The Politics of Prevention is an occasional series on the effects of state policy on women's health services.More in this series
The next stage in abortion rights advocates’ efforts to block implementation of strict new regulations on the procedure in Texas began on Friday, as the Center for Reproductive Rights, the American Civil Liberties Union and a group of abortion providers across the state filed a lawsuit in federal court.
“Today's lawsuit is a united strike back against the hostile politicians who have made clear their willingness to sacrifice the constitutional rights, health and even lives of Texas women in support of their extremist ideological agenda,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement.
The lawsuit asks the court to issue a preliminary injunction to stop the state from implementing the hospital privileges and medical abortion requirements in House Bill 2, the law state legislators approved in July. Absent the injunction, the state will begin requiring physicians who perform abortions to have active hospital-admitting privileges within 30 miles of where the procedure is performed and distribute abortion-inducing medications in person starting Oct. 29. The plaintiffs in the suit represent the majority of licensed abortion providers in Texas, including the four Planned Parenthood affiliates in Texas that provide abortion services, Whole Woman’s Health and other independent abortion providers in the state.
The lawsuit does not seek to block the ban on abortions at 20 weeks of gestation, which is also slated to take effect on Oct. 29, or the requirement that abortion facilities meet the structural requirements of ambulatory surgical centers, which takes effect in September 2014.
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Jim George, a lawyer representing the plaintiffs, said they chose not to challenge the 20-week ban on abortion at this time so they could focus on blocking the provisions that would have an immediate impact on reducing access to abortion in Texas.
“Abortions that are performed subsequent to that time limit are relatively rare,” he said. “The immediate problem that we’re facing here is that there are large parts of the population of Texas that will be effectively precluded from ever getting an abortion by the statutes and provisions that we are challenging.”
Plaintiffs also did not immediately challenge the ambulatory surgical center rules, George added, because the state has not finalized those rules. The state posted the proposed rules on the state register on Friday, and will accept input from public stakeholders for the next 30 days.
Proponents of the new law argue the additional regulations on abortion would improve women’s safety. Emily Horne, a lobbyist for Texas Right to Life, said requiring hospital privileges would ensure additional oversight of those doctors, as their credentials would be peer-reviewed and the procedures monitored by hospital administrators. Hospitals would also be better equipped in the case of an emergency, she added, because they would have the doctor’s information and better access to patient records.
A review of state inspection records this summer by The Texas Tribune found little evidence that existing abortion facilities in Texas put patients in imminent danger. Although state auditors identified 19 regulatory violations in the year preceding the passage of the new restrictions that they said presented a risk to patient safety at six abortion clinics that are not ambulatory surgical centers in Texas, none was severe enough to warrant financial penalties. The Department of State Health Services deemed the facilities’ corrective action plans sufficient to protect patients.
Abortion rights advocates assert that the new restrictions are a thinly guised attempt to block access to abortion services and force providers to stop offering the procedure.
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"This law is part of a coordinated national strategy to shut down women's health centers and outlaw abortion all across the country," Anthony Romero, executive director of the ACLU, said in a statement. "In Texas and across the nation, people are standing up to tell politicians to stop interfering in a woman's private decisions.”
Advocates who filed the lawsuit on Friday allege that 13 of the 36 existing licensed abortion facilities in Texas would not be able to perform abortions and access to the procedure would be cut off in Lubbock, Fort Worth, Waco, McAllen, Harlingen and Killeen if the hospital privileges requirement goes into effect in October.
That provision unfairly singles out abortion services, the advocates argue, as doctors who perform other outpatient procedures aren’t required to have hospital admitting privileges in Texas. In addition, they say it’s intentionally burdensome, because each hospital has its own set of rules for granting admitting privileges and none are required to grant any particular doctor privileges. Many hospitals have religious affiliations or rules that would effectively prohibit an abortion doctor from gaining privileges, such as requirements for doctors to perform a certain number of procedures within their specialty at the hospital.
Since January, at least nine abortion clinics have shut their doors and another facility has stopped performing abortions. Only six of the state’s remaining facilities currently meet the structural requirements of ambulatory surgical centers.
This story was produced with the support of the Dennis A. Hunt Fund for Health Journalism, a program of the USC Annenberg School of Journalism's California Endowment for Health Journalism Fellowships, and in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
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