The war on a woman’s right to choose in Texas is at an all-time high. From executive orders to anti-abortion legislation, state-level GOP officials are doing everything within their power—and arguably some things outside of their power—to reduce, if not completely stop abortions in the state.
At the top, Texas Gov. Greg Abbott is leading the charge against reproductive rights in the state, most recently re-affirming his commitment to an anti-abortion agenda during his State of the State Address and using the guise of the COVID-19 pandemic to rip rights away from women.
“I have signed 11 laws that protect innocent lives, but more must be done,” Abbott said Feb. 1. “This session we need a law that ensures that the life of every child will be spared from the ravages of abortion.”
More than a dozen abortion-related bills have been introduced in the GOP-controlled state legislature this session, which started last month. The bills include a “heartbeat bill”—making abortion illegal after a heartbeat has been detected, appointing an attorney to represent an unborn child in court, and allowing healthcare providers (e.g. physicians and nurses) to object to participating in an abortion procedure if it violates their ethical, moral or religious beliefs.
Lawmakers have even introduced trigger legislation – laws that are unenforceable under current federal law, but would automatically trigger abortion bans in the first and second trimesters if Roe v. Wade is overturned. Only a handful of states – including Arkansas, Idaho, Kentucky, Louisiana, Mississippi, North Dakota, Missouri, Tennessee, South Dakota and Utah – have such laws.
The actions in Texas represent one of the toughest fights for women's healthcare rights in the nation, but the bills also reveal just how far state-level Republicans are willing to go.
Planned Parenthood fights back
A huge upset to women’s healthcare rights in the Lone Star State over the last year stems from a fight to kick Planned Parenthood out of the Texas Medicaid program. Planned Parenthood provides a variety of reproductive health services including well-woman exams, cancer screening and prevention, abortion, STD testing and treatment, infertility services and general healthcare.
Earlier this month, the Texas Health and Human Services Commission (HHSC) attempted to drive Planned Parenthood out of the state’s Medicaid program. For years, state health officials and Planned Parenthood have contentiously debated Planned Parenthood’s eligibility to provide services within the Medicaid system, according to court documents obtained by The Whipp. Worse, the Governor seems set on limiting women’s healthcare rights by using the COVID-19 pandemic as cover.
“More than 2 million Texans have been infected with COVID-19, yet Gov. Abbott is focused on attacking people’s constitutionally protected right to access abortion,” Dyana Limon-Mercado, executive director of Planned Parenthood Texas Votes, said in a statement.
This recent conflict between the two organizations comes after the conservative Fifth Circuit Court of Appeals ruled last November that qualifying as a Medicaid provider is between the state or federal-level government and the provider.
Planned Parenthood asked the HHSC to stay on as a Medicaid provider for six more months due to the ongoing pandemic and assist an upwards of 8,000 patients in finding alternative care. The HHSC denied Planned Parenthood’s request in a letter on Jan. 4 and gave a 30-day grace period before its Medicaid status was terminated.
“Let’s be clear: Gov. Abbott, emboldened by the Trump legacy, is harming the same people who are struggling the most to survive this pandemic,” Alexis McGill Johnson, president of the Planned Parenthood Action Fund, said in a statement. “By forcing people—disproportionately Black and Brown people, essential workers, and single parents—to go without critical health care, his administration is jeopardizing their futures, safety and ability to control their own bodies. Planned Parenthood will use every tool we have to ensure patients have the care they need, where they need it.”
Planned Parenthood filed suit in a Texas district court, arguing health officials did not provide “reasonable notice and an opportunity for a hearing.” Judge Maya Guerra Gamble issued a two-week restraining order, allowing Planned Parenthood to continue serving as a provider in the Medicaid system, according to court documents obtained by The Whipp.
Gamble has scheduled a hearing for Feb. 17 to determine if a temporary injunction should be issued.
“This is a distraction—in the style of Trump politics—that ignores the real health care needs of Texans and prioritizes scoring political points with his base, much like when he temporarily banned abortion at the start of the pandemic,” Limon-Mercado said in the same statement.
The Governor's hand
One major overreach by Gov. Abbott was to use his executive order power to decide abortion procedures were not essential care during the COVID-19 pandemic. And even though legal fight ensued and eventually went to the Supreme Court, women faced a myriad of problems accessing timely abortion care and were forced to travel far distances to receive the care they needed. All these changes increased COVID-19 risks.
Abbott issued an executive order mandating all healthcare professionals and facilities to postpone surgeries and medical procedures that were not “immediately medically necessary" from March 19 to April 21, 2020. Though the executive order was intended to preserve “desperately needed” medical supplies for providers to combat COVID-19 and did not explicitly mention abortion care, Texas Attorney General Ken Paxton announced the ban also applied to “any type of abortion that is not medically necessary to preserve the life or health of the mother.”
"Abbott's executive order was never about protecting personal protective equipment. It was about the opportunity to advance an anti-abortion agenda, despite the fact that Texas were (and still) suffering the consequences of failed leadership during the pandemic," Aimee Arrambide, executive director of Texas-based pro-choice non-profit Avow (formerly NARAL Pro-Choice), told The Whipp. "They always knew the outcome of this order would be restricted access, and they were willing to take a chance to make that happen."
Healthcare providers fought back, obtaining a temporary restraining order from a U.S. District Court to prevent the executive order from applying to abortion care. A lawsuit eventually made its way to the Fifth Circuit Court of Appeals, which upheld the state’s order and prevented abortion care in Texas.
However, pro-choice advocates and abortion providers won out after the U.S. Supreme Court vacated the lower court’s ruling. The pro-choice advocates and abortion providers told the Court they didn’t have the chance to challenge the court’s decision because Abbott issued a new executive order that allowed abortions to resume in the state.
In spite of the Supreme Court’s actions, damage was done.
Women were injured by the executive order, according to research from The Texas Policy Evaluation Project (TxPEP), which sought to better understand the impact the executive order had on those seeking abortion care.
The number of abortions in Texas declined 38% while the executive order was in effect compared to the same time the previous year, the research revealed. More women were also forced to seek care outside the state. Texas residents who received care from out-of-state facilities increased from 157 patients in February 2020 to 947 in April 2020. Plus, the order forced many women to unnecessarily wait for care, as there was a 61% increase in second trimester abortions after the order was lifted.
TxPEP Principal Investigator Kari White, PhD, MD, and colleagues also conducted 10 interviews with Texas residents who were seeking abortion while the order was in effect. The executive order created unnecessary barriers to abortion access, including repeating a pre-procedure ultrasound because of canceled appointments or scheduling issues, the women said. Additionally, patients had increased exposure to COVID-19––the opposite effect of what the executive order intended.
The interview participants, White noted, experienced “considerable distress” as they tried to navigate themselves around job loss and economic uncertainty brought on by the COVID-19 pandemic.
“Our research shows just how disruptive the executive order was for Texans seeking abortion care,” White told The Whipp. “Delayed care and out-of-state travel imposed risks and costs that were completely unnecessary, because these services could have been provided in a safe and timely manner closer to home.”
While the executive order was short lived, its impact foreshadows what could happen if the Supreme Court overturns Roe v. Wade and allows states to determine if abortion should be legal or accessible.
“Gov. Abbott says he wants to protect our ‘freedoms’ as Texans, but that protection does not extend to women and people who need to access essential and time-sensitive abortion care," Limon-Mercado said. "Planned Parenthood will always keep up the fight for health care, no matter what, while the Governor continues to fail so many in need.”
Should Abbott and state legislators choose to make abortions illegal in the state, they will have an immense fight on their hands. Pro-choice advocates and providers have said they will do everything they can to ensure reproductive rights and abortion access remains for women in Texas. Unfortunately, attempts to undermine a woman’s right to choose in the state–even if they ultimately fail in court–still have a devastating impact.
"At the root of all reproductive healthcare decisions lies an anti-abortion ideology that deserves to be confronted head-on," Arrambide told The Whipp. "We will continue to work at the state and local levels of government with a more narrow and intentional focus on abortion advocacy that includes political, policy and culture change work."