The Biden administration told emergency room doctors they must perform emergency abortions when necessary to save a pregnant woman’s health, following last week’s Supreme Court ruling that failed to settle a legal dispute over whether state abortion bans override a federal law requiring hospitals to provide stabilizing treatment.

In a letter being sent Tuesday to doctor and hospital associations, Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services Director Chiquita Brooks-LaSure reminded hospitals of their legal duty to offer stabilizing treatment, which could include abortions. A copy of the letter was obtained by The Associated Press.

“No pregnant woman or her family should have to even begin to worry that she could be denied the treatment she needs to stabilize her emergency medical condition in the emergency room,” the letter said.

It continued, “And yet, we have heard story after story describing the experiences of pregnant women presenting to hospital emergency departments with emergency medical conditions and being turned away because medical providers were uncertain about what treatment they were permitted to provide.”

CMS will also resume investigations into complaints against emergency rooms in Idaho, after the Supreme Court ruled last week that hospitals there must be allowed to perform emergency abortions for now, despite the state’s abortion ban.

But enforcement in Texas, the country’s most populous state with a strict six-week abortion ban, will still be on hold because of a lower court ruling.

The letter is the Biden administration’s latest attempt to raise awareness about a 40-year-old federal law that requires almost all emergency rooms — any that receive Medicare dollars — to provide stabilizing treatment for patients in a medical emergency. When hospitals turn away patients or refuse to provide that care, they are subject to federal investigations, hefty fines and loss of Medicare funding.

The Texas Alliance for Life responded to the letter by saying the Biden administration “falsely suggests that Idaho and other state pro-life laws fail to protect women facing life-threatening emergencies during pregnancy.”

“This is untrue,” the anti-abortion group said in a statement. “All state pro-life laws provide an abortion exception for those rare but tragic circumstances in which a pregnancy poses a threat to a mother’s life, including circumstances when death is not imminent. Those include Texas and Idaho.”

The emergency room is the last place that the Democratic White House has argued it can federally require rare emergency abortions to be performed, despite strict state abortion bans. After Roe v. Wade was overturned in 2022, and U.S. women lost the constitutional right to an abortion, HHS quickly sent letters to doctors, saying that they were required to provide abortions in emergency medical situations when they were needed to keep a woman medically stable.

An AP investigation found that complaints about pregnant women being turned away from emergency rooms spiked in 2022 after the U.S. Supreme Court overturned Roe, raising concerns about emergency pregnancy care in states that have enacted strict abortion laws.