Texas Republicans seek to clarify when doctors can intervene under abortion bans

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Texas Republicans in the Senate have filed a bill that aims to make it more clear when a doctor can intervene to save a pregnant patient’s life, despite the state’s near-total abortion ban. The bill does not expand abortion access or change the exceptions, but rather aims to clarify the existing law.

Sen. Bryan Hughes, author of one of the state’s abortion bans, filed Senate Bill 31, called the “Life of the Mother Act.” The bill is one of Lt. Gov. Dan Patrick’s priorities. A matching bill has been filed in the house by Rep. Charlie Geren, a Republican from Fort Worth.

Texas’ abortion laws have an exception to save the life of the pregnant patient. But since the laws went into effect, doctors have said the vague language and strict penalties leave them uncertain of when they are actually free to intervene. Despite lawsuits, and court rulings, and guidance from the Texas Medical Board, the confusion and fear persists for doctors and the lawyers who are advising them.

Until recently, Texas Republicans maintained that the laws are clear. Hughes wrote an op-ed in the Houston Chronicle, titled, “I wrote Texas' abortion law. It's plenty clear about medical emergencies.” Anti-abortion groups argue that because some abortions are being performed each month, the law is working the way it was intended.

But at least three women have died, and dozens have reported medical care delayed or denied due to their doctors’ hesitation to act. In January, Patrick said he was open to clarifying the laws “so that doctors are not in fear of being penalized if they think the life of the mother is at risk.” Hughes echoed the sentiment and agreed to carry the bill.

The bill reiterates existing law that says doctors can remove an ectopic pregnancy or the remains of a fetus after a miscarriage. It also matches the definition of medical emergency to existing state law and clarifies that a doctor or a lawyer can talk with a patient about a medically necessary abortion without it being considered “aiding and abetting.” The bill also clarifies that doctors are not required to delay, alter or withhold life-saving medical treatment to try to preserve the life of the fetus.

The bill would bring into state law previous guidance from the Texas Supreme Court, which ruled that nothing in the law required the medical emergency to be imminent or irreversible before a doctor could intervene. It also proposes continuing education requirements for lawyers and doctors, to better educate them on interpreting and applying these laws.

Texas banned nearly all abortions after six weeks of pregnancy in 2021, with a legal loophole that allowed the state to skirt the protections of Roe v. Wade. After the Supreme Court overturned that 50-year-old precedent in 2022, the state banned abortions from the moment of conception.

A doctor who performs a prohibited abortion can face up to life in prison, fines of $100,000 and the loss of their medical license. Doctors report delaying care until a patient is closer to death, or pursuing procedures that are riskier medically but safer legally because they are unsure how else to proceed. Others say their hospital administrators and lawyers are restricting their ability to fully practice medicine.

The bill is unlikely to satisfy abortion advocates, who would like to see access to the procedure restored more widely, or many doctors who say the state should not be legislating the decisions they make with their patients.

Patrick also has designated another abortion bill, SB 33, as a priority. This bill would stop cities and counties from supporting abortion funds and nonprofits that help people travel out of state to terminate their pregnancies.

Last year, Austin City Council appropriated $400,000 to help city residents travel out of Texas to get abortions. Attorney General Ken Paxton and a former city councilor sued over the policy, saying it violated state law. Those lawsuits are ongoing.

The San Antonio City Council also allocated $500,000 for a reproductive justice fund, some of which was to be used to support out-of-state travel. But after much debate and a lawsuit, ultimately none of the organizations the fund supports pay for abortions or logistical support for abortion-seekers.

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