Update (10/14/2014): This afternoon, the Supreme Court blocked a ruling from the US Court of Appeals for the Fifth Circuit that had shuttered most of Texas' abortion clinics. Thirteen clinics in the state will be able to reopen tomorrow, according to the New York Times.
On October 2, the Fifth Circuit overturned a Texas district court ruling from August that had blocked the ambulatory surgical center provision of HB2—arguably the most onerous for abortion clinics—from kicking in on September 1, 2014. The appeals court decision left just eight clinics open in the state, all in metro areas, leaving nearly a million women more than 150 miles from their nearest clinic.
Today's Supreme Court's order blocked portions of the Fifth Circuit's ruling that upheld HB 2's surgical center provision, as well as the requirement that doctors performing abortions at McAllen and El Paso clinics must have admitting privileges at a nearby hospital.
Update (8/29/14): Judge Lee Yeakel of the US District Court in Austin blocked a key provision of HB 2 today. This portion of the law, which required abortion clinics to meet the standards of hospital-like ambulatory surgical centers, was set to go into effect Monday, September 1.
The state of Texas has already announced it will appeal Judge Yeakel's decision to the US Court of Appeals for the Fifth Circuit in New Orleans. This past March, the Fifth Circuit upheld a different provision of HB 2, reversing a block on the rule also issued by Yeakel.
At the new Planned Parenthood clinic in Dallas earlier this month, exam rooms were stocked, desks, chairs, and computers were installed, and even a few phones had started to ring. Construction workers came in and out, and the waiting room stood empty, save for a corner stack of moving boxes.
"We're just waiting for furniture," said Kelly Hart, senior director of government relations for Planned Parenthood of Greater Texas, while giving a tour of the clinic, which opened to patients two weeks ago.
This facility, a preexisting ambulatory surgical center that Planned Parenthood purchased and refurbished, will cost the organization $6.1 million. It's an unexpected bill they've spent months fundraising to cover, because a year ago, Planned Parenthood had no plans for a new Dallas facility: A different clinic already provided safe, legal abortions and vasectomies to patients.
"It was working just fine," says Hart.
But come next week, abortions can no longer legally be performed at that old facility thanks to HB 2, the omnibus abortion bill that made national headlines last summer after Texas Sen. Wendy Davis' 11-hour filibuster. The law requires that abortions—though not vasectomies—be performed in ambulatory surgical centers, hospital-like facilities that specialize in outpatient surgery. This provision goes into effect on September 1.
Ahead of this deadline, women's health care providers have raced to meet HB 2's burdensome requirements, spending millions of dollars and countless hours of fundraising and construction labor. Converting a medical facility into a full-blown ambulatory surgical facility can be very expensive. Texas has 114 pages of regulations governing ASCs, which mandate wide, gurney-accommodating hallways, larger operating rooms, and sterile ventilation. According to one Texas provider, it will cost them about $40,000 more each month to operate an ASC than it would a regular clinic.
In the face of the law's requirements, all but eight abortion clinics in the state will close by September 1. Many were forced to lock their doors earlier this year as other HB 2 provisions went into effect, including a rule that required doctors to have admitting privileges at a hospital within 30 miles of where they perform abortions by the end of October 2013.
While supporters of HB 2 argue that the ASC requirements are vital for women's health and safety, medical groups, including the American College of Obstetricians and Gynecologists, have repeatedly noted that typical doctor's offices are fully able to perform medically safe abortions, and that ASCs do little to enhance the standard of care. (Texas has required that second-trimester abortions take place in ASCs since 2003.)
Come September 1, about 750,000 Texas women will live 200 or more miles from the nearest abortion provider. There were only 10,000 women in that situation just a year ago.