New Research Reveals Devastating Impact of Clinic Shutdown Laws on Texas Women

Without U.S. Supreme Court intervention, widespread clinic delays will undermine the constitutional rights of women

(PRESS RELEASE) New research released today by the Texas Policy Evaluation Project (TxPEP) exposes the tremendous impact the state’s clinic shutdown law will have on Texas women if the U.S. Supreme Court fails to take up a case brought by the Center for Reproductive Rights to strike down the state’s sham regulations.

Texas’ omnibus clinic shutdown law, HB2, has already forced the closure of more than half of the 42 clinics previously operating in the state. If the Supreme Court declines to review the case and allows the challenged provisions to go into effect, the state would be left with as few as 10 clinics to serve a population of 5.4 million women of reproductive age. This massive reduction in essential services would overwhelm the small number of remaining clinics and increase already significant delays, cutting off access to safe and legal abortion care for millions of women.

TxPEP’s report reveals substantial increases in average wait times at clinics in Dallas, Forth Worth and Austin following HB2’s enactment in 2013. For example, the report finds that in Dallas, the state’s third largest city, women face delays as long as 20 days to receive an initial consultation in 2015 -- up from an average wait time of 5 days prior to the enactment of HB2. The report concludes, “If the remaining non-ASC clinics were forced to close because of HB2 and if demand for services remained constant, our analysis indicates that it is very likely that wait times would increase at the remaining ASCs."

Said Nancy Northup, president and CEO of the Center for Reproductive Rights:

“This research is a shocking reminder of how the state of Texas has knowingly undermined the fundamental rights of its citizens with laws that force women to unnecessarily delay their care or push access to safe, legal abortion entirely out of their reach.

“Texas’s sham laws are no more than a thinly veiled attempt by cynical politicians to upend four decades of legal precedent and deny women their constitutional rights and access to essential health care.

“These findings underscore the urgency of the case now sitting at the doorstep of the nation’s highest court. It is time for the Supreme Court to step in and put an end to the reckless games Texas politicians are playing with women’s lives and livelihoods.”

Said Amy Hagstrom Miller, president and CEO of Whole Woman’s Health, lead plaintiff in the case:

“A woman’s ability to get safe medical care should not depend on whether she has the resources necessary to navigate a horrific and complex obstacle course dreamt up by anti-choice lawmakers. This is the real world and these laws have real implications on real women’s lives. Unfortunately, it is our low-income women, women of color and rural women that bear the brunt of these harsh laws. 

"For thousands of Texans access to safe abortion care is a right on paper but no longer actually accessible. Texans are now forced to undertake multiple,  unnecessary visits to clinics that are now farther away; they take more days off of work, lose income, have to find childcare, and arrange and pay for transportation for hundreds of miles."

Representing a coalition of women’s health care providers, the Center for Reproductive Rights last month formally requested that the nation’s highest court review a June 2015 decision from the U.S. Court of Appeals for the Fifth Circuit, which upheld two of the law’s most harmful components: a requirement that all abortion providers obtain local hospital admitting privileges, and a provision requiring every clinic offering abortion services to meet the same hospital-like building standards as an ambulatory surgical center (ASC) – at a cost of millions of dollars in medically unnecessary facility upgrades

Major medical groups oppose the types of restrictions found in Texas’ clinic shutdown law.  The American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) jointly submitted an amicus brief opposing the law to the Fifth Circuit, stating that “H.B. 2 does not serve the health of women in Texas but instead jeopardizes women’s health by restricting access to abortion providers.”  Medical experts confirm that legal abortion care in the U.S. is extremely safe, and that laws like Texas’ would do nothing to make it safer. 

Since Roe v. Wade was decided in 1973, the U.S. Supreme Court has continually maintained women have a constitutional right to decide whether to end or continue a pregnancy— a right that is central to personal dignity, autonomy, and the liberty protected by the 14th Amendment.

Further, the Court’s 1992 decision in Planned Parenthood v. Casey reaffirmed a woman’s constitutional right to abortion and held that states could not enact medically unnecessary regulations meant to create substantial obstacles for a woman seeking to end a pregnancy. Justices Kennedy, O’Connor, and Souter made clear that “these matters, involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy, are central to the liberty protected by the 14th Amendment.”

Clinic shutdown laws have swept the South in recent years, threatening to further devastate abortion access in a region already facing limited availability of reproductive health care services.  The last abortion clinic in Mississippi is awaiting a decision on whether the U.S. Supreme Court will review its state’s clinic shutdown law when the Court’s term starts on October 5 while health care providers in Louisiana are awaiting a federal court ruling which could shutter all but one clinic in the state.  Courts have blocked similar measures in Oklahoma and Alabama. 

Case History: Whole Woman’s Health v. Cole (formerly Whole Woman’s Health v. Lakey)

Following a lawsuit brought by the Center for Reproductive rights on behalf of Whole Woman’s Health and several other Texas health care providers in April 2014, a federal district court blocked two of the most harmful restriction of Texas’ House Bill 2 (HB2) in late August 2014: the ambulatory surgical center requirement and the admitting-privileges requirement.

The U.S. Court of Appeals for the Fifth Circuit stayed that decision in large part on October 2, 2014, allowing the requirements to immediately take effect. Because forcing hospital-style surgery center building and staffing requirements on every clinic would amount to a multi-million dollar tax on abortion services, all but 7 reproductive health care facilities in the state were prevented from offering safe and legal abortion services for 12 days. On October 14, 2014, the U.S. Supreme Court reinstated the injunction in large part, allowing many of the previously closed clinics to reopen their doors while the state’s appeal moved forward.

On June 9, 2015, the Fifth Circuit’s final decision in the appeal once again upheld the state restrictions in substantial part, this time threatening to shutter all but 10 abortion providers in the state. Once again, the U.S. Supreme Court stepped in to block the Fifth Circuit’s decision and allow the clinics to remain open while the legal challenge continued. The Center for Reproductive Rights has now asked the nation’s highest court to formally review the Texas law. The Court is likely to decide whether it will hear the case sometime before the end of 2015. 

The clinics and physicians in this challenge are represented by Stephanie Toti, David Brown, Janet Crepps, and Julie Rikelman of the Center for Reproductive Rights, J. Alexander Lawrence of the law firm Morrison & Foerster, and Austin attorneys Jan Soifer and Patrick O’Connell of the law firm O’Connell & Soifer.

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