MSNBC's Scarborough: Supreme Court “Could Have Found A Rational Reason" To Justify Texas’ Anti-Abortion HB 2
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ABC’s Mary Bruce allowed an anti-choice activist to push the false claim that Texas’ abortion restrictions were about protecting women’s health during a segment on the Supreme Court’s ruling that Texas’ anti-choice law HB 2 was unconstitutional.
During the segment, anti-choice activist Kristian Hawks falsely claimed the Supreme Court’s ruling jeopardizes women’s health and that women seeking abortion procedures at health clinics will now have to wonder if they’ll “be coming out alive.” ABC’s report failed to report that Hawkin’s allegation were not based in fact, but rather right-wing misinformation frequently pushed to undermind clinics that provide abortions. From the June 27 edition of ABC World News Tonight with David Muir:
GEORGE STEPHANOPOULOS: We begin tonight with the most sweeping decision on abortion in a generation. Today, the Supreme Court struck down a Texas law that imposed strict requirements on clinics and doctors, finding those limits placed an undue burden on the constitutional right to abortion. And on the steps of the Supreme Court, you see it there, activists squared off. Jubilation from the pro-choice side, but despair from anti-abortion forces, because this ruling could affect so much of the country. At least two dozen states have passed laws similar to those struck down today. ABC's Mary Bruce is in Washington with the dramatic decision and its resounding consequences.
MARY BRUCE: At the Supreme Court today, chants of victory from abortion rights advocates. The crowd cheering as interns raced out, carrying the most consequential abortion decision in a quarter of a century. Many of these people have been here since before dawn, making sure they were here to witness this historic decision. The court striking down a Texas law that required abortion providers have admitting privileges at a nearby hospital, and that clinics meet standards for surgical centers. Requirements that have already forced more than half of Texas abortion clinics to close, and threatened half of those still open. In a 5-3 decision, Justice Kennedy, the swing vote, joined the court's four liberals to rule that the restrictions went too far, and placed "an undue burden" on the constitutional right to an abortion. Disappointed, the law's supporters say women's health will now be at risk.
KRISTAN HAWKINS: This means every time a woman walks into an abortion facility in our nation, she's going to have to wonder, will I be coming out alive?
BRUCE: The implications stretch far beyond Texas. About two dozen states have similar laws.
KATE SHAW: Many states have restrictions like Texas's, and I think that those are quite likely unconstitutional after today's ruling.
BRUCE: And the decision could call into question many other restrictions, such as a required waiting period, counseling, and ultrasounds before abortions.
STEPHANOPOULOS: And Mary joins us from the Supreme Court right now. Mary, you know, the future of the Supreme Court, right at the heart of the presidential campaign. You've got that vacancy left by the death of Justice Scalia, and perhaps more to come.
BRUCE: Yes, this decision underscores what's at stake in this election. Clinton tweeting today, "This fight isn't over. The next president has to protect women's rights." And Donald Trump has been noticeably absent from commenting on today's ruling. George?
STEPHANOPOULOS: Yeah, uncharacteristic silence. Mary, thanks very much you.
Laws such as HB 2 are frequently referred to as “TRAP (Targeted Regulation of Abortion Providers) laws,” and seek to restrict access to abortion by requiring clinics to adhere to unnecessary medical standards. TRAP laws are promoted under the guise of public health, despite the fact that abortion is one of the safest surgeries performed in the United States and that many abortions are done with medication instead of surgery.
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On June 27, the Supreme Court ruled 5-3 in Whole Woman’s Health v. Hellerstedt that Texas’ anti-choice law HB 2 placed an “undue burden on abortion access.” Supporters of the unconstitutional law argued that HB 2’s restrictions were necessary to protect women’s health and prevent another “Kermit Gosnell scandal” -- talking points pushed by right-wing media. Writing the majority opinion of the court, Justice Stephen Breyer rebuked these anti-choice myths, saying there was unequivocal evidence that HB 2 lacked medical benefits and posed extreme harm to Texas women.
Editorial Board Concludes Ryan’s “Better Way” Could Lead To “Much Higher Costs” For Many, Allow States “With The Skimpiest Regulations” To “Set The National Standard”
The Washington Post blasted Speaker of the House Paul Ryan’s (R-WI) outline for replacing Obamacare, which could cut health care for millions of Americans and might lead to more rapidly rising insurance costs for an inferior product.
Ryan released a health care reform plan on June 22 under the “Better Way” brand that he hopes will become a fixture for Republican policy making in the next Congress. The plan seeks to repeal the Affordable Care Act (ACA) -- commonly referred to as Obamacare -- and replace it with a series of tax credits for Americans to purchase private insurance. The Post picked apart Ryan’s health care agenda in a June 26 editorial, saying the plan would be “hard on the poor, old and sick” and adding that “those in late middle age could face much higher costs.” The editorial board also derided the plan, which offers no cost projections or estimates for the number of Americans who could lose their ACA-compliant insurance, for being yet another vague proposal from a Republican Party that “has no excuse for blank spaces” after so many years of fruitless opposition to the health care law.
The Post noted that “the rate of uninsured Americans has plummeted to a historic low” since Obamacare was enacted, and Ryan’s plan does not appear capable of maintaining the same low rate. Instead, the plan would create tax credits that increase as Americans age, but it would also let insurers “raise premiums with age much more than the ACA currently allows.” Since “the proposal gives no sense that the two will come close to matching up,” it is possible that the tax credits proposed in the Ryan plan could be much smaller than the actual cost of insurance, making the reform agenda costlier for millions of middle-aged Americans currently benefitting from Obamacare. From The Washington Post (emphasis added):
House Speaker Paul D. Ryan (R-Wis.) seemed to promise better when he announced that he would roll out an ambitious policy agenda this summer. Instead, last week he released an Obamacare alternative that is less detailed in a variety of crucial ways than previous conservative health reform proposals. The outlines that the speaker did provide suggest that it would be hard on the poor, old and sick.
Mr. Ryan’s plan would replace Obamacare with a tax credit available to people buying insurance plans in markets regulated by the states, not the federal government.
The proposal hints that the credit would be sufficient to cover the cost of plans that existed before the ACA. This is not reassuring: Pre-ACA, individual-market insurance plans were often thin, with limited benefits, extensive cost-sharing and other elements designed to deter anyone who might actually need care. Without strong coverage requirements, insurers would have limited incentive to offer plans that appealed to people who may be — or may become — sick. States would be hampered in responding to these issues: The proposal would allow insurers to sell plans across state lines, so the state with the skimpiest regulations would likely set the national standard.
People with money to put into health savings accounts (which the proposal would expand), could cover gaps in thin insurance coverage with tax-advantaged out-of-pocket spending — but this would not be a realistic option for low-income people. As for the old, the plan would scale up the tax credits with age, but it would also permit insurers to raise premiums with age much more than the ACA currently allows. The proposal gives no sense that the two will come close to matching up; as in other conservative plans, those in late middle age could face much higher costs. For the sick, meanwhile, Mr. Ryan’s plan would offer an ultimate backstop by funding high-risk insurance pools. But health-care experts caution that this approach would cost a massive amount of federal money — a fact that has caused Republican lawmakers to balk at policies like it when fleshed out.
This harsh treatment of Ryan’s health care reform agenda mirrors the tone of criticism he drew from various quarters for each of his recent attempts to rebrand misleading Republican economic talking points as a “Better Way” forward. Ryan’s “Better Way” anti-poverty reform agenda, which was based almost entirely on right-wing media myths rather than professional economic research, was slammed by critics as being “doomed to fail” and “based on faulty assumptions.” His health care reform agenda seems to be drawn from the same right-wing media perspective, which considers the full repeal of the ACA to be of paramount importance despite the law’s continued success and the failure of every right-wing prediction of its demise to come to fruition.
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Since 2009, self-described “guerilla journalist” James O’Keefe has repeatedly embarrassed himself while attempting to launch undercover stings targeting government agencies, media outlets, and liberal organizations and institutions.
Patients and Providers Explain What’s At Stake In Supreme Court’s Landmark Abortion Rights Case
When the Supreme Court releases its decision in Whole Woman’s Health v. Hellerstedt, the landscape of abortion access will be altered in Texas and beyond. Before reporting on the potential consequences of the court’s decision, reporters should read these 10 stories about the challenges some people face in obtaining an abortion, told in patients’ and providers’ own words.
HB 2 Is Keeping Abortion Training Out Of Medical Curricula, Which Could Have Dire Consequences For Reproductive Health Care
This June the Supreme Court will release its decision in Whole Woman’s Health v. Hellerstedt -- a landmark abortion rights case challenging the constitutionality of Texas’ extreme anti-choice law HB 2.
HB 2 requires that abortion providers have admitting privileges to a hospital within 30 miles of their clinic and that clinics meet the standards of ambulatory surgical centers (ASCs). Although supporters claim that these restrictions are medically necessary and that they protect patient’s health, the vast majority of experts agree that HB 2’s mandates are based on medically inaccurate information. The Supreme Court's decision in Whole Woman’s Health v. Hellerstedt could set the precedent for all future abortion restrictions.
Even if the court rejects HB 2, Texas clinics still face an uncertain future. As Molly Hennessy-Fiske wrote for the Los Angeles Times, the process of reopening or reauthorizing clinics that closed when the law was implemented to perform abortions would be arduous. The piece quoted Whole Woman’s Health president Amy Hagstrom Miller, who said, “We can’t reopen clinics overnight.” Hennessy-Fiske explained that the process of reopening clinics is difficult because, as Miller noted, “providers have had to sell buildings, give up leases, lay off staff and allow doctors to take other jobs.”
A two-part report from Houston Public Media confirmed these warnings: Thanks to political attacks on abortion access, Texas may be facing a shortage of medical professionals capable of performing abortions. In the piece, Carrie Feibel reported that “the battle over reproductive rights has penetrated academic medicine in Texas” and deterred medical programs from providing abortion education and training. Feibel explained that this “abortion training taboo” in Texas was a result of the logistical challenges of and stigma surrounding abortion care after HB 2.
In part one, Feibel detailed the logistical hurdles created by HB 2 that have made providing abortion training “increasingly difficult,” if not impossible, for many medical programs. According to Feibel, only “three out of the 18 programs in Texas have made arrangements for residents to spend time learning at an outpatient family-planning clinic” -- the type of facility “where most abortions in Texas take place.” In many cases, program directors argue that providing such training is difficult when “the nearest abortion clinic is now closed.”
Dr. Robert Casanova, a recent residency director at Texas Tech University, told Feibel, “The limited choices for our patients pretty much parallels the limited choices for our residents to get training, to where they feel comfortable doing something along those lines.” Texas Tech is located in Lubbock, TX, where the last abortion clinic in the area closed after HB 2 went into effect. As Manny Fernandez reported for The New York Times, because there are no remaining clinics in or near Lubbock, many patients now must make “a five-hour trip to Dallas or to Albuquerque, some 320 miles away” in order to receive abortion care.
Lubbock is not unique in this sense. According to research from the Texas Policy Evaluation Project (TxPEP), since HB 2 went into effect nearly half of Texas’ abortion clinics have closed. In an article about the study, Rewire’s Andrea Grimes described the results in terms of their political ramifications. Grimes wrote that since May 2013 -- shortly before Texas lawmakers passed HB 2 -- “Forty-six percent of Texas’ legal abortion providers have closed.” In addition to the loss of clinics, the overall number of physicians who perform abortions in Texas has also decreased since HB 2 went into effect. In a February 2016 research brief, TxPEP researchers also reported that HB 2 had decreased the number of “physicians providing services in the state” drastically:
In the fall of 2013, before HB2 went into effect, there were 48 physicians providing abortion across the state. Currently there are 28 physicians with admitting privileges providing abortions in Texas. This represents a decline of 42% in the number of physicians providing abortion in Texas since HB2 went into effect. An additional three physicians are currently providing services in El Paso and McAllen due to a partial stay of the Fifth Circuit Court of Appeals’ ruling issued by the US Supreme Court. These physicians would not be allowed to continue to provide abortion services if the Supreme Court ruled to allow the Fifth Circuit decision to go into effect.
Of the 28 physicians with admitting privileges currently providing abortion services in Texas:
15 (54%) were providing in Texas prior to HB2 and had admitting privileges prior to October 2013.
6 (21%) were providing in Texas prior to HB2 and were able to get admitting privileges after the law went into effect.
- 7 (25%) are new abortion providers with admitting privileges.
The lack of available resources for training medical students in abortion care is not entirely a product of accessibility challenges. As Feibel explained, for many programs, HB 2 has had a chilling effect on institutional willingness to support abortion training. “Academic medical centers in Texas receive tens of millions of dollars a year in state funding,” reported Feibel. Because of this funding relationship, “Doctors working in these institutions are walking a very delicate line,” Carol Joffe, a medical sociologist who studies abortion providers, told Houston Public Media. Joffe explained that even when doctors want to provide abortion training, “they are fearful of the other sectors of the university coming down on them and saying ‘You’re threatening our funding.’”
Although abortion is both common and overwhelmingly safe, Feibel explained that institutional concerns coupled with a fear of “backlash from anti-abortion groups and politicians” means that when medical students receive abortion training, it “happens quietly, almost in secret.”
Abortion stigma is defined as the “shared understanding that abortion is morally wrong and/or socially unacceptable." This belief is reinforced through media coverage, popular culture, and by a lack of accurate information in the general public about the procedure itself. Right-wing media and anti-choice groups have worked relentlessly to “exploit the stigma of abortion” -- describing the procedure as sickening, “grisly,” and “selfish” while calling abortion providers “villains” and comparing them to Nazis.
According to Feibel, one of the best ways to combat stigma is for residents to work with patients and understand their motivations for seeking an abortion. She wrote:
There’s another intangible, but critical, experience residents get from abortion training, though it has nothing to do with technique. Jane, the resident, summed it up this way: “Every woman has a different story and a different reason why she chooses to end her pregnancy.”
Hearing those stories from patients is crucial to an ob-gyn’s professional development, said Dr. Jody Steinauer, an ob-gyn professor and researcher at the Bixby Center for Global Reproductive Health at the University of California, San Francisco.
Counseling patients teaches doctors valuable bedside skills like compassion, empathy, and political awareness.
“When they spend time in a setting that provides abortion care, they have real epiphanies,” Steinauer said. “They become more aware of their biases. They’re surprised that more than half of women having abortion are already mothers, for example.”
Challenging abortion stigma by encouraging greater dialogue is a familiar strategy for many reproductive health advocates. Organizations including Sea Change, #ShoutYourAbortion, and the 1 in 3 Campaign all encourage people to speak out about their abortion experiences through a variety of media.
Aside from the social benefits of addressing abortion stigma, exposing medical residents to abortion procedures is beneficial for their development overall. As one doctor told Feibel, “The technical procedure is the same, whether you are doing it for a miscarriage, or whether you’re doing it to terminate an ongoing pregnancy.” Another resident explained that a number of the skills practiced during her time at an outpatient abortion clinic would improve her proficiency in other aspects of the field:
Jane spent about a month at this family planning clinic during the third year of her residency. Abortion is just one of the skills she learned. She counseled patients about abortion, contraception and sexually-transmitted diseases. She also learned techniques for pain management and dilation of the cervix.
Many of those skills will be useful in other practice areas, Jane said. For instance, ob-gyns use ultrasounds for many different reasons.
“Before in residency, we were doing ultrasounds maybe once during a clinic afternoon, or a few ultrasounds in the o-b triage area,” Jane said. “But here we do 30 ultrasounds in a morning, so it’s a lot of good learning about how to do ultrasounds.”
Despite these tangible benefits from providing abortion training to medical students, many training programs won’t embrace the practice; contacted by Feibel, program representatives refused to answer questions about whether they train students to perform abortions. One hung up on her, another cancelled the interview, and six more “simply refused to answer the questions about how the training takes place.”
If the Supreme Court upholds HB 2, the need to “train the next generation” of abortion providers will only grow. To underscore this point, Feibel included comments from Dr. Bernard Rosenfeld, a 74-year-old abortion provider who “hasn’t been able to line up a successor” to lead his medical practice. According to Rosenfeld, although he’s reached out to other doctors, “none of them are interested in the political consequences of providing abortions.”
Fox Host Bill O’Reilly downplayed the dangers of anti-abortion attacks claiming he was unable to remember the last time an abortion clinic was attacked by right-wing extremists, ignoring the long history of attacks against abortion clinics.
On the June 21 edition of Fox News’ The O’Reilly Factor, O’Reilly argued with contributor Kirsten Powers over remarks made by CNN’s Van Jones claiming that “young white” right-wing extremists are seven times more likely to kill an American citizen than Muslim terrorists. During his discussion with Powers, O’Reilly dismissed the prevalence of right-wing Christian attacks by asking, “When is the last time a Christian blew up an abortion clinic?”
The National Abortion Federation reports there have been 42 documented cases of bombing or attempted bombings of abortion clinics since 1977. Most recently, in 2005 a man confessed to two deadly bombings at women’s clinics in Georgia and Alabama. After pleading guilty to the crimes, he told the court “abortion is murder.”
From 1977-2014, 6,948 incidents of violence have been reported at abortion clinics, including the Nov. 27 deadly shooting at a Colorado Planned Parenthood clinic that was inspired by false claims that alleged the network of clinics illegally sold “baby parts.”
Reproductive health clinics have faced a surge of violent threats following conservative media’s wave of anti-abortion attacks that tailed the release of the deceptive video that inspired the Colorado shooter.
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The Supreme Court is expected to rule this month in the landmark abortion case centered around 2013 Texas law HB 2, a statute that was propelled by right-wing media myths and imposes unnecessarily restrictive requirements on the state’s abortion providers. If the country’s highest court allows the Texas law to stand, it will set a dangerous precedent, opening the door for similar restrictions in other states and putting women’s health at dire risk.
Whole Woman’s Health v Hellerstedt – “the most important Supreme Court abortion case in a generation,” – will determine the fate of HB 2, the Texas law that has already forced nearly half of the state's abortion clinics to close by placing medically unnecessary requirements on providers. HB 2 "requires abortion doctors to be affiliated with nearby hospitals and also limits abortion to ambulatory surgical centers," under the guise of necessary women’s health protections, but health experts overwhelmingly say those requirements are both dangerous and “medically unnecessary.” Admitting privileges laws like Texas' HB 2 not only impose stricter requirements on abortion providers than on facilities that perform riskier procedures, but they also severly limit the number of abortion providers; most providers "cannot meet the number-of-admissions standard for gaining privileges because so few of their patients need hospital care."
In the March oral arguments, Texas Solicitor General Scott Keller relied on a common right-wing media myth to justify the restrictions, falsely claiming that they’re necessary to prevent another “Kermit Gosnell” scandal in which illegal operations led to multiple deaths in Philadelphia. But Gosnell’s crimes bear no resemblance to safe, legal abortions – such as those performed at the clinics targeted by HB 2 – and the Texas law, if allowed to stand, could actually make crimes like Gosnell’s more likely given that his business model was to prey on low-income women who could not access legal abortions and “felt they had no alternative.” The Texas lawmakers who pushed for this legislation echoed the right-wing media myth that women's health clinics were unsafe and required increased regulation, capitalizing on a lie that originated with anti-choice activists. Numerous reviews have concluded that abortion facilities nationwide are safe, routinely inspected, and subject to onerous regulation.
The Texas law has already forced more than half of the state’s abortion clinics to close, and if the law is allowed by the Supreme Court to take full effect, another 10 of the 19 remaining clinics in the state could close – meaning that 75 percent of all of the clinics in the state will be shut down because of the law. The final remaining clinics would all be clustered in metropolitan areas. This means the average distance women must travel each way to reach a clinic would be 85 miles (the national average is 30 miles), with nearly 1 million women more than 150 miles from the nearest abortion provider, effectively ending “abortion access for low-income women in rural areas of the state, who are already having a hard time finding providers.” Research conducted by the Texas Policy Evaluation Project (TxPEP) demonstrated the law has “resulted in significant burdens for women” attempting to access abortion care, and the burdens would disproportionately impact low-income women, women of color, and Latinas in particular.
But it’s not just Texan women’s fates at stake in the Supreme Court ruling. The same medically unnecessary restrictions on abortion providers exist in at least 22 other states -- and dozens of additional abortion restrictions exist throughout the country.
As Refinery29’s Lilli Petersen explained, “what’s at stake in Whole Woman's Health v. Hellerstedt isn’t actually the legal right to have an abortion, but what states are allowed to do to regulate the procedure.” A “decision in favor” of HB 2, Petersen expounded, “would set a national precedent and open the door for other states to enact similar limitations on abortion.”
If the Supreme Court finds in Texas’ favor it's likely to have an immediate impact on neighboring state Louisiana, for example, which passed a similarly styled law in 2014. If allowed to stand, Louisiana’s law would shutter three of the state’s four abortion clinics. Just days after hearing oral arguments in Whole Woman’s Health v Hellerstedt, the Supreme Court issued a brief order that reversed the Fifth Circuit, allowing the temporary closed clinics in Louisiana to reopen, but the law’s ultimate fate is still in question. Likewise Alabama has also passed a similar bill that requires doctors who perform abortions to have hospital admitting privileges. That law has been struck down by a federal court but its status could also be affected by the ruling in Whole Women’s Health and reportedly “if the law is allowed to take effect, four of the state’s five clinics would close, and the lone surviving clinic could never meet the demand for abortions in Alabama, which average around 9,000 a year.”
If the impact in Texas is an indicator of what might happen elsewhere, the consequences of the Supreme Court upholding HB 2 are dire. Another TxPEP study predicted that if the Supreme Court fails to overturn HB 2, women in Texas will become increasingly more likely to self-induce abortion "as clinic-based care becomes more difficult to access." Incidents of self-induced abortions are most prevalent among women who reported facing significant obstacles to reproductive healthcare in the past, as is the case with Latina women living in a rural area of Texas that has seen several clinic closures.
In a New York Times article, economist Seth Stephens-Davidowitz outlined how demand for self-induced abortion is concentrated in areas where abortion is most difficult to access, “reminiscent of the era before Roe v. Wade.” Stephens-Davidowitz analyzed data based on Google searches for phrases like “how to miscarriage” and “how to self-abort,” and found that the “state with the highest rate of Google searches for self-induced abortions is Mississippi, which now has one abortion clinic.” Stephens-Davidowitz concluded: “there is an unambiguous fact in Google search data that the eight justices of the Supreme Court and everyone else should know. In some parts of the United States, demand for self-induced abortion has risen to a disturbing level.”
As Dr. Daniel Grossman, co-author of the TxPEP study told reporters, "This is the latest body of evidence demonstrating the negative implications of laws like HB2 that pretend to protect women but in reality place them, and particularly women of color and economically disadvantaged women, at significant risk."
Medically unnecessary restrictive laws don’t protect women and they don’t curb the number of abortions. They actually tend to increase unsafe abortion, according to international evidence. As Taylor Crumpton wrote in Glamour magazine, “when providers are too far away, or waiting periods become untenably long, women look to cross the border to secure abortion-inducing medication or try to get abortion pills through the black market.”
Unless the Supreme Court makes a binding rule striking down both restrictions in HB 2, the door to similar restrictions in other states will be left wide open. The outcome could also be negatively affected by the unprecedented GOP obstruction of the Supreme Court nomination of Merrick Garland to fill the seat left vacant by the death of Justice Antonin Scalia. Due to the empty seat, there’s a chance the court could deadlock or postpone a decision, which could permit Texas HB 2 to stand, but wouldn’t set a binding precedent, “leaving uncertainty for other states and highlighting more than ever the importance of the next Supreme Court appointment,” as The New York Times reported. That uncertainty could weigh especially heavily on “states like Alabama, Mississippi and Wisconsin [as they] press to remove blocks on their admitting-privilege laws.”
Refinery29 has laid out a number of possible outcomes:
When the Supreme Court releases its opinion in Whole Woman’s Health v. Hellerstedt this June, the landscape of abortion rights in the United States will be fundamentally altered -- for better or for worse.
Pro-choice advocates have called Whole Woman’s Health v. Hellerstedt “the most consequential case for abortion rights in this country since Roe v. Wade.” The case itself challenges the constitutionality of Texas’ HB 2 -- a sweeping anti-choice bill that severely limits access to abortion and medical care. HB 2 requires that abortion providers have admitting privileges to a hospital within 30 miles of their clinic, and that clinics themselves meet the standards of ambulatory surgical centers (ASCs) in order to remain operational.
Proponents claim these restrictions are medically necessary to protect the health and safety of women during abortions -- a claim echoed throughout right-wing media and by other anti-choice legislators. Texas lawmakers pushing for the legislation in 2013 capitalized on myths from anti-choice extremists about abortion safety to insist abortion providers required increased regulations. At the time, media gave this claim further oxygen by promoting the misinformation that HB 2’s restrictions were medically necessary. In the years since the bill’s passage Fox News has continued to advance the claim that these anti-choice restrictions improve clinic safety without impeding access to care.
In reality, these restrictions are based on medically inaccurate information, and they serve only to further limit already marginalized communities’ access to abortion by building on pre-existing economic barriers to care.
Even without HB 2, the economics of abortion access are complicated, greatly disadvantaging marginalized communities. According to Salon’s Christina Cauterucci, “Studies show that poor women take up to three weeks longer than other women to secure an abortion” partly because of the time necessary to gather the money for the procedure. She continued that “the further along the fetus, the more expensive her abortion will be and the more likely she is to experience health complications.”
For many low-income patients, however, federal funding restrictions have already created a significant barrier to accessing necessary funds for abortion services. For example, the Hyde Amendment greatly disadvantages low-income communities by blocking use of federal Medicaid funds to cover abortion care except in cases of rape, incest, or to save the life of the mother. In a July 2015 report, the National Women’s Law Center explained that the Hyde Amendment puts low-income persons at a substantial financial disadvantage in obtaining abortions, and it says they “may have to postpone paying for other basic needs like food, rent, heating, and utilities in order to save the money needed for an abortion.”
This financial challenge adds to the usual barrage of anti-choice restrictions already complicating access to abortion care. Between mandatory waiting periods, long wait times to get an appointment, and the great distances many patients must travel to reach a clinic, abortion care is already tenuously out of reach for many. As Amy Hagstrom Miller, president of Whole Woman’s Health, explained during a June 7 press call, HB 2 means there is “a situation in Texas where a right exists on paper, but it is out of reach for a tremendous amount of Texas women.”
Yet media frequently ignore or underestimate the impact of these barriers when talking about abortion. In a recent study, Media Matters analyzed 14 months of evening cable news, looking at discussions of abortion. We found that only eight news segments mentioned the economic barriers women face to accessing reproductive health care -- and even those discussed it only briefly. Although much of the media coverage of abortion restrictions hasn’t emphasized the significance of economic barriers to abortion care, clinic accessibility has been a central aspect of the legal debate over Texas’ HB 2.
During oral arguments on March 2, Justice Elena Kagan described HB 2 as “the perfect controlled experiment” for what will happen if extensive anti-choice restrictions are allowed to take effect. Before Texas lawmakers passed HB 2, there were more than 40 clinics in Texas providing abortion services. According to the Center for Reproductive Rights, “that number has dwindled to 19,” with even more clinics at risk. Indeed, as Eesha Pandit reported for Salon, if HB 2 is upheld, “there would be 10 clinics left in Texas, a state of 27 million people,” and there would be “more than 500 miles between San Antonio and the New Mexico border without a single clinic.”
In a series of studies, the Texas Policy Evaluation Project (TxPEP) evaluated the impact of HB 2 on Texas women’s access to abortion care. In a November 2014 study, TxPEP researchers predicted that if the Supreme Court upholds HB 2, “abortion self-induction will increase” in Texas. Researchers further reported that at the time of the study, between 100,000 and 240,000 Texas women between the ages of 18 and 49 had already attempted to self-induce an abortion. In a January 2015 study, researchers conducted a series of interviews with women “who either had their abortion appointments cancelled when clinics closed or who sought care at closed clinics" following the passage of HB 2. According to a news release about the study, researchers found that because of HB 2, access to care was “delayed, and in some cases [patients were] prevented altogether” from obtaining an abortion.
Dr. Daniel Grossman, a co-author in both TxPEP findings on HB 2's effects on patients, explained that the bulk of TxPEP’s research "demonstrates that the sudden closure of clinics created significant obstacles to obtain care, forcing some women to obtain abortion later than they wanted, which increases the risks and cost." Grossman added that if HB 2 remains in effect, the undue burden on women would grow, as "wait times to get an appointment will likely increase in most cities across the state, as they recently have in Dallas and Ft. Worth, because the 10 remaining facilities will not be able to meet the demand for services statewide."
These clinic closures have had a disproportionately large impact on Texas’ substantial Latina population. In an amicus brief to the Supreme Court about the impact of HB 2, the National Latina Institute for Reproductive Health (NLIRH) cited previous District Court decisions to argue that due to the geographic locations of remaining providers, for many Latina women, clinic closures are “a complete ban on abortion.” Research by the NLIRH indicates that disparities in Latinas’ access to health are now so dire that they could constitute “violations against basic human rights.” Beyond abortion care, research shows that such laws exacerbate the “significant geographic, transportation, infrastructure, and cost challenges in accessing health services” for Texas Latinas more broadly.
As Tina Vasquez reported for Rewire, the impact of HB 2 on undocumented persons would be even more extreme. She wrote that “while a person’s citizenship status affects her ability to access health care throughout the United States, this is especially true in Texas, which has the second-highest undocumented population in the country and some of the nation’s harshest anti-immigration laws.” According to Ana Rodriguez DeFrates, NLIRH’s state policy and advocacy director, internal immigration checkpoints mean “if you’re undocumented, you simply couldn't get to the heart of the state where abortion access is available.”
The potential impact of HB 2 extends far beyond Texas. All four of the mostly likely positions the Supreme Court could take in deciding Whole Woman’s Health v. Hellerstedt would have wide-reaching implications for clinic access across the country. As Nancy Northup, president of the Center for Reproductive Rights, explained, HB 2 represents “a watershed moment in the battle for reproductive rights.” She continued that if the Supreme Court rejects HB 2 it would “protect the health and safety of women and put a stop to the onslaught of laws restricting access to safe and legal abortion.”
For people in Texas, however, HB 2 has already had a decidedly negative impact. Writing in The New York Times, Valerie Peterson recounted the challenges she faced trying to access safe and affordable abortion care in Texas:
Nearly six months after my abortion I still carry the scars of the experience — not of the procedure itself, which was a blessing I will never regret, but of how hard it was to get the care I needed in the state where I live.
After my doctor called the clinic, I was told I would have to wait three to four weeks for the next available appointment. There was no way I could wait that long. Not only would I be carrying a baby I knew wouldn’t survive, but that kind of wait could push me past the 20-week mark after which almost all abortions are illegal in Texas.
My doctor was able to find me an appointment the following week instead. But when I found out the procedure would then take three to four days to complete as a result of other restrictions that include mandatory counseling, a required sonogram and an additional 24-hour waiting period, I broke down.
I didn’t know how I was going to make it that long. One unnecessary additional day was one more than I could bear.
Through a friend, I was connected to a clinic in Florida that caters to women who are terminating for medical reasons, and I spoke to the doctor and nurse there. The doctor explained that Florida didn’t have a 24-hour waiting period, and they could get me in the next day.
I booked the first plane ticket I found. I got a hotel room and rental car. I flew to Florida on Friday, and my procedure was over by Saturday afternoon. Including the cost of the procedure, I had to spend close to $5,000.
I remember thinking: What happens to women in my situation who don’t have the ability to do what I just did? My heart aches for those women.
* Image courtesy of Cosmopolitan
Conservative pundits lashed out at the American Medical Association (AMA) for adopting a policy calling gun violence “a public health crisis,” claiming the policy is “pseudoscientific” and telling the association to “shut up.” But numerous public health and medical experts have previously noted that "gun violence is a public health issue that has reached epidemic proportions."
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