The 5-3 ruling is the court's first abortion decision in almost a decade. It invalidates provisions that required clinics to meet hospital-like surgical standards and forced abortion doctors to get admitting privileges at a local hospital.
Texas said the rules safeguarded patient safety, while opponents said the real aim was to reduce access to abortion.
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The law provides “few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions, and constitutes an undue burden on their constitutional right to do so,” Justice Stephen Breyer wrote for the court.
The case divided the court along ideological lines. Chief Justice John Roberts and Justices Clarence Thomas and Samuel Alito dissented.
Writing for the group, Alito said the court should have thrown out the suit on procedural grounds because of an earlier, unsuccessful challenge to the admitting-privileges requirement.
“If at first you don't succeed, sue, sue again,” Alito said from the bench as he read a summary of his opinion.
Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan joined Breyer in the majority.
Presumptive Democratic presidential nominee Hillary Clinton hailed the ruling in a Twitter posting as a “victory for women in Texas and across America. Safe abortion should be a right — not just on paper, but in reality.”
The case tested how much leeway the government has to regulate clinics in the name of protecting women's health. The effect of the law was to leave some patients hundreds of miles away from the nearest provider.
300 Restrictions
The ruling raises new questions about some of the more than 300 abortion restrictions put in place around the country since 2010. Those laws include limits on drug-induced abortions and bans on procedures after specified points in a pregnancy.
Abortion-rights advocates called the case the biggest since 1992, when the court reaffirmed the constitutional right to end a pregnancy.
The New Orleans-based 5th U.S. Circuit Court of Appeals had largely upheld the rules. The Supreme Court blocked the surgical-center requirement during the litigation, but the admitting-privileges rule had been in effect.
Texas said the admitting-privileges rule ensured qualified doctors and promoted continuity of care in the event of complications. The state said the surgical-center requirements provided a sterile environment for abortions and protected patients from being treated in substandard clinics.
10 Abortion Clinics
The clinics and doctors challenging the law said the state failed to show the regulations actually further its stated objectives.
Abortion-rights advocates said during the litigation that the measure, had it taken full effect, would have cut to 10 what once were 42 Texas abortion clinics. All but one of those would have been in state's four biggest metropolitan areas — Houston, Dallas, San Antonio and Austin.
None would have been in the western half of the state because the two clinics now in El Paso would have had to close. The nearest Texas clinic to El Paso would have been 550 miles (885 kilometers) away.
“We're thrilled that today justice was served and our clinics stay open,” said Amy Hagstrom-Miller, the chief executive of Whole Woman's Health, which operates clinics and challenged the law.
Texas was one of 10 states with admitting-privileges requirements and one of six that requires clinics to meet surgical-center standards, according to the Center for Reproductive Rights, which is representing the clinics and doctors. About half of those laws have been on hold.
Texas Attorney General Ken Paxton said he was disappointed.
“It's exceedingly unfortunate that the court has taken the ability to protect women's health out of the hands of Texas citizens and their duly-elected representatives,” he said.
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