Friday, August 29, 2014

Judge Rejects Texas Stricture on Abortions - New York Times

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Whole Woman’s Health in McAllen, Tex., has not been able to perform abortions since October. Credit Jennifer Whitney for The New York Times

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A federal judge in Austin, Tex., blocked a stringent new rule on Friday that would have forced more than half of the state’s remaining abortion clinics to close, the latest in a string of court decisions that have at least temporarily kept abortion clinics across the South from being shuttered.


The Texas rule, requiring all abortion clinics to meet the building, equipment and staffing standards of hospital-style surgery centers, had been set to take effect on Monday. But in his opinion, Judge Lee Yeakel of the United States District Court in Austin said the mandate placed unjustified obstacles on women’s access to abortion without providing significant medical benefits.


The rule “is unconstitutional because it imposes an undue burden on the right of women throughout Texas to seek a pre-viability abortion,” Judge Yeakel wrote.


Texas officials immediately vowed to appeal the decision, while abortion-rights advocates were elated.


“The state disagrees with the court’s ruling and will seek immediate relief from the Fifth Circuit,” said Lauren Bean, a spokeswoman for the Texas attorney general.


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In this 21-page ruling, Judge Lee Yeakel of the United States District Court in Austin, Tex., said the restrictions, which would have closed more than half the state’s abortion clinics, placed an unconstitutional burden on a woman’s right to an abortion.




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Amy Hagstrom Miller, chief executive of Whole Woman’s Health, which operates abortion clinics in the state and was a plaintiff in the suit, said in a statement: “We are extremely pleased by Judge Yeakel’s ruling today. As he clearly states in his decision, requiring every abortion clinic to turn into a surgical center is excessive and not based on good medicine.”


Judge Yeakel’s decision followed recent legal victories across the South for abortion-rights advocates, as federal courts have blocked measures that would have forced the closing of the only abortion clinic in Mississippi and three of five clinics in Alabama. And it reflects the still-charged legal and political environment surrounding abortion in the face of restrictions enacted by Republican-led legislatures across the nation in recent years.


Adopted as part of a sweeping anti-abortion measure last year, the rule would have forced the closing of more than a dozen of the Texas’ remaining abortion clinics because they were unable to afford to renovate or to open new facilities that met the standards for such things as hallway width, ceiling height, advanced ventilation equipment, staffing and even parking spaces.


The closings would have left Texas — the second-biggest state in the country by population as well as by size — with seven or eight abortion clinics, all of them in major cities like Houston and Dallas. Women seeking abortions in El Paso in West Texas and in the Rio Grande Valley in South Texas would have lived more than 150 miles — a distance ruled constitutional by a federal appeals court — from the closest clinic, in San Antonio.


But state officials and other supporters of the abortion law in Texas were confident that they would prevail on appeal.


Last year, Judge Yeakel stayed enforcement of another provision of the 2013 law — a requirement that doctors performing abortions obtain admitting privileges at a hospital within 30 miles of their clinic — but the United States Court of Appeals for the Fifth Circuit, in New Orleans, reversed his decision. The appeals court ruled that because women in Texas were still within driving distance of clinics, the rule did not impose an “undue burden.”


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Amy Hagstrom Miller, chief executive of Whole Woman's Health, outside the federal courthouse in Austin this month. Credit Callie Richmond for The Texas Triibune

The admitting-privilege provision has already forced numerous clinics in Texas to close. In part because of the rule, the number of facilities providing abortions in Texas has fallen to 19, from 41 in November 2012.


In the case decided Friday, Judge Yeakel, who was appointed by President George W. Bush in 2003, reinstated a block on the admitting-privileges rule for two clinics — in El Paso and McAllen, in the Rio Grande Valley — saying that the evidence was especially clear that the law’s requirements would substantially reduce access to abortion for women in West and South Texas.


Over all, he concluded, with the additional clinic closings that would have been forced by the surgery-center rule, many more women would be hours away from a clinic.


“Even if the remaining clinics could meet the demand,” Judge Yeakel wrote, the practical impact of the widespread closings, between long travel distances and other logistical impediments facing many women, would be as drastic as “a complete ban on abortion.”


The Texas attorney general, Greg Abbott, who is the Republican candidate for governor, has defended the law and said the distances women would have to travel for abortions posed no unconstitutional burden, arguing that 86 percent of Texas women of reproductive age would live within 150 miles of a clinic if the law were fully in place.


Four clinic operators and the doctors working for them sued the state in federal court, claiming that parts of the abortion law passed by the Republican-dominated Legislature in July 2013 prevented women in largely poor and Hispanic communities from accessing abortion services, even leading some to self-induce abortions with black-market drugs. Other parts of the law, already in effect, bar most abortions after the 20th week of pregnancy and limit the use of nonsurgical, drug-induced abortions.


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A federal judge in Austin blocked a state law requiring abortion facilities to be licensed as ambulatory surgery centers.




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While Republican legislators and anti-abortion campaigners said the law was needed to protect patients, opponents denounced it as a thinly disguised effort to reduce access to abortions.


Judge Yeakel wrote, “The great weight of the evidence demonstrates that, before the act’s passage, abortion in Texas was extremely safe, with particularly low rates of serious complications and virtually no deaths.”


Texas has for years required that clinics performing later-stage abortions, from 16 weeks of pregnancy, which are more complex, meet surgical-center standards. But the new law would apply those standards to a large majority of clinics that perform only earlier surgical abortions, and to those performing nonsurgical abortions with medication.


In a trial in Austin before Judge Yeakel this month, lawyers for abortion providers argued that the cost of building a site that met the construction standards was more than $3 million. Ms. Hagstrom Miller, the chief executive of Whole Woman’s Health, testified that she had tried to obtain financing to buy a $2.3 million surgical-center facility in Fort Worth but had been rejected by more than 15 banks.


James D. Blacklock, a deputy state attorney general, told the judge that the real issue was not that abortion providers could not afford to comply with the law, but that they had chosen not to because they disagreed with it. He assured the judge that women would have access to abortions throughout Texas after the surgical-center rules went into effect. “This case is really about the effect of the new health and safety regulations on the plaintiffs’ businesses,” Mr. Blacklock told the judge.


The Texas surgical-center rule is part of a drive by anti-abortion groups across the country to impose stiffer regulations on abortion clinics. More than two dozen states have imposed surgery-center-type standards of widely varying stringency, said Elizabeth Nash, the state issues coordinator for the Guttmacher Institute, a research group that supports abortion rights.


The most costly requirements, such as those for hospital-grade ventilation systems, have helped force clinics to close in a few states, including Pennsylvania and Virginia, Ms. Nash said. But the combination of exacting standards and an inflexible deadline, with no waivers for existing facilities, would have had a particularly far-reaching effect on clinics and abortion access in Texas.


Correction: August 29, 2014

Because of an editing error, an earlier version of this article misspelled, on one reference, the surname of the judge who ruled on the Texas law. He is Judge Lee Yeakel, not Yakel.



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