and Labor Act (EMTALA) guidance, which restates hospitals’ obligations under EMTALA, requiring doctors nationwide to perform abortions when necessary in emergency situations. In July 2022, Texas filed a lawsuit challenging that EMTALA guidance, and in August 2022, a judge in the U.S. District Court for the Northern District of Texas barred the guidance from being applied in Texas. California and the coalition of states supporting the Biden Administration wrote in their amicus brief that the district court ruling, if allowed to stand, would not only endanger patients in Texas, but would also have serious repercussions on the health systems of other states.

“Emergency treatment can mean the difference between life and death for a patient,” said Attorney General Bonta. “Those seeking to exclude abortion from emergency healthcare are endangering the lives of countless patients. That's why I stand with my coalition partners in urging the Fifth Circuit to reverse the Texas court decision and ensure critical emergency healthcare for all. California will not stand idly by as anti-choice states like Texas trample over the rights and protections that allow people to live healthy, safe lives.”

Every hospital in the United States that operates an emergency department and participates in Medicare is subject to EMTALA. Under the law, emergency rooms are required to provide all patients who have an emergency medical condition with the treatment required to save their lives. In June 2022, the Biden Administration issued guidance restating hospitals’ obligation to provide abortion services when needed to stabilize a patient experiencing an emergency medical condition.

The district court's ruling blocking the application of the EMTALA guidance in Texas has already put multiple patients’ lives at risk by plunging providers into a climate of uncertainty and fear about the legal and criminal repercussions they may face for performing abortions on patients in emergency situations. In Texas, for example, a pregnant woman who experienced a miscarriage was forced to carry a dead fetus for two weeks because of her providers’ fears about violating Texas law. Another Texas woman who went into early labor at 18 weeks was forced to wait until she was too weak to walk, had a 103-degree fever, and contracted sepsis — a life-threatening medical emergency — before her doctors agreed she was sick enough to legally end her pregnancy.

The Biden Administration on March 10, 2023, filed an appeal in the U.S. Court of Appeals for the Fifth Circuit, asking it to reverse the Texas district court's ruling. In their brief, the coalition of states wrote that they supported the Biden Administration because:

• For decades, EMTALA has been interpreted to require the treatment of pregnancy-related conditions that need emergency abortion care, and states have relied on that determination to protect their residents' health and safety;
• Prohibiting physicians from providing emergency abortions causes serious harm to pregnant patients and puts their lives in jeopardy; and
• When Texas hospitals and providers do not provide the emergency abortion care required by EMTALA, patients are forced to turn to out-of-state hospitals and doctors, adding strain to other states’ emergency departments that are already struggling with overcrowding, long wait times, and staff shortages. The added strain will cause more delays and threaten the safety and health of all patients who need emergency care.

The amicus brief was led by Attorney General Bonta and New York Attorney General Letitia James. They were joined by the attorneys general of Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, and Washington.

A copy of the amicus brief can be found here.