In certain parts of Texas, if you need an abortion, your nearest clinic may be in New Mexico. And not because you live on the border.
That's the likely scenario since a panel of the U.S. 5th Circuit Court of Appeals issued a troubling ruling Tuesday upholding an onerous state law requirement that abortion clinics be outfitted to the standards of ambulatory surgical centers. The appellate court had already upheld the provision of the law that requires doctors who provide abortions to have nearby hospital admitting privileges. On Tuesday, it did allow some exceptions to those requirements in the case of one specific clinic in McAllen, Texas, which is the only one in a very underserved area.
That said, the new ruling will leave, at most, seven or eight clinics open in the entire state. Before the law was passed in late 2013, there were 41 clinics. Then, as various regulations of the law survived court cases, that number dwindled to 16. The latest court ruling will close half of those in three weeks when it takes effect.
The Center for Reproductive Rights and the group of Texas women's healthcare providers that have been challenging the state law in court announced that they would appeal this decision to the U.S. Supreme Court. (I hope the court hears it -- but only if Justices Elena Kagan, Ruth Bader Ginsburg, Sonia Sotomayor and Stephen Breyer are sure they can get a fifth vote on the high court to join them in overturning this law.)
There is absolutely no medical or health reason for doctors to have admitting privileges or for abortion clinics to be outfitted like hospitals, according to doctors, medical groups, women's healthcare advocates and the federal judges who have thrown out these unnecessary provisions through the years in various states.
Last year, U.S. District Judge Lee Yeakel blocked the surgical center requirement of the Texas law, saying it would leave so many women so far from an abortion clinic that it would have the practical effect of "a complete ban on abortion."
Which is exactly what the Legislature and governor of Texas want -- a ban on abortion. This has nothing to do with protecting women's health. More than 90% of abortions performed in the United States are done in outpatient settings, with a less than 0.3% risk of major complications requiring hospitalization. The risk of major complications from first-trimester abortions alone is even lower: 0.05%.
This is just about (unconstitutionally) making it difficult to get an abortion. The clinics that could meet the standards to remain open are in the big urban areas of the state. Clinics would disappear from the rural areas of Texas, leaving lower-income women to make a difficult journey of 200 miles or more in some cases to get to the few remaining clinics.
As Brigitte Amiri, senior staff attorney at the American Civil Liberties Union, said: "For some women in Texas, it will be as if Roe vs. Wade never existed."