Final Piece of Texas Law Will Further Slash Access to Abortion

When the final provision of Texas' omnibus anti-abortion law, HB 2, goes into effect Monday, September 1, hundreds of thousands of women -- especially those who are poor and live outside of major cities -- will see their access to safe, legal abortion drop dramatically.

Despite Democratic state senator Wendy Davis's 10-hour filibuster, and the people's filibuster that followed, HB 2 passed the Texas legislature in July 2013. The bill was part of an unprecedented wave of state-level abortion restrictions that swept the country over the past three years.

HB 2 includes four new restrictions on reproductive care:

• A requirement that physicians performing abortions have admitting privileges at hospitals within 30 miles of the facility;
• A ban on abortions at 20 weeks post-fertilization or later, except in cases where the woman's life is in danger or where there is severe fetal abnormality (but not rape);
• Further restrictions on the use of the medical abortion pill;
• A requirement that all facilities meet the standards of amulatory surgical centers (ASCs), even if they only offer medical abortion.

It's the last provision that goes into effect September 1. Already, 19 of the state's 41 clinics have had to close as a result of HB 2, and 16 more are in line to shut down on Monday. That will leave between six and eight legal abortion providers in a state of more than 26 million people, of whom about 5.5 million are women of reproductive age.

"That's one legal abortion provider for every one million Texans who could become pregnant, according to an estimate from the University of Texas' Texas Policy Evaluation Project," Andrea Grimes writes for RH Reality Check. "Those eight facilities will all be located along the I-35 and I-45 corridors, in major cities in the eastern half of the sprawling state. No legal abortion facilities will operate south or west of San Antonio."

According to the Texas Policy Evaluation Project, the number of women of reproductive age in Texas living more than 200 miles from a clinic providing abortion in Texas increased from 10,000 in May 2013 to 290,000 by April 2014. When the ASC requirement goes into effect this will increase to 752,000. And almost 2 million women will live more than 50 miles from an abortion provider.

Considering that Texas also requires women to have a sonogram 24 hours before their procedure, the necessary investment of time and money makes a legal abortion increasingly inaccessible especially for low-income women, immigrants, and women of color.

The San Antonio Current reports:

Amy Hagstrom Miller runs the Whole Woman's Health abortion provider network in Texas. Right now, the San Antonio location is the only facility in the city operating an ambulatory surgical center, and it will remain open after September 1. McAllen's Whole Woman's Health closed last year, and since then, Miller said her organization has purchased 15 gas cards and bus tickets for women to travel the more than 200 miles to San Antonio. The McAllen clinic used to treat about 45 women weekly, she said, so she knows more need help.

"We're here and ready, but the vast majority of women can't add those travel costs to the cost of an abortion or they can't take off work," she said. "There will be access in San Antonio, but abortion becomes out of reach for so many women."

The effects of the law could be catastrophic. At FiveThirtyEight.com, Amelia Thomson-Deveaux looks at how Texas's abortion restrictions may increase the number of self-attempted abortions. She quotes Dan Grossman, a co-investigator of the Texas Policy Evaluation Project: "One important reason that women turn to self-induction is because of a lack of clinic-based care. It's a hypothesis, but it seems likely that given the clinic closures, greater knowledge about self-induction methods, and the high rates of poverty in the area, that this is something more women are going to consider."

According to the Guttmacher Institute, an advocacy organization focused on sexual and reproductive health, state legislatures have continued in the first half of 2014 to restrict access to abortion through targeted regulations of abortion providers, known as TRAP laws. Altogether, 26 states have some sort of TRAP law, a sharp increase from 2000, when only 11 states had such requirements. With the addition of new laws passed this year, 59 percent of women of reproductive age live in a state that has enacted TRAP provisions.