Kathleen Pittman has been the clinic administrator at Hope Medical Group in Shreveport, Louisiana, since 2010. Back when she first took the job, there were seven abortion clinics operating in the state. Today, there are three. Earlier this year, after the Fifth Circuit Court of Appeals upheld a law that would have required every doctor who provides abortions to have admitting privileges at a local hospital, that number temporarily fell to two. It could have dwindled to just one if the Supreme Court had not stepped in, temporarily blocking the law from going into effect.
On Wednesday, the Center for Reproductive Rights asked the Supreme Court to overturn the Fifth Circuit’s decision, keeping the three clinics left in Louisiana open. And, in an unusual step, they’re asking for the court to overturn the law without a hearing because of its striking similarities to a law the court already struck down three years ago, in Whole Woman’s Health v. Hellerstedt.
“The Louisiana law is identical to the Texas law struck down three years ago by the Supreme Court,” Nancy Northup, president of the Center for Reproductive Rights, which successfully led the charge to strike down that Texas law, said in a call with reporters on Wednesday. “The Louisiana law was modeled on the Texas law specifically in recognition of the Texas law’s ‘tremendous success’ at closing abortion clinics and reducing abortion access.”
Because none of the circumstances have changed in the three intervening years, lawyers for the Center for Reproductive Rights say there is no reason for the court to hold a hearing on the matter. “That’s how clear-cut this case is: There is no need for new argument,” Northup says.
But it would be unusual for the court to strike down the law without a hearing, acknowledges Northup, especially since the court’s motion to temporarily halt the law in February only narrowly passed in a 5-4 vote.
Going forward, there are several ways the Louisiana case could play out. The court could grant the Center for Reproductive Rights’ request to strike down the law without even a hearing, or the court could hold the hearing and strike down the law; in both of those cases the justices would be upholding the precedent they set three years ago. The other possible scenarios are less rosy for abortion advocates. The court could hear the case and uphold the Fifth Circuit’s decision that the Louisiana law was constitutional: two new conservative justices have been added to the court since 2016, when Whole Woman’s Health was decided, and though Chief Justice John Roberts sided with the liberal wing in February to temporarily block the Louisiana law, he voted against striking down the Texas law in 2016.
The final possibility is that the court could decide to not hear the case, leaving the Fifth Circuit ruling in place — in which case the Supreme Court would be declining to uphold the precedent it set in Whole Women’s Health, overturning it, in effect if not overtly, and all but ensuring the shuttering of two of the last three abortion clinics in Louisiana. That scenario would likely open the floodgates for copy-cat laws around the country. “After the Whole Woman’s Health decision, admitting privileges laws in five other states were either blocked by courts or abandoned by states,” Northup says. But if states knew the Supreme Court would no longer stand in the way of such legislation, it would be open season. “Anti-abortion forces will see that not just as a road map but as an invitation to enact all manner of abortion restrictions and try to do an end run around women’s health,” Travis Tu, senior counsel for the Center for Reproductive Rights, told Rolling Stone in March.
Depending on how long it takes the state of Louisiana to respond to the petition filed Wednesday, the case could potentially end up before the court within the next two months.
In the meantime, Louisiana women and the doctors who provide abortions in the state, will have to wait. Literally. The decreasing number of clinics means fewer available appointments. “During the brief period in which we were down to just two providers, early on in this case before it was stayed, we were seeing women have to postpone abortions for several weeks,” Pittman says. “This cannot happen again. At the very least, if the delays mean women having abortions later, which drives up the cost, it may even put abortion beyond reach for some of these women.”
“Lack of financial resources is the most common reason given for women terminating a pregnancy,” Pittman says. The state already has a 24-hour waiting period on the books, which means the women who seek abortions at Hope Medical — most of whom already have children and live near or below the poverty line — need to come at least twice. “It isn’t uncommon when reviewing charts to see patients noted on the top of the chart that they scheduled and rescheduled multiple times due to issues with having to arrange for transportation, childcare or even time off work.”
And for the providers, the decreasing number of clinics is directly proportional to an increase in the intensity of anti-abortion protesters outside their doors. “At Hope we have seen protester activity become more frequent and nasty, and nasty is the only word I have for it,” says Pittman, “It’s become more personal, with physicians and staff being called out in-person and on social media. Patients are being recorded arriving and leaving and are being subjected to harassment they shouldn’t have to endure. All of this is already happening with the three clinics.”