Supporters of the bill maintained that these requirements would guarantee a higher level of care for women seeking abortions. Opponents, however, characterized the requirements as unnecessary and costly, and argued that they would make it more difficult for abortion facilities to operate. 2 required a physician who performs or induces an abortion to have admitting privileges at a hospital within 30 miles from the location where the abortion was performed or induced. In general, admitting privileges allow a physician to transfer a patient to a hospital if complications arise in the course of providing treatment. 2 required an abortion facility to satisfy the same standards as an ambulatory surgical center (ASC). These standards address architectural and other structural matters, as well as operational concerns, such as staffing and medical records systems. Hellerstedt has been recognized both for its impact in Texas and for its perceived refinement of the undue burden standard that is used to evaluate the constitutionality of abortion regulations. Because at least 25 states are believed to have either an admitting privileges or ASC requirement, Hellerstedt is also expected to have an impact in other jurisdictions. Following Casey , the Court applied the undue burden standard in just three cases prior to Hellerstedt . Justice Breyer noted that the undue burden standard requires courts to consider "the burdens a law imposes on abortion access together with the benefits those laws confer." Moreover, Justice Breyer maintained that courts should place considerable weight on the evidence and arguments presented in judicial proceedings when they consider the constitutionality of abortion regulations. Citing other evidence concerning the closure of abortion facilities as a result of the admitting privileges requirement and the increased driving distances experienced by women of reproductive age because of the closures, the Court maintained: "[T]he record evidence indicates that the admitting-privileges requirement places a 'substantial obstacle in the path of a woman's choice.'" The Court again referred to the record evidence to conclude that the ASC requirement imposed an undue burden on the availability of abortion.
In Whole Woman's Health v. Hellerstedt, the U.S. Supreme Court (Court) invalidated two Texas requirements that applied to abortion providers and physicians who perform abortions. Under a Texas law enacted in 2013, a physician who performs or induces an abortion was required to have admitting privileges at a hospital within 30 miles from the location where the abortion was performed or induced. In general, admitting privileges allow a physician to transfer a patient to a hospital if complications arise in the course of providing treatment. The Texas law also required an abortion facility to satisfy the same standards as an ambulatory surgical center (ASC). These standards address architectural and other structural matters, as well as operational concerns, such as staffing and medical records systems. Supporters of the Texas law maintained that the requirements would guarantee a higher level of care for women seeking abortions. Opponents, however, characterized the requirements as unnecessary and costly, and argued that they would make it more difficult for abortion facilities to operate.
In Hellerstedt, the Court concluded that the admitting privileges and ASC requirements placed a substantial obstacle in the path of women seeking an abortion, and imposed an undue burden on the ability to have an abortion. In applying the undue burden standard that is now used to evaluate abortion regulations, the Court explained that a reviewing court must consider the burdens a law imposes on abortion access together with the benefits that are conferred by the law. The Court also indicated that courts should place considerable weight on the evidence and arguments presented in judicial proceedings when they consider the constitutionality of abortion regulations.
Hellerstedt has been recognized both for its impact in Texas and for its perceived refinement of the undue burden standard. Because at least 25 states are believed to have either an admitting privileges or ASC requirement, Hellerstedt is expected to have an impact in other jurisdictions. This report examines Hellerstedt and discusses how the decision might affect the application of the undue burden standard in future abortion cases.