More Than Mileage: The Preconditions of Travel and the Real Burdens of H.B. 2

Abstract

During the winter break of my second year in law school, I drove from my childhood home in Fort Worth, Texas to New Orleans, Louisiana to watch oral arguments at the Fifth Circuit in the case Planned Parenthood v. Abbott} That case was the first legal challenge to the constitutionality of Texas House Bill 2 (H.B. 2), (2) the omnibus anti-abortion bill enacted by the Texas legislature in 2013. In total, I drove 541 miles door-to-door, spending about eight hours on the road each way. That distance is slightly less than what a woman living in El Paso would have to travel to get an abortion in Texas if H.B. 2 had been fully implemented. Because of the Supreme Court's decision in Whole Woman's Health v. Hellerstedt, (3) the second attempt to strike down the law, that potential outcome will hopefully remain a hypothetical. Whole Woman's Health challenged two provisions of H.B. 2, (4) which is aimed at shuttering clinics that provide abortions, as Texas politicians have more or less admitted. (5) The first provision under review required abortion providers to have admitting privileges at a hospital within thirty miles of the clinic where they provide services. (6) The second required abortion clinics to meet the standards of an ambulatory surgical center (7) : outpatient medical facilities equipped for invasive surgeries. Mainstream medical experts unanimously agree that these requirements, and others like them, are not only onerous and expensive, but also arbitrary and unnecessary. (8) The provisions did nothing to ensure women's health and safety. In fact, data shows that H.B. 2 harms women's well-being. (9) That harm is largely the result of the law, especially the two provisions in question, forcing clinics to close, thereby making abortion services inaccessible to Texas residents in need of care. In reversing the Fifth Circuit and striking down the admitting privileges and ambulatory surgical center provisions in H.B. 2, the Supreme Court's majority opinion recognized the extensive harm caused by TRAP (Targeted Regulation of Abortion Providers) laws. (10) And, more than recognize the harms, the justices in the majority declared an evaluation of the harm done by such regulations a necessary part of Constitutional analysis. But as bold as Justice Breyer's opinion was in Whole Woman's Health, it is only forward-looking, preventing future harm. It cannot and does not undo the damage already inflicted upon the women of Texas, nor does it solve the access problem caused by H.B. 2; there are not enough clinics in Texas. Even just partial implementation of H.B. 2 caused a significant reduction in the number of abortion clinics in the state. Prior to the law's enactment, Texas had roughly forty-one clinics. (11) Approximately nineteen remain--meaning that in just three years, over half the clinics providing abortion closed. (12) Had the law gone into full effect, the number would have been reduced to ten or fewer, with all the remaining clinics clustered in the state's major metropolitan areas of Fort Worth, Dallas, Houston, Austin, and San Antonio. (13) Today only one clinic remains in McAllen, Texas. (14) By reversing the lower court's ruling and declaring these two provisions of H.B. 2 unconstitutional, the Supreme Court's decision enables the McAllen clinic to operate at full capacity rather than the reduced schedule forced upon it by the Fifth Circuit's earlier decision. (15) But it will take time--months or, more likely, years--to return capacity in the Rio Grande Valley and elsewhere in the state to pre-2013 levels. Thus, the weight of the burdens imposed by H.B. 2 continues to bear down on Texas residents and to fall most heavily upon those most immediately and abundantly hurt by the law: Latina immigrants and their families, especially those living in rural communities. These harms, and the clinic shortage causing them, are the legacies of H.B. 2 and of a toothless undue burden standard that guided abortion jurisprudence for far too long. …