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Supreme Court overturns Texas abortion restrictions

June 27, 2016

The Supreme Court, in a victory for abortion-rights advocates, has limited the power of Texas and other states to restrict or effectively shut down clinics that offer the procedure.

The justices, by a 5-3 votesaid Monday that Texas lawmakers went too far by imposing unnecessary regulations that had forced most of the state’s abortion clinics to go out of business.

The decision is the court’s clearest pronouncement since 1992 on abortion, and it makes clear that states may not impose health regulations that severely restrict the right to abortion.

The Texas case has been seen as a crucial test of a state’s power to regulate the practice of abortion. Though states have the authority to regulate doctors and hospitals to protect the health of patients, the Supreme Court has said states may not put an “undue burden” on pregnant women who seek an abortion. This includes “unnecessary health regulations,” the court said in 1992.

Abortion-rights advocates said the ruling sends a clear warning to states attempting to restrict abortion.

“Without question, today’s ruling is a game-changer in what has been an unrelenting assault on women’s rights across the country,’’ said Nancy Northup, president of the Center for Reproductive Rights, which pushed the case. “This tremendous victory renews the promise of Roe vs. Wade for the next generation. We will not stop fighting until access is restored for all women in the U.S.”

At issue in the case were two stringent regulations adopted by the Texas Legislature in 2013. One required doctors who perform an abortion to have admitting privileges at a hospital within 30 miles. The state’s lawyers said the rule ensures that doctors are “qualified,” and that it “promotes continuity of care” if an emergency arises. Abortion-rights advocates said hospitals often refuse to extend privileges to these doctors because of the controversy over abortion and because very few of their patients will be admitted to a hospital.

The other disputed rule would require all abortions, even those within the first weeks of a pregnancy, be performed in a facility meeting the standards of an outpatient surgical center. The state said this would help ensure “a sterile operating environment” for surgery, but clinic directors say the extra space and equipment is costly and unneeded.

“We conclude that neither of these provisions [on admitting privileges and surgical center requirements] offers medical benefits sufficient to justify the burdens upon access that each imposes,” Justice Stephen Breyer said for the majority. “Each places substantial obstacles in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access, and each violates the federal Constitution.”

He was joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan.

In a concurring opinion, Ginsburg said it “is beyond rational belief that [the Texas law] could genuinely protect the health of women and certain that the law would simply make it more difficult for them to obtain abortions.”  She said closing licensed abortion providers could force “women in desperate circumstances [to] resort to unlicensed rogue practitioners.”

In dissent were Chief Justice John G. Roberts Jr. and Justices Clarence Thomas and Samuel A. Alito Jr.

Medical experts told the court that dental surgery, colonoscopies and other medical procedures commonly take place in doctors’ offices, not in surgical centers. Moreover, they say early abortions are safe and simple. The rule extends to women who take medication to induce an early abortion. The new law “requires those tablets be swallowed in a multi-million dollar surgical facility,” clinic directors told the court.

Texas had no reported deaths from abortions in the five years prior to the enactment of the new law in 2013.

Breyer said abortions were “extremely safe with particularly low rates of serious complications” prior to the 2013 law. The new standards resulted in the closure of many of the state’s abortion clinics, and these “closures meant fewer doctors, longer waiting times and increased crowding.”

When abortion-rights advocates sued, a federal judge held a trial and decided the two regulations were unnecessary and unconstitutional. But the U.S. 5th Circuit Court of Appeals in New Orleans disagreed and upheld the regulations last year. 

About the half of the state’s 40 abortion providers closed after the admitting-privileges rule took effect, but the Supreme Court blocked enforcement of the surgical-center requirement. 

In their appeal, lawyers for the Whole Woman’s Health said only nine clinics would remain in business in Texas if the law were fully enforced, leaving a “vast geographic area that is larger than California” without a licensed abortion facility.

The ruling should allow some of the state’s clinics to reopen, especially in rural areas, said Nan Kirkpatrick, executive director of the Dallas-based Texas Equal Access Fund, which helps those who cannot afford abortions.

“It’s vital in West Texas and the Panhandle, where people are hundreds of miles from care,” said Kirkpatrick. “We are really hoping this decision will reopen providers.”

On Twitter: DavidGSavage

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UPDATES:

8:23 a.m.: This post has been updated with reaction from abortion-rights advocates.

7:39 a.m.: This post has been updated with an excerpt from Justice Ruth Bader Ginsburg’s concurring opinion.

7:33 a.m.: This post has been updated with excerpts from the Supreme Court ruling.

This post was originally published at 7:08 a.m.

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