Court Ruling Devastates Texas’ Abortion Clinic Infrastructure

CREDIT: AP Photo/Tamir Kalifa, File

The number of abortion clinics in the second most populous state is dwindling to just eight, following a ruling from the U.S. Court of Appeals for the Fifth Circuit that allows a stringent new law to take effect immediately in Texas. On Thursday night, a panel of conservative judges reversed an earlier decision that allowed 13 clinics to remain open for the past several weeks.

Now, as those facilities are no longer allowed to remain operating, Texas residents are waking up to learn that the number of health care facilities in their communities has been drastically reduced overnight. “This is a devastating day for Texas women,” Jennifer Dalven, the director of the Reproductive Freedom Project at the ACLU, said in a statement.

Thursday’s decision is the latest installment in the battle over HB 2, the package of harsh abortion restrictions that Texas lawmakers approved last summer despite gubernatorial candidate Wendy Davis’ infamous filibuster against the legislation. An earlier provision of the law, which started going into effect last fall, requires abortion doctors to have admitting privileges from local hospitals, an unnecessary business arrangement that has forced half of the state’s clinics to close their doors already. Another portion of HB 2, which requires abortion clinics to make costly renovations to bring their building codes in line with ambulatory surgical centers, will now also take effect.

Just eight clinics in the entire state of Texas are currently certified as ambulatory surgical centers, or ASCs. They’re all located in San Antonio, Dallas, Fort Worth, Austin and Houston. With the building code restrictions in effect, a broad swaths of the state — including the incredibly impoverished regions along the Mexico border — is now left without any clinics for hundreds of miles. Texas’ new reproductive rights landscape is illustrated in this map from the Texas Tribune:

texas abortion clinics

CREDIT: Texas Tribune

“What we have been fearing is now official: Texas faces a health care crisis, brought on by its own legislators,” Amy Hagstrom Miller, who used to operate five clinics in the state, said in a statement in response to the ruling.

Hagstrom Miller, the CEO of a group called Whole Woman’s Health, has just one clinic left under HB 2: A building that she rents in San Antonio that was already certified as an ASC when she moved in. She has been fighting hard to keep her other clinics operating, particularly the facilities she used to run in the Rio Grande Valley, a border community where immigrant women are left without many health care options. But in a recent interview with ThinkProgress, she explained that building more ASCs is simply not a tenable option.

“I wouldn’t be able to afford to raise the money for a $3 million ambulatory surgical center as a small business owner. There’s no bank that’s going to lend that money to me,” Hagstrom Miller said. “Plus, I would not be interested in building from the ground up. I think it’s the wrong solution on many levels. Philosophically, it’s wrong because it’s completely based on misinformation — it has nothing to do with patient care. It’s also, to me, just a poor use of resources. I could help so many women have safe abortions for $400 dollars rather than put $3 million dollars into a building.”

Medical experts have repeatedly spoken out against Texas’ new law, saying that the requirements won’t do anything to improve abortion clinics. Abortion is already an incredibly safe medical procedure that’s less risky than colonoscopies, gallbladder surgery, knee replacement surgery, or giving birth to a child. Both the American Medical Association (AMA) and the American Congress of Obstetricians and Gynecologists (ACOG) oppose requiring abortion providers to get hospital admitting privileges. ACOG also opposes imposing additional building code requirements on clinics.

Nonetheless, these type of restrictions are rapidly advancing throughout the country. Known as the “Targeted Regulation of Abortion Providers,” or TRAP, these laws have particularly taken root in Southern states, where an estimated 8.6 million women of reproductive age may soon be left with just 12 abortion clinics across five states.

TRAP laws are typically framed as protecting women’s health, even though there’s absolutely no relationship between harsh abortion restrictions and better health outcomes. But that hasn’t stopped conservative judges in the Fifth Circuit from buying into the framing. According to Nancy Northup, the president of the Center for Reproductive Rights, the most recent court decision in Texas “is an endorsement of politicians’ disingenuous tactic of undermining women’s safety under the false pretext of protecting it.”