WASHINGTON (AP) — The Supreme Court on Monday let stand a decision barring emergency abortions that violate the law in Texas, which has one of the country’s strictest abortion bans.

The justices did not detail their reasoning for keeping in place a lower court order that said hospitals cannot be required to provide pregnancy terminations if they would break Texas law. There were no publicly noted dissents.

The decision comes weeks before a presidential election where abortion has been a key issue after the high court’s 2022 decision overturning the nationwide right to abortion.

The state’s strict abortion ban has been a centerpiece of Democratic U.S. Rep. Colin Allred ’s challenge against Republican U.S. Sen. Ted Cuz for his seat.

At a campaign event over the weekend in Fort Worth, Texas, hundreds of Allred’s supporters broke out in raucous applause when he vowed to protect a woman’s right to an abortion. “When I’m in the Senate, we’re going to restore Roe v. Wade,” Allred said.

At a separate event the same day, in a nearby suburb, Cruz outlined a litany of criticisms against Allred, but didn’t bring up the abortion law.

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The justices rebuffed a Biden administration push to throw out the lower court order. The administration argues that under federal law hospitals must perform abortions if needed in cases where a pregnant patient’s health or life is at serious risk, even in states where it’s banned.

Complaints of pregnant women in medical distress being turned away from emergency rooms in Texas and elsewhere have spiked as hospitals grapple with whether standard care could violate strict state laws against abortion.

The administration pointed to the Supreme Court’s action in a similar case from Idaho earlier this year in which the justices narrowly allowed emergency abortions to resume while a lawsuit continues.

Texas, on the other hand, asked the justices to leave the order in place. Texas said its case is different from Idaho because Texas does have an exception for cases with serious risks to the health of a pregnant patient. At the time the Idaho case began, the state had an exception for the life of a woman but not her health.

Texas pointed to a state supreme court ruling that said doctors do not have to wait until a woman’s life is in immediate danger to provide an abortion legally.

Doctors, though, have said the Texas law is dangerously vague, and a medical board has refused to list all the conditions that qualify for an exception.

Pregnancy terminations have long been part of medical treatment for patients with serious complications, as way to to prevent sepsis, organ failure and other major problems. But in Texas and other states with strict abortion bans, doctors and hospitals have said it is not clear whether those terminations could run afoul of abortion bans that carry the possibility of prison time.

Mary Ziegler, a law professor at the University of California at Davis who has written extensively about abortion, said that there remains much uncertainty for doctors in Texas.

“I think we’re going to continue to see physicians turning away patients, even patients who could qualify under the state’s exceptions because the consequences of guessing wrong are so severe and the laws are not that clear,” Ziegler said.

The Texas case started after the Supreme Court overturned Roe v. Wade in 2022, leading to abortion restrictions in many Republican-controlled states. The Biden administration issued guidance saying hospitals still needed to provide abortions in emergency situations under a health care law that requires most hospitals to treat any patients in medical distress.

Texas sued over that guidance, arguing that hospitals cannot be required to provide abortions that would violate its ban. Texas The 5th U.S. Circuit Court of Appeals sided with the state, ruling in January that the administration had overstepped its authority.

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Stengle contributed to this report from Dallas and AP reporter Sean Murphy contributed to this report from Oklahoma City.

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