The Supreme Court on Monday left in place a court order blocking the Biden administration from enforcing in Texas its policy of requiring hospitals to provide emergency abortion care or risk losing federal funding.

The justices rejected a Justice Department request that they wipe away the lower-court ruling and send the case back down for more proceedings. That ruling had struck down guidance from the Department of Health and Human Services asserting that, under federal law, hospitals were obligated to offer abortion in medical emergencies even in states that ban the procedure.

The move is setback for the Biden administration in its uphill effort to assert some protections for abortion access since the Supreme Court overturned Roe v. Wade in 2022.

Monday’s maneuver also keeps abortion off the Supreme Court’s docket – for now – after two major abortion cases last term, including one from Idaho raising very similar issues as the Texas dispute.

The high court’s handling of both the Idaho and Texas cases leaves unanswered questions about whether, under a law known as the Emergency Medical Treatment and Labor Act, federally-funded hospitals must offer abortions to emergency patients with pregnancy complications putting their health at risk – even in states that ban the procedure.

Texas, joined by other plaintiffs, successfully sued to halt Biden administration guidance to hospitals asserting that EMTALA trumps state abortion bans. A ruling blocking the administration from enforcing the policy in the Lone Star State was upheld by the 5th US Circuit Court of Appeals.

US Solicitor General Elizabeth Prelogar had asked the Supreme Court to wipe away that ruling and instruct the lower courts to reconsider the case with more recent legal developments in mind.

Last term, the Supreme Court punted on a similar case arising out of Idaho, where the Justice Department sued the state over its strict abortion ban, alleging that the ban violated EMTALA for its lack of exemptions for abortions when pregnancy complications imperil woman’s bodily functions but do not yet imperil her life.

The Supreme Court paused a lower court’s order blocking the ban in medical emergencies and took up the case before a full appeal played out in lower courts, only to rule 5-4 this summer that the case had been taken up prematurely, sending it back to lower courts.