Editor’s Note: Amy Hagstrom Miller is the founder and CEO of Whole Woman’s Health and Whole Woman’s Health Alliance. Whole Woman’s Health was the lead plaintiff in the landmark 2016 Supreme Court ruling Whole Woman’s Health v. Hellerstedt. The views expressed here are hers. Read more opinion on CNN.
This week, the US Supreme Court hears arguments for and against a Louisiana law that is identical to one that the clinics I founded and operate challenged successfully four years ago, along with other abortion providers in Texas.
By the time it was struck down in 2016 in a 5-3 decision, this one abortion restriction had forced the closure of half the clinics in Texas. Then the Supreme Court found that this law was medically unnecessary and an undue burden on access to abortion. With that precedent in hand, we didn’t expect to see other states trying to promote the exact same laws, or for a court to uphold them.
But then the 5th Circuit US Court of Appeals ruled that a copycat law could stand in Louisiana. So now, the Center for Reproductive Rights, which led our challenge in Texas, is again challenging this law on behalf of providers in Louisiana in June Medical Services v. Russo.
Medically unnecessary abortion restrictions are clinic shutdown laws, plain and simple. I am watching with great urgency and (though the composition of the court has changed significantly since 2016) a sense of déjà vu as Louisiana clinics and physicians challenge Louisiana’s Act 620. It requires physicians who provide abortion care to have admitting privileges at a hospital within 30 miles of a clinic.
If Louisiana’s admitting privileges law goes into effect, two of the three remaining abortion clinics in the state will close, leaving an estimated 1 million women of reproductive age in Louisiana with just one abortion provider. That is unacceptable.
Some might think it’s cause for alarm that a newly constituted Supreme Court wants to hear a case challenging an identical law so soon, especially one trying to restrict a woman’s access to abortion care. But while part of me is also alarmed, I am not surprised. Our victory in that case has been a bulwark against the evisceration of abortion rights that abortion opponents now believe is within their reach. It’s a logical target.
The Supreme Court’s landmark decision in our 2016 case, Whole Woman’s Health v. Hellerstedt, affirmed that the Constitution protects the right to abortion, and that courts must apply a rigorous legal standard when they evaluate abortion restrictions — a standard that scrutinizes actual evidence and rejects false reasoning.
At stake is the Supreme Court’s holding in 2016 that laws restricting access to abortion must be supported by scientific evidence that benefit patients and are not just attempts to make it harder to access abortion disguised as health regulations. Applying this standard, the court found that requiring abortion providers to have admitting privileges at a nearby hospital was medically unnecessary and did nothing to improve patient safety, but instead harmed patients by putting abortion out of reach.
Since Whole Woman’s Health was decided, lower courts across the country have blocked abortion restrictions by determining that they impede access to abortion without offering any valid benefits. The standard has even been applied in voting rights cases in Wisconsin and Texas, where judges cited the decision when ruling that states had not brought valid proof to support claims that new, restrictive laws were actually needed to advance a legitimate purpose.
None of us knew when we started that our case would have such reach and significance. My intention was simply to do what was right for our patients. My team still operates Whole Woman’s Health clinics in Texas, Virginia, Indiana, Minnesota and Maryland. We provide sensitive and holistic gynecological care, including abortion services, to thousands of women each year who are making very personal decisions about their lives, their futures, their families and their reproductive health care. At the same time, we try to offer them hope and compassion during what is often a difficult juncture.
Restrictions like the Louisiana and Texas admitting privileges laws that target abortion providers and deny women access to care are not about preserving health or safety. As the Supreme Court determined in Whole Woman’s Health, using nationwide data, abortion is incredibly safe and almost never requires a patient to be transported to a hospital. In the very few instances where emergency transport is needed, federal law requires hospitals to treat patients.
And critically, abortion providers don’t qualify for admitting privileges for that precise reason — they rarely or never admit patients, which most hospitals require as a condition of granting privileges for business reasons that have nothing to do with the quality of patient care. These laws are about controlling women by limiting their options and spreading confusion among patients and providers alike to make the reproductive healthcare landscape volatile. In doing so, they deprive women of personal autonomy, equality and hope.
Laws that target abortion providers don’t reduce or prevent unplanned pregnancies. These restrictive laws only limit access and shutter clinics, adversely affecting families.
There were more than 40 clinics providing abortion care in Texas in 2013 when lawmakers approved onerous and burdensome new restrictions for clinics. The new rules forced roughly half of those clinics to close before and during the years we were litigating Whole Woman’s Health v. Hellerstedt. Since our Supreme Court victory, very few of those clinics have reopened. There are still only 22 clinics in Texas today, serving a state that is home to nearly 30 million people. That crumbling care environment continues to be felt across the state, and the impact on many communities is long-lasting.
When it decides June Medical Services v. Russo, the Supreme Court will have an opportunity to demonstrate that it can rise above politics and rule based on facts and evidence. When the Court strikes down this copycat attempt from Louisiana, arguably one of the most aggressively anti-abortion states, it will once again send a loud and clear message that these blatant clinic shutdown laws do nothing to improve patient health or safety. Instead, they simply deny people access to their fundamental rights.