United States Supreme Court Overturns Abortion Restrictions

On June 27, the U.S. Supreme Court struck down Texas’ strict regulations on abortion clinics, in the court’s most significant decision on abortion rights in decades. 

At issue in the case, Whole Woman’s Health v. Hellerstedt, is to what extent states can regulate abortion within their borders, and the ruling likely will have ramifications for states across the country that have passed similar legislation restricting abortion in recent years.

Lisa Soronen, director of the State and Local Legal Center, describes the case as the “most significant abortion case since Planned Parenthood v. Casey,” the 1992 Supreme Court case that held that state lawmakers could restrict abortion rights as long as they do not provide an “undue burden” to women seeking an abortion. In the Casey decision, the court defined an undue burden as a “substantial obstacle in the path of a woman’s fundamental right to choice.”

“Since the case was decided in 1992, states have passed a large number of restrictions on abortion, testing the limits of undue burden and making it inevitable that the court would have to revisit it,” said Soronen. “It’s been a long time coming.”

At the center of Hellerstedt is a 2013 Texas law that banned abortions after 20 weeks and required doctors at abortion clinics to obtain admitting privileges at a hospital located within 30 miles. It also required clinics to meet the same standards as hospital-style surgical centers, although this provision had previously been on hold pending resolution by the Supreme Court.

Writing for the 5-3 majority, Justice Stephen Breyer wrote, “We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes. Each places a 
substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access, and each violates the Federal Constitution.”

Supporters of the Texas bill had argued the requirements were put in to place to improve the quality of medical care for women.

“This bill is about life—the life of women and the unborn,” said Texas state Rep. Tim Kleinschmidt, who sponsored the bill, in a statement after its passage. “This legislation is necessary to ensure that women receive the highest quality health care from the clinics where they are treated.”

Opponents argued—and the Supreme Court agreed—that the restrictions go far beyond what is needed to ensure the safety of patients and are costly for facilities, forcing the closure of many abortion clinics.

According to Elizabeth Nash, a state issues expert at the Guttmacher Institute, a nonprofit research and policy organization that tracks reproductive health issues, there were more than 40 abortion clinics in Texas in 2013. “Once doctors were required to have admitting privileges at local hospitals, more than 20 had to close,” Nash said. “If the clinic regulations had been upheld, that number could have dropped again, down to 10 for the entire state.”

Abortion Restrictions in the States

Some state restrictions, such as waiting periods up to 72 hours, parental consent for minors 17 and under, mandatory ultrasounds and required counseling, have mostly been upheld by lower courts. State lawmakers also have sought to set limits on how late abortions can be performed, with 14 states now banning abortions at 20 weeks of pregnancy. Two state laws banning abortion after six weeks (North Dakota) and 12 weeks (Arkansas), however, have been blocked by federal courts.

Almost half of states have passed additional regulations on abortion clinics, requiring that they meet the licensing standards for hospital-­style ambulatory surgical centers, often requiring renovations such as widening hallways and installing sophisticated air filtration systems. Of these, 17 states have regulations that apply to sites where medication-induced abortions are provided even if surgical abortions are not.

There was a “renewed focus at the state level around abortion restrictions beginning in 2011,” said Nash.

Between 2010 and 2015, 288 abortion restrictions were enacted by the states—the largest number in a five-year period since the 1973 Roe v. Wade decision that legalized abortion. An additional 21 laws restricting abortion have been passed by states so far in 2016, such as bills banning a second-trimester abortion procedure known as dilation and evacuation and legislation prohibiting abortions due to the fetus’ sex, race, national origin or ancestry, or because of a diagnosis of a genetic anomaly.

Looking Ahead

Now that the Texas provisions have been struck down, the court’s decision could open the door for challenges to restrictions in other states. According to Soronen, “although the court’s ruling applied only to Texas, any state laws requiring admitting privileges and surgical-center regulations are mostly likely unconstitutional.”

Soronen said the ruling may also provide a framework by which other state restrictions on abortion will be judged. “While all abortion restrictions are different and will have to be judged individually, it is clear that the court was concerned about the large number of clinics that would be closed as a result of the Texas law,” she said.

“State lawmakers have needed more information on the court’s definition of undue burden to better understand the outer boundary of what actions states can legally take,” said Soronen. “The Supreme Court has now ruled that Texas went too far.”