On Monday, the Supreme Court ruled on the most important abortion case in decades, dealing a decisive blow to the anti-abortion movement. In a 5–3 decision, the court struck down two provisions of a sweeping anti-abortion law that threatened to drastically reduce the number of abortion clinics in Texas.
The ruling concerned two provisions of the law, also known as HB 2, which placed strict regulations on abortion providers and clinics. One required that abortion providers have difficult-to-obtain credentialing requirements, or “admitting privileges,” from local hospitals. The other stipulated that abortion clinics comply with the costly regulations imposed on “ambulatory surgical centers,” an endeavor pro-choice advocates say can be prohibitively expensive. Had the law been upheld, it’s estimated that at least 32 of the state’s 40 abortion clinics would have shut down.
The decision was a coup for pro-choice activists, who have long argued that the provisions in HB 2 — also known as “Targeted Regulation of Abortion Providers,” or TRAP laws — were intended to regulate abortion out of existence, and as a consequence, place an undue burden on a woman’s right to choose. In a press call following the ruling, Nancy Northup, the president and CEO of the Center for Reproductive Rights, called the decision a “game-changer.“
But the ruling was a rare victory for another group as well: researchers.
Justice Stephen Breyer’s majority opinion heavily cited studies published by the Texas Policy Evaluation Project (TxPEP), a research group based at the University of Texas at Austin that has spent the past several years meticulously documenting the impacts of Texas’ reproductive health laws. The court’s reliance on rigorous data collection to inform their decision was unusual for a topic like abortion, which is often driven by emotional rhetoric instead of scientific evidence and fact.
‘It’s heartening to see this victory of evidence over ideology.’
“It’s heartening to see this victory of evidence over ideology,” Dr. Daniel Grossman, a lead researcher and a professor of obstetrics and gynecology at University of California, San Francisco, told ThinkProgress. “This has been hard at times, and there were definitely times when the state was trying to discredit our research and me personally, and so it’s really great to see the majority ruling, how they really looked to our research and how valuable it was.”
Since the omnibus abortion legislation was enacted in 2013, the number of abortion clinics in Texas dropped from 48 to 18. Grossman’s research team found that the clinic shutdowns resulting from HB 2 significantly impacted abortion access statewide.
A report released by TxPEP earlier this year revealed that the clinic shutdowns not only increased the amount of time women had to wait to get an appointment at an abortion clinic, but also resulted in a small but noteworthy increase in the proportion of abortions performed in the second trimester. Although later term abortions are generally safe, they are associated with a higher complication risk than earlier procedures and are significantly more expensive. The researchers also found that only 22 percent of abortions were being performed at ambulatory surgical centers (ASCs) in early 2014. If all of the non-ASC clinics were to shut down, they speculated, it would be difficult for the remaining clinics to meet the demand for abortions in the state.
Grossman, who had been collaborating with colleagues at UT Austin for more than a decade, said his team was well-situated to conduct the research that eventually made its way into the court’s opinion. The researchers began collecting data after the Texas legislature notoriously slashed the state’s family planning budget by two-thirds in 2011. Two years later, when HB 2 was passed, they knew they had to continue examining the various reproductive health impacts of the law. As Grossman explained, official state-level data on abortion clinics are often released well after relevant legislation is debated, leaving behind a crucial research gap.
“We knew that we couldn’t wait for these official statistics to actually inform the court’s decision around this law,” he said. “So we went and collected all this data from all of the providers in the state.”
The question at the center of the court’s decision focused on a precedent set in Planned Parenthood v. Casey, a landmark 1992 Supreme Court abortion case, that prohibited states from placing an “undue burden” on a woman’s ability to obtain an abortion. In his majority opinion, Justice Breyer indicated that the contested regulations in HB 2 did precisely that.
“We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes,” Breyer wrote. “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.”
Monday’s decision is already having a direct impact on other states with similar TRAP laws on the books. On Tuesday, the Supreme Court refused to review admitting privileges requirements on abortion providers in Mississippi and Wisconsin, ensuring that Mississippi’s sole abortion clinic will remain open. Moreover, the Alabama Attorney General announced that it would drop its appeal of a decision finding a similar admitting privileges law unconstitutional.
Still, the ruling doesn’t necessarily mean that the dozens of existing TRAP laws in other states will automatically be overturned. Indeed, many of the successful arguments against Texas’ restrictions relied on TxPEP’s state-specific data about the impacts of the law on women there. While other states could certainly argue that their own laws have had less harmful consequences, Monday’s ruling set a legal precedent that irrefutably placed data and scientific evidence at the center of its decision.
While laws in other states are being debated, Grossman is heartened to see how his team’s research was used — and hopes that the decision will help encourage the development of similar research projects in other states fighting abortion restrictions.
“I’m not aware of any other state where there’s this comprehensive approach that has brought together demographers and other social scientists and physicians to look at the impact of reproductive health policy in the state,” he said, “and I’m hoping that particularly this decision will help to encourage the development of similar kinds of collaborations in other states.”