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WASHINGTON — The US Supreme Court struck down a Texas law on Monday that imposes tough regulations on the state’s abortion clinics, setting the stage for a new wave of lawsuits that could overturn similar state laws across the country.

In a 5-3 decision, the court ruled that the Texas law imposes an “undue burden” on women seeking abortions because its regulations have forced too many clinics to shut down. The law could have left as few as 10 clinics in the entire state if it were allowed to take full effect, down from 20 now, according to abortion law experts.

Other clinics haven’t been able to meet the law’s main standards: Their building codes have to be the same as ambulatory surgical centers — facilities that let people get same-day surgery outside of hospitals — and their doctors have to have admitting privileges at hospitals within 30 miles of the clinics.


Texas argued that the law was necessary to improve the standard of care at abortion clinics and protect the health and safety of the patients. But supporters of abortion access said they were unnecessary and have already led to the closure of half of the clinics in the state, with more likely to follow.

“We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes,” the court ruled in an opinion written by Justice Stephen Breyer. “Each places a substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access … and each violates the Federal Constitution.”


“The record makes clear that the surgical-center requirement provides no benefit when complications arise in the context of an abortion produced through medication,” Breyer wrote, because “complications would almost
always arise only after the patient has left the facility.”

Justice Anthony Kennedy — who had always been expected to be the swing vote — joined with Breyer, as did Justices Ruth Bader Ginsburg, Sonia Sotomayor, and Elena Kagan. Chief Justice John Roberts and Justices Samuel Alito and Clarence Thomas dissented.

The ruling was quickly cheered by abortion rights supporters, including Whole Woman’s Health, the lead plaintiff in the case.

“Today, the Supreme Court affirmed what we at Whole Woman’s Health have known all along — that every woman, no matter where she lives — deserves access to compassionate, respectful, and comprehensive care from a clinic she trusts. Today justice was served,” Amy Hagstrom-Miller, president and chief executive officer of the group, said in a statement.

President Obama said he was “pleased to see the Supreme Court protect women’s rights and health.” Democratic presidential candidate Hillary Clinton called the decision “a victory for women across America,” declaring that the court “upheld every woman’s right to safe, legal abortion, no matter where she lives.”

Texas officials slammed the ruling and insisted they were only trying to protect women’s health.

The regulations were “an effort to improve minimum safety standards and ensure capable care for Texas women,” Texas Attorney General Ken Paxton said in a statement. “It’s exceedingly unfortunate that the court has taken the ability to protect women’s health out of the hands of Texas citizens and their duly-elected representatives.”

The decision gets rid of two Texas laws that are “among the most burdensome in the country” in their regulation of abortion clinics, according to Elizabeth Nash, an expert on state laws at the Guttmacher Institute, a research group that supports abortion access.

And although it’s not likely have an immediate impact on other state laws — since they’re not identical to the Texas law — it could make them vulnerable to new lawsuits targeting similar restrictions, Nash said.

About half of the states have laws setting building standards for abortion clinics, according to the institute. But the ruling has the most direct implications for four states with laws nearly as restrictive as the one in Texas: Michigan, Missouri, Virginia, and Tennessee.

In addition, four states besides Texas — Missouri, North Dakota, Tennessee, and Utah — have laws requiring abortion clinic physicians to be able to admit patients at nearby hospitals.

Texas law also requires women to receive a sonogram and pregnancy counseling at least 24 hours before having an abortion.

There’s no designation of how far is too far to force women to travel to obtain an abortion, and the court did not set a limit on Monday. But the court ruled that while long driving distances are not an “undue burden” in themselves, they are “one additional burden” for Texas women because of all the clinic closures — enough to cause an undue burden in combination with the law’s restrictions.

If the law was upheld, closing more clinics, it’s estimated that more than 752,000 Texan women of reproductive age would have lived more than 200 miles from an abortion provider.

The case, Whole Woman’s Health v. Hellerstedt, was filed by a group of abortion providers who argued that the 2013 Texas law creates an “undue burden” on women seeking abortions — the standard created by the last major Supreme Court abortion ruling in 1992.

During the arguments before the Supreme Court in March, Stephanie Toti of the Center for Reproductive Rights, the attorney for the abortion providers, declared that “these laws impose heavy burdens on abortion access that are not medically justified.” She said there was “no evidence … that there is a medical benefit to having a medication abortion at a multimillion-dollar surgical facility.”

However, Texas Solicitor General Scott Keller argued that the facility standards were justified because “there would be surgery in a complication” from a drug-induced abortion, adding that all Texas clinics perform surgical abortions anyway.