The Department of Health and Human Services issued clarifying guidance Monday that says federal law preempts state abortion bans in emergency situations.

The new guidance is in response to states enacting strict anti-abortion laws following the Supreme Court's decision to overturn Roe v. Wade.

In a letter to healthcare providers, Health and Human Services Secretary Xavier Becerra says, "As frontline health care providers, the federal EMTALA statute protects your clinical judgment and the action that you take to provide stabilizing medical treatment to your pregnant patients, regardless of the restrictions in the state where you practice."

Becerra adds that the course of treatment is up to the physician or other qualified medical personnel.

"Stabilizing treatment could include medical and/or surgical interventions (e.g., abortion, removal of one or both fallopian tubes, anti-hypertensive therapy, methotrexate therapy etc.), irrespective of any state laws or mandates that apply to specific procedures," he said.

Becerra said that hospitals that don't comply with the guidance could lose their Medicare provider agreement or face civil monetary penalties.

According to the Associated Press, abortions are banned or restricted in more than 20 states.

ALBUQUERQUE, New Mexico — Since the passage of Senate Bill 8, which prohibits abortion once a heartbeat is detected, many Texans who need abortions have left home for care. It's lead to a surge in patients at clinics in surrounding states

Planned Parenthood of South Texas would normally be filled with patients receiving different types of care for abortion. Jeffrey Hons, the president and CEO, says they had no choice but to shut down those procedures.

“It’s eerily quiet here now and that’s been the case here for the month of September," Hons said. “And then when the Supreme Court turned its back on not only the women of Texas, but the legal framework of the United States of America, then things went eerily quiet here when people realized finding abortion in Texas had essentially become nearly impossible and the flurry of activity has now moved across state lines where people are desperately trying to find the care very very far away that they should be able to find right here.”

Hons says it feels wrong for them to not be offering the services their patients desperately need.

“And for those people finding abortion care that is legal, safe and offered without judgement and without stigma, it’s essential. It’s a human dignity, it’s a human right. And so, it is very painful right now, to be experiencing the emotion and physic toll that Senate Bill 8 is creating for staff who want to help people but can’t," Hons said.

This reality has put some people in a tough spot; their options are slim.

“There is so much to be worried about right now. I mean when you talk to abortion providers in neighboring states, whether that be Louisiana, New Mexico Oklahoma, they are seeing an uptick in the number of patients who are reporting Texas zip codes as their home address," Hons said.

The New Mexico Religious Coalition for Reproduction Choice is seeing that firsthand.

Brittany Defeao, the program manager, shows us some context. She says In September 2019, they performed 20 abortions, in September of 2020 that number dropped to 15, and this year, it’s up to 50 people, 80% of whom are Texans.

“We were not really seeing new Mexico patients, it’s a very small amount of what we serve. We do anyone. Anywhere you come from, we will support you. Clearly Texas is the majority, it always has been, now it’s overwhelming, it is all Texas people," Defeao said.

To look at it another way, in 2020 they provided abortions to 216 people and they have already surpassed that this year with three months to go.

“It’s not how it used to be. It’s like they scatter in, they are just showing up. A lot of them are flying in in the morning. I’m getting them at the airport, taking them straight to an appointment, picking them up, getting food, they are flying back," Defeao said.

She says their phones have not stopped ringing; people are terrified to submit an application while still in Texas and are unsure of the boundaries around Senate Bill 8.

“So, we have the people who are afraid to travel, the people who are afraid to travel in a pandemic, and the people who are afraid that they are going to go to jail if they come out here to access care," Defeao said.

On top of all of that, their resources are slim.

“So, what we’re seeing is really low income, marginalized communities, the people that need the help the most," Defeao said. “These are people that have nothing, that don’t have access to birth control, to health care, to food, to safety.”

That’s why this clinic in New Mexico is making sure the people of Texas are reminded that they do have options.

“Just like confirming that community and trying to break that shame and stigma that’s even heavier because of this law," Defeao said.

Texas passed a law that bans abortions after a heartbeat can be detected, usually around six weeks of pregnancy.

“This law is different. For the most part it tries to adopt relatively strict or restrictive approach to abortion policy,” Robert Preuhs, a professor and the chair of political science at Metropolitan State University of Denver, said.

The law also allows any person to sue anyone who helps a woman get an abortion after that time -- from the provider to the driver who brought her there.

“The key difference here among the Texas bill as opposed to other laws is instead of the enforcement mechanism being the state, now you allow citizens to actually sue in civil court to prevent that abortion,” Preuhs said.

He said when states have pushed further restrictions on abortion in the past, the biggest blockage has been the Supreme Court because the abortion seeker or provider can sue the state. However, with this law, that’s not the case.

"This new law from Texas has a unique way of approaching enforcement and so therefore it’s still up in the air exactly how far the Supreme Court will let this stand. So far it has,” Preuhs said.

“We’ve seen other abortion statutes that authorize private individuals to sue, but we’ve never seen anything that allows quite literally anyone to sue,” Mary Ziegler, a professor at Florida State University College of Law, said.

Ziegler has authored multiple books on abortion.

“It does seem the federal government has limited options to change what's going on on the ground in Texas.”

Ziegler said the Texas law is more difficult to challenge.

“There's no state actor you can sue, and to bring a Constitutional challenge you can't sue a private citizen because the Constitution only gives you rights against the government. So then it creates a catch 22,” she said.

Constitutional law expert Ernest Young said those fighting the Texas law will have to find a different way. The Department of Justice’s lawsuit is one possibility.

“Once the law is actually challenged in a posture where the court can rule on the merits, that would raise as one of the issues whether the court is going to continue to follow Roe v. Wade,” Ernest Young, a professor at Duke Law School, said.

Roe v. Wade currently gives pregnant women the choice to have an abortion without excessive government restriction.

“The most interesting things are likely to happen in those state court lawsuits as they progress,” Young said.

Preuhs said what happens in Texas will be a big indicator of what we could see elsewhere.

“If this law does stand the Constitution test, then you will see Republican-held governments, state governments, adopting further restrictions and probably modeling those restrictions on something similar to Texas,” he said.

The Supreme Court hasn’t allowed a law like this since the ruling on Roe v. Wade, but later this year, the high court is also expected to hear a case from Mississippi on a law that would ban abortion at 15 weeks. That decision could also affect abortion laws across the country.

“If the Supreme Court wanted to hear this case, that would require the court to either say Roe v. Wade is gone, or part of Roe v. Wade is gone which is to say you can ban at least some abortions before viability and that’s why its such a major event. Because there’s no way for the court to uphold this law without either undoing or rewriting what it means to choose to have an abortion,” Ziegler said.

“We don’t really know how this is going to play out,” Preuhs said.

A Texas law banning most abortions in the state took effect at midnight, but the Supreme Court has yet to act on an emergency appeal to put the law on hold.

If allowed to remain in force, the law would be the most dramatic restriction on abortion rights in the United States since the high court’s landmark Roe v. Wade decision legalized abortion across the country in 1973.

The fact that the Supreme Court did not act on an emergency request to halt the law from taking effect came as a surprise to some legal analysts, given that the law is facing court challenges by political opponents.

The Texas law, signed by Republican Gov. Greg Abbott in May, would prohibit abortions once a fetal heartbeat can be detected, usually around six weeks and before most women even know they’re pregnant.

According to NPR, the bill does not make exceptions for pregnancies that result from rape or incest. The law also allows individuals to sue those suspected of helping a woman obtain an abortion, with an award of up to $10,000. The Texas Tribune reports that those who file such lawsuits do not need to provide a personal connection to whomever they sue.

Abortion doctors and advocates in Texas fear that women will lose their right to an abortion provided to them under Roe v. Wade before they even know they are pregnant. But beyond that, they worry that lawsuits against medical professionals could financially ruin them or force abortion providers out of the state.

"This is a full-scale assault on patients, our health care providers, and our support systems," the American Civil Liberties Union, who has filed a lawsuit in an attempt to block the law, tweeted early Wednesday. "This abortion ban is blatantly unconstitutional. We won’t stop fighting until it’s blocked."

Texas Right to Life, an anti-abortion group in the state, celebrated the law taking effect by tweeting "God bless Texas."

In a statement released late Wednesday morning, President Joe Biden slammed the law as "blatantly" violating the constitutional precedent set by Roe v. Wade.

"The Texas law will significantly impair women’s access to the health care they need, particularly for communities of color and individuals with low incomes. And, outrageously, it deputizes private citizens to bring lawsuits against anyone who they believe has helped another person get an abortion, which might even include family members, health care workers, front desk staff at a health care clinic, or strangers with no connection to the individual," the statement read. "My administration is deeply committed to the constitutional right established in Roe v. Wade nearly five decades ago and will protect and defend that right."