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HB 2 Aftermath: Clinic Closures Could be Worse Than Expected

by: Genevieve Cato

Fri Jul 26, 2013 at 10:30 AM CDT

During the first and second special sessions, much of the testimony against each iteration of the omnibus abortion bill centered on the potentially devastating impact of these restrictions on the number of clinics operating in Texas. House Bill 2 contained two key sets of restrictions on clinics providing abortions in Texas: all clinics providing abortions must be licensed ambulatory surgical centers, and all physicians providing abortions must have admitting privileges at a hospital within thirty miles.

The licensing requirement received the most attention and coverage during the debate. Planned Parenthood, and later David Dewhurst, tweeted an illustration of the impact of this restriction on clinics in Texas: the number of clinics in Texas providing abortion and reproductive health care services could drop to five.

On the same day that Governor Perry signed House Bill 2 into law, Planned Parenthood Gulf Coast announced that three of its clinics would close by August. Only one, the clinic in Bryan, provides abortion services.

Could there be fewer than five clinics remaining in Texas' future? More on the impact of HB2 below the jump.

In a segment on Huffington Post Live highlighting the impact of House Bill 2 on Latinas in Texas, a physician from Lampasas spoke to the consequences of this legislation for his own practice and the women his clinic serves.

In less than 90 days, Dr. Lester Minto said, his clinic will have to close. They cannot afford to upgrade to an ambulatory surgical center. Lillian Ortiz, another panelist in the segment and a NARAL Pro-Choice Texas board member, pointed out that clinics like his will have to spend $1 million or more to reach these new standards.

Unfolding stories like the closure of Planned Parenthood clinics and local practices like Dr. Minto's come as no surprise to those who were paying attention to the concerns around the licensing requirements. The new requirements for physicians admitting privileges received far less attention, but could be the nail in the coffin for access to reproductive healthcare in Texas.

As Jordan Smith reports for the Austin Chronicle, the impact of this part of the law is much harder to predict. Amy Hagstrom Miller, the founder of Whole Women's Health, said that of the twelve doctors she employs, most do not currently have the admitting privileges required by this new law.

Physicians attempting to gain admitting privileges in light of the new law will face significant barriers. According to the Texas Hospital Association, admitting privileges are granted based on the services available at the hospital. The majority of hospitals in Texas currently do not provide elective abortion care. The hospital granting admitting privileges must at least provide obstetrician services at their facility, and in 74% percent of counties in Texas, hospitals provide no such services.

Data on the number of physicians currently providing abortion services who have admitting privileges is not easy to obtain, and so the possible impact of this aspect of the law is difficult to predict. However, those working in the field of reproductive health find cause for significant concern.

We are already starting to see the impact of this law as organizations and physicians announce that their clinics will have to close. With the added uncertainty over whether physicians employed by ambulatory surgical centers have the necessary admitting procedures to continue their practice, the future of family planning in Texas is precarious indeed.  

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