globalpolicyreview.org [email protected] Texas’s Drive to Restrict Abortion By Deepa Mani Policy Briefs Team 29 July 2021 The Texas Legislature, where severe restrictions were passed to limit women’s access to abortion. Source: Wikimedia Commons Amidst the re-energised assault on abortion in Texas, this brief traces Texas’ abortion restrictions over the last decade. It will first look at Texas’ legislation from 2011 to 2021 and its effects on women’s safety, and will more specifically look at how the state of Texas used COVID-19 to further its desire to outlaw abortion. The paper will also discuss who these restrictions most affect within society, and finally, the article will conclude with two policy recommendations that could be utilised to ease the situation. At the start of the COVID-19 lockdown in March 2020, Governor of Texas, Greg Abbott, signed an executive order prohibiting all surgical procedures which were not medically necessary, including abortions. This order ultimately forced clinics to pause their abortion procedures for around four weeks. 2 IWI BROUGHT TO YOU BY THE IWI: INTERNATIONAL WOMEN'S INITIATIVE Background The war against women’s abortion rights in Texas has intensified over the last decade. While the number of women who required reproductive assistance increased between 2000 and 2011, the state’s ability to provide this care shrunk during this period. The amount of care provided decreased even despite progressive reforms the state made in 2007, when Texas’ Women’s Health Program was created, which provides contraceptive care for women 175% below the poverty line. (Guttmacher Policy Review, 2014). In 2011, after cutting the state family planning budget from $111 million to $37.9 million, the state attempted and subsequently failed to exclude abortion providers from federally funded Medicaid Waiver programs, which are utilised by low-income women to access healthcare (Texas Policy Evaluation Project, 2021). In the subsequent year, Texas continued to challenge federal dollars given to Planned Parenthood and other reproductive health clinics. After the Centers for Medicare and Medicaid Services did not accept the Women’s Health Program renewal request due to its restrictive nature, which banned women from choosing their providers, the state absorbed the costs of Texas’ Women’s Health Groups (Texas Policy Evaluation Project, 2021). As a result of this decrease in funding, the number of reproductive health clinics providing abortion services dwindled. In the summer of 2013, Governor Rick Perry signed House Bill 2B (Texas Policy Evaluation Project, 2021). This bill possessed four further restrictions on abortion, which included banning abortions from 20 weeks “post-fertilisation” (with some exceptions), requiring physicians who perform abortions to have admitting powers in a hospital 30 miles from the clinic, requiring medication-induced abortion to follow an outdated protocol, and mandating all abortion clinics to meet the criteria of ambulatory surgical centres (Texas Policy Evaluation Project, 2021). These restrictions were challenged by Whole Women’s Health vs Hellerstedt, which was heard by the Supreme Court of the United States (Texas Policy Evaluation Project, 2021). In June 2016, the Supreme Court ruled that the admitting privileges and ambulatory surgical centre requirements were unconstitutional because they created an undue burden for women seeking abortion (Texas Policy Evaluation Project, 2021). Over the next few years, further measures were taken to restrict abortion in Texas, including proposing a law to bury fetal tissues after an abortion, attempts to defund Planned Parenthood, plans to dismantle groups such as the Women’s Health Advisory Committee, and plans to ban “taxpayer resource transactions” between cities, counties and abortion providers (Texas Policy Evaluation Project, 2021). In another bill in 2019, the Texas legislature required that a booklet entitled, “A Women’s Right to Know,” which underlines alternatives to abortion, be distributed to women before they receive an abortion (Texas Policy Evaluation Project, 2021). In the same year, alternative measures to abortion received increased funding of $90 million. These alternative measures––which prevent women from attaining actual abortion care––instead help fund things such as crisis pregnancy centres, which provide misleading information to prevent women from obtaining abortions (Texas Policy Evaluation Project, 2021). 3 IWI BROUGHT TO YOU BY THE IWI: INTERNATIONAL WOMEN'S INITIATIVE Further restrictions amidst COVID-19 At the start of the COVID-19 lockdown in March 2020, Governor of Texas, Greg Abbott, signed an executive order prohibiting all surgical procedures which were not medically necessary, including abortions (Texas Policy Evaluation Project, 2021). This order ultimately forced clinics to pause their abortion procedures for around four weeks. On November 23, 2020, the Fifth Circuit Court of Appeals supported the Texas government’s attempt to remove Planned Parenthood from the Medicaid program (Texas Policy Evaluation Project, 2021). On May 19th, 2021, the governor signed into law the “fetal heartbeat” ban on abortion. (Najmabadi, 2021). This bill is one of the most restrictive bills in the country, and bans abortions after a fetal heartbeat is detected, thus banning the procedure from week 6 of pregnancy. (Najmabadi, 2021). It also allows for third parties to sue abortion providers, and does not include exemptions for victims of incest or rape. (Najmabadi, 2021) It has been nearly 50 years since the ruling of Roe v. Wade, where abortion was upheld as a women’s right by the Supreme Court of the United States. According to the precedent of Roe v. Wade, it is a woman’s right to receive an abortion, and abortion should be supported by state and federal law. The actions by the state of Texas in recent history have compromised this fundamental right that a woman has over her body, and has exposed women to further exposure to COVID-19 as they are forced to travel to find abortion care. More so, COVID-19 has exacerbated underlying socioeconomic issues, including access to abortion (Texas Policy Evaluation Project, 2020). TxPEP published two studies in 2020 indicating that Texas’ restrictive laws on abortion affect Latinx and low-income individuals the most, and suggest that new restrictions brought by the pandemic will most severely affect minority groups (Texas Policy Evaluation Project, 2020) (Dixon, 2021). Additionally, a study entitled, The Safety and Quality of Abortion Care in the United States indicates that restrictive abortion laws prolong when women can receive abortions, thus putting these individuals at higher risk (National Academies of Sciences, Engineering, and Medicine et al., 2018). As a result of Abbot’s March 2020 executive order, the nearest out-of-state abortion clinic was over 100 miles away for 94% of counties in Texas (White et al.).The severity of the situation must be addressed, as the most underprivileged communities in Texas are now facing further obstacles to abortion. 4 IWI BROUGHT TO YOU BY THE IWI: INTERNATIONAL WOMEN'S INITIATIVE Policy Recommendations Texas must create oversight to protect the safety of women by separating ideology-driven anti-abortion sentiments from science and health-driven care. As one of 10 states that has attempted to leverage COVID-19 against abortion, Texas provides a clear example of how the continued attempt by the state to block access to abortion intensified under the guise of COVID-19 measures. (White & Grossman, 2021) This article has attempted to underline how Texas is utilising the state of emergency facilitated by COVID-19 to block women’s access to basic health care. The following are policy recommendations to create resources for women to obtain abortions and learn more about the consequences of Texas’ restrictive abortion policies: Government action The U.S. federal government must protect the constitutional rights of women under Roe v. Wade. Access to telemediation and insurance coverage for abortions and clinics must be enforced by the federal government. The Biden Administration should utilise executive orders to ensure that women have access to funding to receive abortions and related care. Advisory group A new advisory group must be created by the federal government to investigate this dire situation in Texas and to investigate how these abortion policies affect women. 5 IWI BROUGHT TO YOU BY THE IWI: INTERNATIONAL WOMEN'S INITIATIVE REFERENCES Dixon, L. & Texas Policy Evaluation Project, 2021. The College of Liberal Arts The University of Texas at Austin. UT College of Liberal Arts: TxPEP. Available at: https://liberalarts.utexas.edu/txpep/releases/abortion-restriction-disparities.php [Accessed May 9, 2021]. Guttmacher Policy Review, 2014. The State of Sexual and Reproductive Health and Rights In the State of Texas: A Cautionary Tale. Me & My OBG. Available at: http://www.meandmyobg.com/2014/06/the- state-of-sexual-and-reproductive-health-and-rights-in-the-state-of-texas-a-cautionary-tale/ [Accessed May 9, 2021]. Najmabadi, S., 2021. Fetal "heartbeat" bill, which could ban abortions at six weeks, nears passage in the Legislature. The Texas Tribune. Available at: https://www.texastribune.org/2021/05/03/texas-house- abortion-heartbeat/ [Accessed May 9, 2021]. National Academies of Sciences, Engineering, and Medicine et al., 2018. The Safety and Quality of Abortion Care in the United States. Available at: https://www.ncbi.nlm.nih.gov/books/NBK507236/