The bill that Wendy Davis fought to kill in 2013 has created a crisis of abortion care in Texas. Since April of that year, when the state legislature started debate on the bill that requires abortion providers to have hospital admitting privileges and meet the conditions of an ambulatory surgical center (ASC), more than half of abortion-providing facilities have either closed or ceased providing abortion care.
According to a study released today by the Texas Policy Evaluation Project (TxPEP) at the University of Texas, wait times for abortions have spiked as 23 of 41 abortion options disappeared across the state. The state’s proportion of second-trimester abortions stands to increase as a result.
TxPEP has made monthly “mystery calls” to Texas abortion providers since HB2, the law that required facility physicians to have admitting privileges, went into effect in November 2013. The average time between an abortion-seeker’s first call to the facility and the first-available consultation appointment was steady in Dallas at five days or less until June of this year, when a clinic that provided 350-500 abortions per month closed. The next month, one of the two remaining abortion providers was so swamped, it was unable to schedule any new appointments at all, and wait times jumped to as long as 20 days. Facilities in Austin and Fort Worth have had to increase their wait times, too, though waits for providers in Houston and San Antonio have remained largely stable.
According to TxPEP, "If the wait time increased to 20 days [across the state], which is not unreasonable based on the findings from our mystery calls in Dallas and Ft. Worth, the proportion of abortions performed in the second trimester would increase from 10.5% to 19.5%."
The Supreme Court has ordered a stay on the second part of HB2, the ASC requirement, and the court may take it up this session. If the court doesn't strike it down, only 10 facilities in Texas would be able to continue providing abortions, putting almost double the demand on the state’s existing clinics. If that came to pass, TxPEP estimates that the average number of abortions performed per year in each Austin facility would more than double; in Houston, it would nearly triple.
“These clinics are barely able to serve the needs of women seeking services,” the study’s co-author, Daniel Grossman, told MSNBC. “So when one closes, like what happened in Dallas, we see that wait times increase. This is kind of a natural experiment for what is likely to happen if the ASC requirement goes into effect.”
Even in states where abortion providers are able to fully meet the demands of their patients, abortion is a time-sensitive endeavor. Second-trimester abortions are more expensive and carry a higher risk of medical complications than earlier ones. And in many states, an appointment is just the first step in a long, heavily legislated procedure. In Texas, an abortion-seeker must visit the abortion provider twice in more than 24 hours and listen to a doctor describe her fetus’s development during an ultrasound. If she can’t get into a clinic for the abortion in the first 20 weeks of her pregnancy, she can’t get an abortion in Texas at all. As the Supreme Court begins its new term today, it’s worth asking whether the right to choose means anything without a right to access.