Reproductive rights and justice activists were holding their breaths as SCOTUS decisions trickled in over the last month waiting on the ruling — June Medical Services v. Russo — that would prove to be the first major test for the current court (and President Donald Trump’s two confirmed justices Brett Kavanaugh and Neil Gorsuch) on an abortion-related case. On Monday morning, the court released the opinion ruling 5-4 against the Louisiana Law that would’ve required abortion providers to have hospital admitting privileges within 30 miles in order to perform their procedures (which would’ve left Louisiana with only one clinic left in the state.)
Though the decision has widely been considered a victory for reproductive rights activists who feared for the future of Roe v. Wade, this case was closer to that of 2016’s Whole Woman’s Health v Hellerstedt than a direct challenge of Roe as it dealt more with the question of whether the law in question (Louisiana ACT 620) put an undue burden on patients in the state that would make it impossible for them to access a safe, timely procedure that is legal on the federal level.
The law, which the Center for Reproductive Rights called “identical” to the one struck down in Texas in the Whole Woman’s Health decision, has also been criticized by healthcare providers as it ignores that abortions (when accessible and affordable) are overwhelmingly safe procedures that rarely require emergency care (fewer than 0.3 percent of abortion patients require emergency care or hospitalization) as they don’t provide additional benefits to patients — particularly lower income individuals and BIPOC individuals. It’s also worth noting that U.S. law requires these patients be treated at any hospital — regardless of a provider’s admitting privileges anyway.
#SCOTUS, by vote of 5-4, strikes down Louisiana law requiring doctors who perform abortions to have right to admit patients at nearby hospitals
— SCOTUSblog (@SCOTUSblog) June 29, 2020
Per the decision written by Justice Stephen Breyer and joined by Justices Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor: “The impact of those increases would be magnified by Louisiana’s requirement that every woman undergo an ultrasound and receive mandatory counseling at least 24 hours before an abortion. Both experts and laypersons testified that the burdens of this increased travel would fall disproportionately on poor women, who are least able to absorb them.”
This law (and more than a thousand others like it since 1976) represent a particular kind of legislation that has been harming reproductive age people on the state level in attempts to erode and overturn Roe. There are restrictions from so-called heartbeat bills (a medically inaccurate term due to oversimplifying fetal pole cardiac activity that’s been popularized for legislation), six week bans (which make abortions illegal before most people realize they are pregnant), mandatory counseling, waiting periods and parental consent laws (which make it difficult for low-income, working and young people to have space and time to make their own bodily decisions) that work to make it difficult for patients to safely access the procedures. But laws like Louisiana ACT 620 and the ones struck down in Whole Women’s Health are a breed called TRAP Laws.
What are TRAP Laws?
Standing for Targeted Regulations of Abortion Providers (TRAP) Laws, these pieces of legislation work on the state level to put additional requirements on abortion providers that are hyper-specific, often not informed by medical guidelines and are designed to be difficult for providers to pull off (leading them to have to close their clinics — which is sort of the point).
As sexual health education research and policy organization the Guttmacher Institute notes, “abortion providers in the United States are subject to strict evidence-based regulations (such as state licensing requirements, federal workplace safety requirements, association requirements and medical ethics) created specifically to ensure patient safety.”
However, in nearly half the states in the country, these additional laws work instead to limit access to procedures by closing clinics and leaving people seeking abortions in their state with fewer options (six states have just one clinic left) and a much smaller window to access care. And, as you read more on TRAP regulations, you tend to see a lot of the same language and a lot of the same requirements that were struck down in the Louisiana and Texas cases — these include requiring abortion clinics to unnecessarily meet the same standards as ambulatory surgical centers (ASCs) or hyper-specific hallway and room dimensions for the facility (that can be as cost prohibitive as they are arbitrary from a healthcare perspective.)
“TRAP regulations often include minimum measurements for room size and corridor width—requirements that may necessitate relocation or costly changes to a clinic’s physical layout and structure. Some regulations also mandate that clinicians performing abortions have admitting privileges at a local hospital, even though complications from abortion that require hospital admission are rare, so abortion providers are unlikely to meet minimum annual patient admissions that some hospitals require,” per the Guttmacher Institute. “TRAP requirements set standards that are intended to be difficult, if not impossible, for providers to meet. Instead of improving patient care, these laws endanger patients by reducing the total number of abortion facilities that are able to stay open under these financial and administrative constraints, thus making safe services harder to obtain.”
Often when court cases come and go it’s hard to really sit and consider the real-world implications of these laws. But, ultimately, what we’re looking at is what it means to burden a patient or clinic in a way that makes it near impossible to access a part of healthcare they need in order to make the right decisions for their families. Particularly for lower income people, having to deal with work or childcare or travel (and the expenses that come with them) in order to get their procedure at the (in a few cases) only available clinic in their area, laws like this can be the difference between having the safe procedure they need or being denied their right to choose.