WASHINGTON — The Supreme Court on Monday turned away a Biden administration appeal in a dispute over emergency room abortion care in Texas, leaving in place a lower court victory for the Republican-led state.

The decision, months after the court wrestled with a similar case from Idaho without reaching a conclusive decision, constitutes a setback for the Biden administration.

The decision leaves intact a ruling by the New Orleans-based 5th U.S. Circuit Court of Appeals in favor of Texas on the question of whether a federal law concerning emergency room care in some cases trumps state abortion restrictions.

The bigger legal question remains unresolved at the national level.

The 1986 federal law, called the Emergency Medical Treatment and Labor Act, requires that patients — including, the federal government says, pregnant women with serious complications — receive appropriate emergency room care. The law applies to hospitals that receive federal funding via the Medicare program.

In the wake of the Supreme Court overturning the constitutional right to abortion in 2022 and the strict bans that followed in some states, the Biden administration issued guidance saying states could not enforce parts of abortion bans that would conflict with the federal law.

That led to litigation, with Texas challenging the guidance and the administration suing Idaho over its strict abortion ban.

In the Idaho case, the Supreme Court in June sidestepped a major ruling on the issue, with some justices indicating that the court was being too quick in taking up the legal question. In the meantime, a lower court ruling that allows emergency room doctors to perform abortion in some situations remains in place.

In Texas, a federal judge ruled against the administration, saying that the federal government had overstepped its authority by issuing the guidance. The decision was upheld on appeal.

The administration appealed to the Supreme Court, but asked the justices to hold the case until it decided the Idaho dispute. Over the summer, Solicitor General Elizabeth Prelogar urged the court to throw out the appeals court ruling so that new developments could be considered afresh.

Separately, the court declined to hear another abortion-related case, this one from Guam, about whether the territory’s Supreme Court had the authority to rule that a 1990 abortion ban no longer remains on the books.

In other action, the court turned away an appeal related to the Alabama Supreme Court’s ruling in February that threatened the availability of in vitro fertilization in the state. The Legislature quickly amended state law to ensure that the treatment remains available, making the case largely moot.