April 3, 2014 — Several abortion clinics in Texas have filed suit over a provision in a wide-ranging antiabortion-rights law (HB 2) that would require them to meet the building standards for ambulatory surgical centers, the New York Times reports. The requirement, which takes effect on Sept. 1, includes facilities that do not perform surgeries but offer medication abortions.
The lawsuit comes less than one week after a federal appeals court upheld other contested provisions in the law (Eckholm, New York Times, 4/2). Those provisions require that abortion providers have admitting privileges at nearby hospitals and mandate that a physician be present when administering medication abortion drugs (Women's Health Policy Report, 3/28).
A fourth provision in the law that imposes a 20-week abortion ban has not been challenged in court (AP/USA Today, 4/2).
According to the Times, there were about three dozen abortion clinics in the state before HB2 took effect. Since then, the number has fluctuated between 20 and 24, and only six clinics -- located in Austin, Dallas, Fort Worth, Houston and San Antonio -- are currently licensed as ambulatory surgical centers.
The clinics that hope to operate under HB2 also must be located in large cities with nearby hospitals to accommodate the law's admitting privileges requirement, the Times reports. The law, when it fully takes effect, will most severely hinder abortion access for low-income women and those living in south and west Texas, according to clinic owners.
The Center for Reproductive Rights filed suit against the ambulatory surgical center requirements in federal court on behalf of several abortion clinics in Texas. CRR also filed a new, narrower challenge to the law's admitting privilege requirement on behalf of two clinics: Whole Woman's Health in McAllen, and El Paso-based Reproductive Health Services, which will likely close in May.
CRR argued that the admitting privileges and ambulatory surgical center requirements "are inconsistent with accepted medical standards, impose costs that are far in excess of any potential benefits and will dramatically reduce the number and geographic distribution of medical facilities in the state where women can access safe and legal abortion services" (New York Times, 4/2).
CRR added that the admitting privileges requirement, which already led to the closure of some Whole Woman's Health clinics, will also likely shut down Reproductive Health Services, even though both are "among the last, if not the only, providers offering abortion care in their communities" (Weissert, AP/Sacramento Bee, 4/3).
According to legal experts, the clinics might have a better chance of overturning the ambulatory surgical center requirements than they did against the admitting privileges mandate if they can demonstrate that the building rule imposes a significant burden on abortion rights without commensurate benefits. Caitlin Borgmann, an expert on reproductive law at the CUNY School of Law said, "The greater the evidence that this rule will cause more clinics to close, and leave large areas of the state without abortion providers, the greater their chance of success" (New York Times, 4/2).