The Supreme Court struck down Texas' widely replicated regulations on abortion clinics Monday in the court's biggest abortion case in nearly a quarter century.
The justices voted 5-3 in favor of Texas clinics that had argued the regulations were only a veiled attempt to make it harder for women to get abortions in the nation's second-most populous state.
Justice Stephen Breyer's majority opinion for the court held that the regulations are medically unnecessary and unconstitutionally limit a woman's right to an abortion.
Texas had argued that its 2013 law and subsequent regulations were needed to protect women's health. The rules required doctors who perform abortions to have admitting privileges at nearby hospitals and forced clinics to meet hospital-like standards for outpatient surgery.
While the landmark ruling echoes across the country, the heart of the case comes back to North Texas and Tarrant County where the petitioners, Whole Woman's Health, have a clinic in Fort Worth.
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"I'm feeling great. That was a big win, a really big win!" said Amy Hagstrom Miller, founder and CEO of Whole Woman's Health.
It's also where one of the first grassroots groups that worked to put the regulations in place is based.
"It's just unfortunate that the court didn't put women first today," said Kyleen Wright, President of Texans for Life.
The Arlington-based group pushed the hardest for requiring hospital admitting privileges. Wright is surprised that piece was reversed, allowing doctors who'd stopped providing abortions to begin again. But she says this was never about ending abortions entirely.
"When women know the truth, women will drive another hour to get a better doctor in a sterile environment, with hallways wide enough to accommodate gurneys," said Wright. "These were common sense reforms that the rest of the medical community understands to be standard of care."
But the Supreme Court's majority disagreed, calling the restrictions medically unnecessary and unconstitutional. Their ruling allows Whole Woman's Health in Fort Worth to stay open, it would have closed under the costly surgical building requirements.
"We get to call our physicians, our clinics, we get to let them know that their doors get to stay open and then we'll look at what it's going to take us to restore access throughout the state of Texas," said Hagstrom Miller.
Advocates say that process of reopening clinics will take time. Half the state's clinics already closed when the hospital admitting privileges requirement began. The piece requiring clinics be constructed like hospitals had been put on hold. If the High Court had allowed that piece to go forward, three quarters of clinics around the state were expected to be shut down.
In the majority opinion, Justice Breyer wrote that "the surgical-center requirement, like the admitting privileges requirement, provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions and constitutes an 'undue burden' on their constitutional right to do so."
Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan joined Breyer.
Ginsburg wrote a short opinion noting that laws like Texas' "that do little or nothing for health, but rather strew impediments to abortion, cannot survive judicial inspection" under the court's earlier abortion-rights decisions. She pointed specifically to Roe v. Wade in 1973 and Planned Parenthood v. Casey in 1992.
Chief Justice John Roberts and Justices Samuel Alito and Clarence Thomas dissented.
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Thomas wrote that the decision "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.'" Thomas was quoting an earlier abortion dissent from Justice Antonin Scalia, who died in February. Scalia has not yet been replaced, so only eight justices voted.
Alito, reading a summary of his dissent in court, said the clinics should have lost on technical, procedural grounds. Alito said the court was adopting a rule of, "If at first you don't succeed, sue, sue again."
When then-Gov. Rick Perry signed the law in 2013, there were about 40 clinics throughout the state. That number dropped to under 20 and would have been cut in half again if the law had taken full effect, abortion rights advocates said.
Texas Attorney General Ken Paxton said the law "was an effort to improve minimum safety standards and ensure capable care for Texas women. It's exceedingly unfortunate that the court has taken the ability to protect women's health out of the hands of Texas citizens and their duly elected representatives."
Nancy Northup, president of the Center for Reproductive Rights, which represented the clinics, said, "The Supreme Court sent a loud and clear message that politicians cannot use deceptive means to shut down abortion clinics."
President Barack Obama praised the decision. "We remain strongly committed to the protection of women's health, including protecting a woman's access to safe, affordable health care and her right to determine her own future."
Democratic presidential candidate Hillary Clinton called the outcome "a victory for women in Texas and across America."
Texas is among 10 states with similar admitting-privileges requirements, according to the Center for Reproductive Rights. The requirement is in effect in most of Texas, Missouri, North Dakota and Tennessee. It is on hold in Alabama, Kansas, Louisiana, Mississippi, Oklahoma and Wisconsin.
The hospital-like outpatient surgery standards are in place in Michigan, Missouri, Pennsylvania and Virginia, and it is blocked in Tennessee and Texas, according to the center.
Texas passed a broad bill imposing several abortion restrictions in 2013. Texas clinics sued immediately to block it, contending it impermissibly interfered with a woman's constitutional right to an abortion. The clinics won several favorable rulings in a federal district court in Texas. But each time, the New Orleans-based 5th U.S. Circuit Court of Appeals sided with the state, at first allowing challenged provisions to take effect and then upholding the law with only slight exceptions.
The Supreme Court had allowed the admitting-privileges requirement to take effect in most of the state, but put the surgical center provision on hold pending the court's resolution of the case.
The justices split largely along liberal-conservative lines in their emergency orders, with the court's conservative justices voting repeatedly to let the law be enforced.
Separate lawsuits are pending over admitting-privileges laws in Louisiana and Mississippi, the other states covered by the 5th circuit. The laws are on hold in both states, and a panel of federal appellate judges has concluded the Mississippi law probably is unconstitutional because it would force the only abortion clinic in the state to close.
A separate appeal is pending at the Supreme Court from Wisconsin, where federal judges have struck down that state's admitting-privileges law.
On the heels of the Supreme Court's decision, Texas lawmakers who supported abortion restrictions, are pushing back.
"I think it's a shame all the way around," said State Rep. Matt Krause (R- Fort Worth). "We've made this procedure less safe and we've made it less healthy today because of what the Supreme Court did."
Krause is already looking at ways to change or improve abortion laws. He co-sponsored HB-2.
"I do know something will happen and a lot of us are motivated to make sure something happens," Krause said. "It was a setback today, but we're undaunted. We'll keep going and we'll get things in place next session."
Planned Parenthood of Greater Texas anticipates the push back from conservative lawmakers.
"I expect Texas legislators, who are opposed to a woman's ability to make her own health care decisions, will continue to do what they can to put up obstacles to a woman's ability to access that care," said Kelly Hart, Senior Director of Public Affairs at Planned Parenthood of Greater Texas.
Hart said Planned Parenthood is assessing its options including the possibility of reopening clinics.
"Some of the uncertainty is gone. We now know what the Supreme Court has decided and we can make some decisions," Hart said.
Supreme Court Reaction
- "The Supreme Court’s ruling in Whole Woman’s Health v. Hellerstedt is profoundly disappointing. Texas enacted HB 2’s commonsense health standards to ensure that women receive safe care. Unfortunately, the Supreme Court sided with abortion extremists who care more about providing abortion-on-demand than they do protecting women’s health. This decision will not silence our fight to protect the most helpless and innocent among us, nor will we cease our efforts to protect women from an abortion industry that prioritizes profit margins over improving the safety and health of Texas women. We will continue to stand resolutely to defend unborn life because we know that every life is a gift from God, and without life there is no liberty.” — U.S. Sen. Ted Cruz (R-Texas)
- “The decision erodes States’ lawmaking authority to safeguard the health and safety of women and subjects more innocent life to being lost. Texas' goal is to protect innocent life, while ensuring the highest health and safety standards for women." — Texas Gov. Greg Abbott (R)
- "Today’s United States Supreme Court ruling striking down House Bill 2 (HB 2) is a devastating blow to the protection of the health and safety of women in Texas. HB 2 was passed during the 83rd Texas legislative session to ensure the health and safety of women by holding abortion clinics to the same standards as ambulatory surgical centers while also requiring practitioners to have admitting privileges at a hospital within 30 miles of the facility. Now abortion clinics are free to ignore these basic safety standards and continue practicing under substandard conditions. 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. Despite today’s devastating impact on women’s health care, and as the proud author of the sonogram bill and co-writer of HB 2, I remain committed to protecting women’s health and safety." — Texas Lt. Gov. Dan Patrick (R)
- “HB2 was an effort to improve minimum safety standards and ensure capable care for Texas women. It’s exceedingly unfortunate that the court has taken the ability to protect women’s health out of the hands of Texas citizens and their duly-elected representatives." — Texas Attorney General Ken Paxton (R)
- "I am extremely disappointed with the Supreme Court's ruling today; however, members of the Texas Legislature like myself, who believe deeply in the value of every human life, will not yield in our efforts to provide the highest quality healthcare for women and our continued promotion of a culture of life." — State Sen. Konni Burton (R-Dist. 10)
- “Today made that day 3 yrs ago all worth it! So grateful 2 all the women who shared their stories. #WholeWomensHealth" — Wendy Davis (D), former Texas state senator, said on Twitter. She also tweeted that "@elizabethforma is killing right now" and "Fifth circuit is reversed!!!"
- "Today women across the nation have had their constitutional rights vindicated. The Supreme Court sent a loud and clear message that politicians cannot use deceptive means to shut down abortion clinics." — Nancy Northup, president and CEO of the Center for Reproductive Rights
- “Today, the Supreme Court affirmed what we at Whole Woman’s Health have known all along—that every woman, no matter where she lives, deserves access to compassionate, respectful, and comprehensive care from a clinic she trusts. Today justice was served.” — Amy Hagstrom-Miller president and CEO of Whole Woman’s Health and lead plaintiff in the case.
- “Texas Republicans should stop wasting our tax dollars defending disastrous policies and start solving urgent state needs like foster care and public education – start improving lives and stop risking them. Thankfully the United States Supreme Court sided with women and families over Texas Republicans in striking down their dangerous and overreaching attack on women’s health.” — Lisa Turner, state director of the Lone Star Project, a Democratic PAC
- “We are extremely pleased with the Supreme Court’s decision. But the fight to protect abortion access isn’t over. State legislatures around the country have passed hundreds of anti-abortion measures since 1973 and Texas lawmakers have been responsible for more than 18 of those. They’ve forced women to undergo unnecessary ultrasounds, face mandatory delays and make extra, unnecessary visits to medical clinics that in many cases were hundreds of miles away. They’ve even passed legislation that forces doctors to lie to their own patients. There is no reason to believe they will give up trying to deny women access to abortion care now and going forward we will continue the fight to make sure that right is protected.” — Terri Burke, executive director of the ACLU of Texas
- “This morning’s historic ruling constitutes a huge victory not only for the women of Texas but for women all around the country who live in states that have tried to restrict access to safe and legal abortion care. In rejecting HB2, the Supreme Court affirmed what we’ve been saying since the Texas legislature passed the law in 2013: HB2 imposed an undue and unconstitutional burden on Texas women. This was never about health care.” — Rebecca L. Robertson, legal and policy director for the ACLU of Texas
- “As it did one year ago in our landmark case that brought marriage equality to the nation, today the United States Supreme Court affirmed the constitutional protections that secure some of the most personal decisions one can make—decisions around family formation. Whether choosing a life partner or determining whether to continue or end a pregnancy, the liberties enshrined in the Fourteenth Amendment are fundamental and cannot be legislated away by politicians. Today’s ruling struck down unconstitutional regulations imposed by Texas on abortion clinics. Those clinics can now resume providing essential reproductive health care, as well as care to the LGBT community, which often turns to these providers as vital sources of compassionate and affirming care.” — Julianna S. Gonen, policy director for the National Center for Lesbian Rights.
- "This is a sad day for women’s health, for the basic right to life and for the right to safe medical procedures. By striking down the Texas law that sets medical standards for abortion clinics in the case of Whole Woman’s Health v. Hellerstedt, the U.S. Supreme Court today placed financial interests above such basic health and safety standards like adequate staffing and sanitary conditions. Such standards currently are legally regulated for other ambulatory surgical centers. The Catholic Diocese of Fort Worth, in solidarity with women and with moral support for those who advocate on behalf of women and on behalf of their unborn children, will continue to promote the dignity of every human life from conception until natural death. We will continue to pray for the promotion of a culture of life, including women’s safety." — Most Rev. Michael F. Olson, Bishop of Fort Worth.
Key Events in the Texas Abortion Restriction Law
Key events leading up to Monday's decision by the U.S. Supreme Court that struck down the strict Texas anti-abortion restriction law known as HB2.
Read the Supreme Court Decision
