The Supreme Court struck down two key abortion restrictions Monday, redefining the scope of Roe v. Wade in what many consider to be the most significant abortion ruling in a generation.
In Whole Woman’s Health vs. Hellerstedt, the Court ruled 5-3 that Texas’s regulations on abortion providers constituted an undue burden on the constitutionally protected right to terminate a pregnancy. In 2013, Texas passed a law requiring all abortion providers to have admitting privileges at local hospitals and all clinics to be equipped with hospital-level surgical centers.
“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,” Amy Hagstrom-Miller, president and CEO of Whole Woman’s Health, said in a statement. “Today justice was served.”
The ruling was a clarification on the 1992 plurality opinion in Planned Parenthood v. Casey, in which Justice Anthony Kennedy joined Justice Sandra Day O’Connor in writing that states may regulate abortion as long as they do not create an “undue burden.” Monday’s ruling attempts to clarify exactly what an “undue burden” means.
The 2013 Texas law, known as HB2, is part of a larger strategy employed by anti-abortion state lawmakers to significantly curtail abortion without actually outlawing it. Conservative lawmakers in dozens of states have implemented waiting periods, term limits, and regulations on doctors and abortion providers that often lead to the closure of clinics. At least 288 abortion regulations have been enacted since conservatives swept into state legislatures in 2010, according to the Guttmacher Institute, which amounts to about 27% of all the restrictions passed in the 43 years since Roe v Wade. Reproductive rights advocates argue that these laws constitute an “undue burden,” since women in states like Texas, Mississippi, and Wisconsin often have to take days off of work and drive hundreds of miles to get to an abortion provider, if they can get an appointment at all.
Supporters of the laws argue that the regulations make abortion safer, and protect women’s health. In his Supreme Court argument in defense of the law, Texas solicitor general Scott Keller repeatedly referred to a high complication rate, an argument that has recently become the rallying cry of the anti-abortion movement.
“The abortion industry cannot be trusted to regulate itself and they know it,” said Marjorie Dannenfelser, president of the anti-abortion organization Susan B. Anthony List, in a statement about the decision. She condemned what she called the “unsanitary conditions” of clinics that provide abortions, called laws like HB2 “common sense” standards, and urged supporters to elect a “pro-life president” to “address the havoc wrought by the Supreme Court on America’s unborn children and their mothers.”
“We have documented page after page of incidents of abuse, negligence, and brutality since 2008,” she said. “This decision means the filth and exploitation will continue unchecked.”
Major medical organizations like the American Medical Association and the American College of Obstetricians and Gynecologists had filed amicus briefs urging the Supreme Court to strike down the law, calling the restrictions “medically unnecessary.” During the hearings in March, the female Supreme Court justices pointed out that abortion has a lower complication rate than many other common medical procedures, including childbirth.
In Texas, HB2 has already led to the closure of half of the more than 40 clinics that existed before the bill was passed. If it had been allowed to go fully into effect, Texas would have been left with fewer than a dozen clinics to serve more than 5 million women of reproductive age.
President Barack Obama said in a statement he was “pleased” about Monday’s ruling. “As the brief filed by the Solicitor General makes clear and as the Court affirmed today, these restrictions harm women’s health and place an unconstitutional obstacle in the path of a woman’s reproductive freedom,” he said. “We remain strongly committed to the protection of women’s health, including protecting a woman’s access to safe, affordable health care and her right to determine her own future. Women’s opportunities are expanded and our nation is stronger when all of our citizens have accessible, affordable health care.”
Democratic presidential candidate Hillary Clinton immediately hailed the decision as a “victory for women in Texas and across America.” “Safe abortion should be a right—not just on paper, but in reality,” Clinton wrote on Twitter.
The former Secretary of State then took the opportunity to say the next president “has to protect women’s health.” “This fight isn’t over,” she tweeted. “Women won’t be ‘punished’ for exercising their basic rights.”
House Minority Leader Nancy Pelosi also celebrated the decision, but noted in a statement that “many challenges remain,” including those expected from GOP lawmakers. “A woman’s health decisions must be her own, in consultation with her family, her physician, and her faith,” she said. “Politicians have no business undermining women’s constitutional right to make their own reproductive decisions. Republicans cannot keep inventing ways to deny women access to their constitutional right to comprehensive health care.”
Reproductive rights advocates joined in on the praise. “The court reaffirmed that the court respects women’s health and dignity in making health decisions, and they shouldn’t have to face needless barriers,” said Stephanie Toti, the lawyer with the Center for Reproductive Rights who argued the case on behalf of Whole Woman’s Health. “This makes it clear that states cannot enact sham laws that limit women’s access to abortion.”
The ruling also sends a signal to other states, like Mississippi and Wisconsin, which are facing similar challenges to abortion laws.
“It would create a strong tool that we could use to dismantle the anti-abortion infrastructure that has been created in so many states in recent years,” Toti said.
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Write to Charlotte Alter at charlotte.alter@time.com