Unless Planned Parenthood's lawsuit gets in the way, Texas' new abortion restrictions will require all abortion providers to become ambulatory surgical centers by September 1, 2014 or close their doors. But state regulators seem to be even tougher on abortion clinics than for your typical ASC.
Until recently, it hasn't been clear exactly how the law, known as House Bill 2, would be enforced when it comes to existing clinics, though abortion-rights advocates predicted all but six clinics in Texas would be forced to shut down unless they agreed to costly renovations.
Now, thanks to proposed rules put forth by the Texas Department of State Health Services, it is, and it doesn't look too good for abortion providers.
To the chagrin of Planned Parenthood and its allies, the clinics won't be grandfathered in as ASCs, even though the state law governing the facilities explicitly allows for that:
A licensed ambulatory surgical center (ASC) which is licensed prior to the effective date of these rules is considered to be an existing licensed ASC and shall continue, at a minimum, to meet the licensing requirements under which it was originally licensed
DSHS has decided that giving clinics such leeway would be "in contradiction of the stated intent of HB 2."
That's not how it's played out in other states that passed similar restrictions on abortion clinics. In Pennsylvania, Missouri and Virginia, most existing clinics got to stay open, even after the state decided that all abortion clinics should become surgical centers. That news prompted Reuters to publish an optimistic piece in July projecting that "most of the Texas clinics that abortion rights advocates predict will close because of a new law requiring tighter health and safety standards likely will remain open -- at least if history is any guide."
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There are several other ways that the proposed rules for HB 2 are stricter on abortion clinics than regular ambulatory surgical centers. Take the requirement that abortion providers have "active admitting privileges" at a hospital within 30 miles. Surgical center rules are looser.
"Current ASC regulations require either the ambulatory surgical center have a transfer agreement with a hospital or that all physicians on staff have admitting privileges at a 'local' hospital," says Elizabeth Nash, the state issues manager at the Guttmacher Institute. "The differences are 'active' privileges and the geographic distance between the clinic and the hospital."
She adds: "Second, ambulatory surgical centers are required to be inspected every three years, but existing regulations on abortion clinics and the proposed regulations require annual inspection."
Worried that you might run into the same state inspectors every year when you go in for your annual gynecologist check-up? (Embarrassing!) You have until October 27 to make a public comment about the proposed rules. Here's how.