Dealing a sharp blow to abortion opponents, a divided U.S. Supreme Court on Monday struck down Texas regulations that would have closed more than half of the state’s abortion clinics.
The 5-3 ruling overturned the heart of the law known as House Bill 2, passed during the second of two tense special legislative sessions in 2013, leaving 19 abortion clinics operating in Texas, with the possibility that more could open in the future.
Ten of those clinics would have been shut down almost immediately if the court had upheld the Texas law, leaving no abortion facilities south or west of San Antonio.
Instead, the Supreme Court said the Texas rules — requiring abortions to be performed in hospitallike surgical centers and doctors to have admitting privileges in nearby hospitals — combined to erect an improper barrier for women seeking an abortion.
The ruling cast doubt on the future of similar laws in 12 other states, as well as on efforts by abortion opponents to press for expanded laws that tighten regulations on abortion clinics.
The court rejected arguments from Texas Republican officials who insisted that HB 2 was intended to protect the health and safety of women seeking an abortion, signaling that future clinic-closing restrictions will have to show demonstrable health benefits to survive scrutiny.
“We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes,” Justice Stephen Breyer wrote for the majority.
Breyer agreed with numerous points raised by U.S. District Judge Lee Yeakel of Austin, who struck down both regulations in August 2014, ruling that they created “a brutally effective system” designed to close abortion facilities, not to improve women’s health.
The 5th U.S. Circuit Court of Appeals later overruled Yeakel, only to be overruled itself Monday by the Supreme Court.
RELATED CONTENT: Supreme Court abortion ruling: Texas officials, others react
Breyer said evidence showed abortions have “extremely low rates of serious complications,” giving Texas officials “no significant health-related problem for the new law to cure.”
Even so, he wrote, the admitting-privileges rule, which went into effect in November 2013, was responsible for closing about half of the 42 Texas abortion clinics that had been operating when HB 2 was signed into law.
“Those closures meant fewer doctors, longer waiting times and increased crowding,” he wrote, adding that the number of reproductive-age women who lived farther than 150 miles from an abortion clinic rose from 86,000 to 400,000.
Likewise, Breyer said, the surgical-center rule — which the Supreme Court had previously blocked Texas from enforcing — was unnecessary because evidence shows abortion is safe — “indeed, safer than numerous procedures that take place outside hospitals and to which Texas does not apply its surgical-center requirements.”
Before HB 2, he wrote, clinic safety was well-regulated, with state rules requiring annual reporting and record keeping, quality-assurance programs, personnel policies, environmental requirements, infection-control standards, patient-rights standards and more — all “policed by random and announced inspections, at least annually.”
Justice Anthony Kennedy joined the court’s liberal wing to hand a legal victory to abortion providers who sued to overturn the Texas regulations, indicating that the absence of the court’s leading conservative, Justice Antonin Scalia, who died in February, did not affect the outcome.
The court’s conservative bloc — Chief Justice John Roberts and Justices Clarence Thomas and Samuel Alito — was opposed.
Writing in dissent, Thomas said the majority ruling “exemplifies the court’s troubling tendency to bend the rules when any effort to limit abortion, or even to speak in opposition to abortion, is at issue.”
“Our law is now so riddled with special exceptions for special rights that our decisions deliver neither predictability nor the promise of a judiciary bound by the rule of law,” Thomas wrote.
Texas Republican leaders, who championed HB 2 in 2013, reacted with frustration and sadness — and vows to continue fighting for limits on abortion providers.
“The decision erodes states’ lawmaking authority to safeguard the health and safety of women and subjects more innocent life to being lost,” Gov. Greg Abbott said. “We will redouble our efforts to protect innocent life and mothers’ health.”
Lt. Gov. Dan Patrick said the ruling left abortion clinics free to ignore basic safety standards.
“By its ruling, the court held that the ability of abortion clinics to remain open — even under substandard conditions — outweighs the state’s ability to put women’s health and safety first,” Patrick said.
But abortion rights supporters agreed with Justice Ruth Bader Ginsburg, who in a concurring opinion wrote, “It is beyond rational belief that HB 2 could genuinely protect the health of women.”
The law, Progress Texas advocacy director Lucy Stein said, was a blatant attempt to close clinics, not protect women.
“The U.S. Supreme Court saw through Texas Republicans’ lies today and rightfully stopped them from further rolling back a woman’s constitutional right to access abortion care in our state,” Stein said.
The head of Whole Woman’s Health, the lead plaintiff in the lawsuit to overturn the regulations, said she was “beyond elated.”
“After years of fighting heartless, anti-abortion Texas politicians who would seemingly stop at nothing to push abortion out of reach, I want everyone to understand: You don’t mess with Texas, you don’t mess with Whole Woman’s Health, and you don’t mess with this beautiful, powerful movement of people dedicated to reproductive health, rights and justice,” said Amy Hagstrom Miller, who operates three abortion clinics and an abortion surgical center in Texas.
The ruling, coming 4½ months before the presidential election, could have an impact on the race for the White House, with the winner being able to fill the vacancy left by Scalia’s death.
“Our fight is far from over. In Texas and across the country, a woman’s constitutional right to make her own health decisions is under attack,” Democrat Hillary Clinton said. “Today’s decision is a reminder of how much is at stake in this election. … We must continue to protect access to safe and legal abortion — not just on paper, but in reality.”
Republican Donald Trump did not immediately respond to the ruling.
Status of the Texas abortion law
House Bill 2, passed into law in 2013, was a combination of four regulations. Here’s where they now stand:
• Abortions must be performed in hospitallike surgical centers: Struck down by the U.S. Supreme Court.
• Abortion doctors must have admitting privileges at a nearby hospital: Struck down by the U.S. Supreme Court.
• Drug-induced abortions must follow rules established by the U.S. Food and Drug Administration: Made moot when the FDA recently relaxed rules, allowing the drug mifepristone to be used later in a pregnancy and at lower doses.
• Banning abortions after the 20th week of pregnancy unless the woman’s life is threatened or in cases of severe fetal abnormality: In place since Oct. 29, 2013; never challenged in court.