Supreme Court Strikes Down Texas Abortion Restrictions

WASHINGTON — The Supreme Court on Monday struck down parts of a restrictive Texas law that could have reduced the number of abortion clinics in the state to about 10 from what was once a high of roughly 40.

The 5-3 decision was the court's most sweeping statement on abortion rights since Planned Parenthood v. Casey in 1992. It applied a skeptical and exacting version of that decision's "undue burden" standard to find that the restrictions in Texas must fall.

The decision Monday means that similar restrictions in other states are most likely also unconstitutional, and it imperils many other kinds of restrictions.

Justice Stephen G. Breyer wrote the majority opinion, joined by Justices Anthony M. Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan. Chief Justice John Roberts and Justices Clarence Thomas and Samuel A. Alito Jr. dissented.

The decision concerned two parts of a Texas law that imposes strict requirements on abortion providers. It was passed by the Republican-dominated Texas Legislature and signed into law in July 2013 by Rick Perry, the governor at the time.

One part of the law requires all clinics in the state to meet the standards for ambulatory surgical centers, including regulations concerning buildings, equipment and staffing. The other requires doctors performing abortions to have admitting privileges at a nearby hospital.

"We conclude," Breyer wrote, "that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes. 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."

The clinics challenging the law say it has already caused about half of the state's 41 abortion clinics to close. If the contested provisions had taken full effect, they said, the number of clinics would again be cut in half.

The remaining clinics would have been clustered in four metropolitan areas: Austin, Dallas-Fort Worth, Houston and San Antonio. "None is located west or south of San Antonio, a vast geographic area that is larger than California," a brief for the clinics said. An appeals court did allow a partial exemption for a clinic in McAllen, the brief added, but "imposed limitations on the clinic's operational capacity that would severely restrict its ability to provide abortions."

Officials in Texas said the contested provisions were needed to protect women's health, while abortion providers said they were expensive, unnecessary and intended to put many of them out of business.

The lower courts are divided over whether they must accept lawmakers' assertions about the health benefits of abortion restrictions or instead determine whether the assertions are backed by evidence.

Last June, the U.S. Court of Appeals for the 5th Circuit, in New Orleans, largely upheld the contested provisions of the Texas law, using the more deferential approach. The court ruled that the law, with minor exceptions, did not place an undue burden on the right to abortion.

The court said women in West Texas could obtain abortions in New Mexico, a ruling in tension with one from a different panel of the same court that said Mississippi could not rely on out-of-state abortion clinics in defending a law that would have shut down the state's only clinic.

Last November, the federal appeals court in Chicago used a more demanding standard in evaluating a Wisconsin law requiring abortion doctors to have admitting privileges at local hospitals. Judge Richard A. Posner, writing for the court, said the state's justification for the law did not withstand scrutiny.

"The requirement of admitting privileges cannot be taken seriously as a measure to improve women's health," he wrote, "because the transfer agreements that abortion clinics make with hospitals, plus the ability to summon an ambulance by a phone call, assure the access of such women to a nearby hospital in the event of a medical emergency."

The justices had already acted once in the Texas case. In June, by a 5-to-4 vote, they temporarily blocked the appeals court's ruling pending its own decision in the case. Kennedy joined the court's liberal wing — Ginsburg, Breyer, Sotomayor and Kagan — to form a majority.

The court's last major abortion decision, in 2007 in Gonzales v. Carhart, upheld the federal Partial-Birth Abortion Ban Act, which banned a particular abortion procedure. Monday's case, Whole Woman's Health v. Hellerstedt, No. 15-274, concerned a more fundamental question and seemed poised to be the third installment in a legal trilogy on the scope of the constitutional right to abortion, one that started in 1973 with Roe v. Wade, which recognized a constitutional right to abortion, and continued in 1992 with Planned Parenthood v. Casey.

The Casey decision said states may not place undue burdens on the constitutional right to abortion before fetal viability. Undue burdens, it said, included "unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion."

Breyer, announcing the majority opinion in the hushed Supreme Court chamber, said the requirements in the Texas statute "are not consistent with the constitutional standard set forth in Casey," and are therefore both unconstitutional.

Alito read an extended dissent from the bench, a sign of deep disagreement. "We are supposed to be a neutral court of law," he said, outlining what he conceded were "dry and technical" points of legal doctrine he argued should have precluded the petitioners from presenting the challenge in the first place. "There is no justification for treating abortion cases differently from other cases."