HB 2: A SCOTUS Pause Before the Next Storm
Patients, clinics struggle with impact of legal rulings
On Friday, Oct. 3, the parking lot of Planned Parenthood on Ben White Boulevard overflowed; in "crisis management" mode, the relatively small staff scrambled to keep up with the unprecedented volume of vulnerable, abortion-seeking patients. Within 24 hours, the center would become the sole abortion care provider in Austin.
Patients arrived in fear and anxiety. Many who had scheduled their procedures at previously open clinics were told they would now need to undergo a second 24-hour pre-abortion sonogram – as mandated by a 2011 state law – prolonging their procedure even further. For some women, that meant jeopardizing their safety – a woman threatened by domestic violence saw her window slowly closing; another, suffering a lethal fetal abnormality, was in dire need of immediate service.
It was a similar scene all over Texas – when the conservative 5th Circuit Court of Appeals stayed U.S. Judge Lee Yeakel's August ruling that found parts of Texas' omnibus abortion law, House Bill 2, unconstitutional, it forced 13 clinics to close their doors, unable to meet the costly ambulatory surgical center building code requirements mandated by the final provision of HB 2. Overnight, the number of abortion clinics – already reduced from 41 in 2013 to roughly 20 due to other rules imposed by HB 2 – shrunk further, to just eight centers serving a population of 5 million reproductive-age women. Under the new rules, an estimated 1 million women would need to travel more than 150 miles (one way) for care, with low-income and rural women, those with the fewest resources, feeling the deepest impact.
The demand on the remaining abortion providers rose dramatically. On Friday, Sept. 26, about 30 patients called the Austin Planned Parenthood ASC to schedule an abortion – following the 5th Circuit ruling, that figure shot to 230, a 660% increase. The number of women undergoing sonograms doubled.
"Our patients were very concerned, very fearful, very worried. We had patients ask us, 'Will you still be open when I come back tomorrow?'" a doctor told the Chronicle during an interview at the center. (For security reasons, he requested anonymity.) "Many patients aren't following the court rulings, and don't understand how things can change so drastically from one day to the next. We did everything we could to reassure them they would continue to have access to our services." But when he heard over the radio of the appellate court ruling, the doctor was worried. "I thought, 'Are we really prepared to meet the need?'"
The emotional roller coaster flipped again just days later. In a rare victory for abortion providers, on Oct. 14, the U.S. Supreme Court vacated the stay ordered by the 5th Circuit and reinstated the injunction by Yeakel. The decision allowed the 13 closed clinics to reopen – but since reinstating a non-operational clinic isn't as simple as turning on the lights, not all have been able to do so. In Austin, the Brookside Women's Medical Center resumed services, but Whole Woman's Health remains closed for now, while staff weigh the options. Nevertheless, pro-choice advocates celebrated the SCOTUS ruling, describing it as "justice" for Texas women and a "tremendous victory."
The waters may quiet for the rest of 2014, but the order is only temporary; a full appeal will be heard by a three-judge panel of the 5th Circuit. Both sides have until Dec. 8 to submit briefs, with oral arguments expected to take place in late December or early January. The 5th Circuit has repeatedly sided with anti-choice state officials on abortion regulations, including HB 2; there is little to indicate this time will be different, meaning the "logistical nightmare" and shock experienced by medical staff and patients will most likely be repeated in the near future. If, as expected, the 5th Circuit rules to uphold HB 2, plaintiffs with the Center for Reproductive Rights plan to appeal to the Supreme Court.
Sarah Wheat, vice president for community affairs at Planned Parenthood, said that to address the increase in patients, the health care center is considering everything from extending hours to hiring additional staff, especially if it once again becomes the only refuge for Austin abortion patients. But the ultimate outcome of the court case is difficult to anticipate.
Meanwhile, providers find themselves saddled with other residual effects of surviving the onerous restrictions. Aside from the enormous influx of patients, a flood of anti-choice protesters from the Brookside clinic (briefly closed by HB 2) recently migrated to the South Austin center. The number of protesters lining the perimeter of the center has risen steadily since clinics in the community closed – after the 5th Circuit decision, the crowd tripled. Wheat said the protesters' "intimidation and disrespect" created such an uncomfortable and hostile environment for patients that center staff members were compelled to ask for police protection. "It's another daily challenge for us and our patients – in the long-term, we don't know what to expect," said Wheat.