Targeted Regulation of Abortion Providers (TRAP)
Texas imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.
Restrictions on Where Abortion Services May Be Provided
Texas places medically unnecessary restrictions on where abortion services may be provided.
Providers, including private physicians, who perform more than 50 terminations per year must become licensed as abortion facilities. Tex. Health & Safety Code Ann. § 245.002 (Enacted 1989), Tex. Health & Safety Code Ann. § 245.004 (Enacted 1989; Last Amended 2003). Additionally, an abortion facility is forced to have the same minimum standards as an ambulatory surgical center or mini-hospital. H.B.2, 2013 Leg., 3d Spec. Sess., 2013.
Abortion facilities must comply with dozens of administrative and professional-qualification requirements. 25 Tex. Admin. Code § 139.1- 139.60. For instance, abortion providers must have admitting privileges at a hospital within 30 miles of the abortion facility, and that provides obstetrical or gynecological health care services. H. 2b, 2013 Leg., 3d Spec. Sess., 2013. Nothing in the regulations requires hospitals to grant such privileges. 25 Tex. Admin. Code § 139.56. Tex. Health & Safety Code Ann. § 245.017 (Enacted 1997).
The admitting privileges law was initially blocked in federal district court as an unconstitutional restriction on a woman's ability to access abortion care. Planned Parenthood of Greater Texas v. Abbott, 2013 WL 5781583 (W.D.Tex. Oct 28, 2013). The U.S. Court of Appeals for the Fifth Circuit, however, reversed that finding after the Texas Attorney General's office filed an emergency appeal to have the lower court's decision reviewed. Planned Parenthood of Greater Texas v. Abbott, 2013 WL 5857853 (5th Cir. , 2013).
The Fifth Circuit denied the providers' petition for rehearing and rehearing en banc. Planned Parenthood of Greater Texas v. Abbott, 2014 WL 5040899 C.A.5 (Tex.), Oct 09, 2014.
In a separate suit, a federal district court blocked the admitting privileges law as applied to clinics in McAllen and El Paso, as well as the requirement that abortion facilities meet the minimum standards for an ambulatory surgical center. Whole Women's Health v. Lakey, 2014 WL 4346480 (W.D.Tex., August 29, 2014). The state filed an emergency motion to stay the injunction pending an appeal in the Fifth Circuit, which granted the stay. Whole Women's Health v. Lakey, 2014 WL 4930907 (5th Cir. 2014). However, the Supreme Court vacated this decision. As a result, the clinics in McAllen and El Paso were able to reopen, and the ambulatory surgical center provision is not in effect across the state. Whole Women's Health v. Lakey, 2014 WL 5148719 (U.S., 2014).
A court upheld the constitutionality of the vast majority of these TRAP regulations. Women's Med. Ctr. of N.W. Houston v. Bell, 248 F.3d 411 (5th Cir. 2001).
Restrictions on Who May Provide Abortion Services
Texas prohibits certain qualified health-care professionals from providing abortion care.
Only a physician licensed by the state may provide abortion care. Tex. Health & Safety Code Ann. § 245.010(b) (Enacted 1985; Last Amended 2003).