Less than a week into the new year, a federal appeals court has already issued a pernicious new decision in a Texas abortion case, setting the stage for the far-right’s escalating assault on reproductive rights in 2024.

The conservative 5th U.S. Circuit Court of Appeals ruled on Tuesday that Texas hospitals are not obligated to perform abortions to stabilize a pregnant patient facing a medical emergency. With a similar Idaho case under reconsideration by the 9th Circuit, the rulings tee up a Supreme Court battle on the question of emergency abortion care.

Under the 1986 Emergency Medical Treatment and Labor Act, or EMTALA, hospitals that receive Medicare funding — which is pretty much all hospitals — must perform emergency services, regardless of the patient’s ability to pay. The law has always been deeply insufficient in a disgraceful, life-denying health care system. Ensuring that vulnerable patients are not left to die by emergency rooms for lack of insurance or insufficient funds is the bare minimum; hospitals still chase patients for the unaffordable cost of emergency treatments following discharge. Until recently, however, the federal legislation has served as a weak protection for patients in need of lifesaving abortion care in red states. Now even that is being undermined.

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