The Supreme Court yesterday heard arguments in a Louisiana case that could fundamentally shift abortion rights in this country. June Medical Services LLC v. Russo centers around whether abortion providers must have hospital admitting privileges. The Court ruled on a similar case, Whole Woman’s Health v. Hellerstedt, just four years ago. But the composition of the Court has shifted. A more conservative court must now determine whether Louisiana’s abortion restrictions conflict with the precedent set by the ruling in Whole Woman’s Health. If the court rules in favor of the state and against the clinic, it could pave the way for extremely restrictive abortion rules that could shut down clinics across the country.
June Medical Services LLC v. Russo: What You Need to Know
Hospital admitting privileges grant a doctor the right to directly admit a patient to a specific hospital and provide care for the patient while they are hospitalized.
Admitting privileges might sound like a good idea, but they don’t actually do anything to improve patient safety. Most of the doctors you see don’t have admitting privileges. And doctors performing procedures that present risks similar to or greater than those of abortion often don’t have them. That’s because they’re not medically necessary. Admitting privileges are not a measure of a doctor’s competence. Moreover, a hospital can deny admitting privileges for any reason at all—including administrators’ dislike of abortion, or of an individual doctor.
In an abortion clinic emergency, a patient would travel by ambulance to the nearest hospital—just as they would if they had an emergency at the dentist or at any other surgicenter. Whether or not their doctor had admitting privileges at the hospital would not affect care, because hospitals are required to care for all emergency patients. And if that patient needed care in the days following their abortion, they would either seek emergency care at the hospital near their home, or return to the clinic for follow-up care.
Several states have tried to force abortion doctors to get admitting privileges at their local hospital. The 2016 Supreme Court ruling in Whole Woman’s Health clarified that requiring admitting privileges places an undue burden on women seeking abortions, and therefore is prohibited by Roe v. Wade.
Louisiana ignored that ruling in the hopes of being heard by a more conservative Supreme Court. And now the issue is in front of the court again. Louisiana defends the law, claiming that it screens out dangerous or incompetent doctors and ensures patients can get care at a nearby hospital. The evidence doesn’t support that. A 2018 analysis by the National Academies of Sciences, Engineering, and Medicine found that similar restrictions delay access, stigmatize abortion, and decrease access to quality care, potentially endangering patients.
In 2016, John Roberts joined the more liberal wing of the court and ruled against abortion restrictions requiring admitting privileges. During oral arguments yesterday, he repeatedly asked lawyers for Louisiana to distinguish their case from the prior case. They did not give a clear answer.
Other conservative justices appeared to defend the law, with Samuel Alito arguing that perhaps abortion clinics should not be able to sue to stop restrictive abortion laws. That might seem irrelevant here, but it’s actually key to the conservative plan to dismantle abortion rights. If clinics can’t sue to protect their patients, then who can? The state in the Louisiana case has argued that providers should not have standing to sue. If the Court agrees with them, individual patients would be forced to sue instead. For many reasons, that would make it nearly impossible to bring a reproductive rights case to court.
It’s unclear how the Court will rule in this case—whether they’ll curtail the right to sue to protect reproductive choice, and whether they’ll allow states to pass laws that could shut down numerous abortion clinics and impose an undue burden on doctors and their patients. Abortion will still be technically legal if the far right has their way, but in many states, it could become virtually inaccessible.
How TRAP Laws Undermine Patient Safety
Research consistently shows that the overwhelming majority of Americans, including most Republicans, oppose total bans on abortion and believe Roe v. Wade should remain in place. The Supreme Court and Republican leaders are far out of step with public opinion and healthcare realities. Perhaps that’s why the Court has approved so many abortion restrictions. They’re a way to quietly remove abortion rights while appearing to technically respect the right to choose.
Laws that close abortion clinics, target providers, or impose medically unnecessary restrictions on abortion are called targeted regulation of abortion providers (TRAP). These laws do more than merely make abortion inaccessible; they may endanger patient safety.
There is no abortion safety crisis. Abortion is roughly as safe as most minor dental procedures. Depending on which state you live in, giving birth is anywhere from 14 to 111 times more dangerous than having an abortion. The U.S. maternal mortality rate is rising rapidly thanks to a collapsing healthcare system. Anti-choice legislators have done nothing to intervene—except, of course, trying to force more women to give birth.
When women cannot access abortion, they don’t give up. They instead choose less safe abortion methods. One recent study found that 8 percent of Texas women have self-induced their own abortions. Other research suggests that restrictive abortion laws may not lower the abortion rate. In Latin America, where abortion is mostly banned, the abortion rate is more than three times higher than the U.S. rate. Pregnant people have always sought abortions. The only question is whether they will be able to safely access them.
Anti-choice leaders want the answer to be no.