The Supreme Court on Monday struck down a Louisiana law that critics said could have forced all but one of the state’s abortion providers to close, granting a major victory for abortion rights supporters and signaling that the more conservative court isn’t ready to overthrow precedent on the divisive issue.
In a 5-4 ruling, with Chief Justice John Roberts casting the deciding vote, the court said the Louisiana law requiring abortion providers to have admitting privileges at local hospitals created an unconstitutional undue burden for patients seeking an abortion.
Justice Stephen Breyer, in an opinion joined by rest of the court's liberal wing, wrote that the Louisiana law would make it "impossible for many women to obtain a safe, legal abortion in the State and [impose] substantial obstacles on those who could." Roberts, in a separate concurring opinion, disagreed with the liberal justices' reasoning but said he was bound by the precedent the court set just four years ago when it rejected a similar law in Texas.
"The Louisiana law imposes a burden on access to abortion just as severe as that imposed by the Texas law, for the same reasons," wrote Roberts, who had voted to uphold the Texas restrictions in 2016. "Therefore Louisiana’s law cannot stand under our precedents."
The case, the first abortion challenge heard by the Supreme Court since the addition of President Donald Trump’s two appointees, has been closely watched by activists on both side of the abortion debate, partly because of its close similarities to the Texas case. Monday’s decision suggests the ruling in the Texas case should be applied more broadly, which may limit the ability of anti-abortion states to mandate admitting privileges.
The ruling in June Medical Services v. Russo also comes just months ahead of a heated presidential election in which anti-abortion and abortion rights groups are spending tens of millions of dollars to mobilize voters. Once again, the court’s ability to shape abortion rights has played prominently in their messaging, with Trump promising to appoint more anti-abortion judges and Joe Biden, the presumptive Democratic nominee, pledging to protect and expand access to the procedure.
Anti-abortion groups swiftly attacked the decision and said it will motivate conservatives to turn out at the polls in November.
“It is imperative that we re-elect President Trump and our pro-life majority in the U.S. Senate so we can further restore the judiciary, most especially the Supreme Court," said Susan B. Anthony List President Marjorie Dannenfelser. "We will not relent until the Supreme Court once again respects the will of the people and ceases its lawless attacks on the right to life."
The White House in a statement called the ruling "unfortunate."
"Instead of valuing fundamental democratic principles, unelected Justices have intruded on the sovereign prerogatives of State governments by imposing their own policy preference in favor of abortion to override legitimate abortion safety regulations," read the statement.
While Democratic lawmakers and abortion rights groups celebrated Monday's ruling as a major victory, many stressed that the 5-4 ruling underscored the fragility of abortion rights.
"It remains a relentless attack," said Nancy Northup, the president of the Center for Reproductive Rights, which argued the case on behalf of Louisiana's clinics and has 30 other active cases against abortion restrictions. "We shouldn’t have to keep playing whack-a-mole. We won on the Texas case four years ago. We won today. But it’s not going to stop those hellbent on those banning access to abortion."
The ruling is the latest in a series of high-profile defeats at the Supreme Court for the Trump administration and its conservative supporters, though the five conservative justices on Monday separately upheld a law allowing the U.S. to withhold HIV/AIDS funding to foreign groups that don't formally denounce prostitution and sex trafficking. Conservatives have increasingly trained their ire on Roberts, who recently joined with the court's liberals to extend civil rights protections to LGBT employees and invalidate the administration's plan to end the Deferred Action for Childhood Arrivals program.
"Justice Roberts, a so-called conservative, is clearly no longer running things," said Heritage Action in a statement.
Roberts defended his finding at length, writing that he still believes the Texas case was wrongly decided but said "adherence to precedent is necessary to avoid an arbitrary discretion in the courts."
The court also rejected Louisiana’s argument that abortion providers do not have legal standing to challenge restrictions on behalf of their patients. A ruling for the state on that point would have upended a nationwide pipeline of abortion litigation, since clinics typically lead such lawsuits.
Justices Brett Kavanaugh, Clarence Thomas, Neil Gorsuch and Samuel Alito authored separate dissents but all agreed that abortion providers shouldn't be allowed to challenge abortion restrictions, arguing they have a "conflict of interest."
Louisiana abortion providers had argued the state’s admitting privileges law would hurt Louisiana residents by forcing two of the state’s three abortion providers to shut down. Further, they argued the requirement was unnecessary since patients experiencing complications from an abortion would be able to get hospital care regardless of whether their provider had admitting privileges.
The Louisiana law was passed in 2014 but only implemented briefly in 2016 before it was halted by federal courts — including the Supreme Court in early 2019 — while legal challenges were underway. While the law was in effect, most of the state’s abortion clinics suspended appointments and referred patients to a single facility in Shreveport, which had admitting privileges at a nearby hospital.
The Supreme Court found the circumstances around the Louisiana requirements were similar enough to the Texas law it struck down 5-3 just four years ago. In that decision, retired Justice Anthony Kennedy joined with the court’s liberal wing in finding the state’s admitting privileges law placed an “undue burden” on a woman’s constitutional right to an abortion. The court noted that the restrictions offer “few, if any health benefits for women,” since abortion-related complications that require hospitalization are very rare.
The court came to the same conclusion on the Louisiana law, writing Monday that "the state introduced no evidence showing that patients have better outcomes when their physicians have admitting privileges or of any instance in which an admitting privileges requirement would have helped even one woman obtain better treatment."
The ruling ensures that Louisiana's three remaining abortion clinics will be able to keep practicing for the time being.
While the case didn’t directly challenge Roe v. Wade, the ruling comes as a wave of recent state laws seeking to overturn the right to an abortion are being reviewed by lower courts. A number of conservative states, including Alabama, Georgia and Mississippi, have approved near-total bans on the procedure in the past two years, hoping the more conservative Supreme Court would be receptive to weakening or eliminating Roe.
But Thomas was the only justice Monday to indicate an interest in revisiting the landmark ruling that legalized abortion nationwide nearly 50 years ago. "Our abortion precedents are grievously wrong and should be overruled," he wrote.