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Whole Woman’s Health v. Hellerstedt

Citation. 136 S. Ct. 2292 (2016)
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Citation. 136 S. Ct. 2292 (2016)

Brief Fact Summary.

Texas passed a law that significantly regulated abortion providers. A group of abortion providers filed suit.

Synopsis of Rule of Law.

Under Casey, a state cannot impose an undue burden on the right to an abortion under the U.S. Constitution.


Texas passed House Bill 2 (H.B. 2), requiring abortion providers to have admitting privileges at a hospital within 30 miles from where they perform abortions, and to meet the standards for ambulatory surgical centers (ASC). These standards included things like requirements for the width of hallways, and requirements for air conditioning systems. Petitioners sued the state, arguing the H.B. 2 created an placed an undue burden on the right to abortion.


Did the Texas abortion law place an undue burden on people seeking abortions in Texas, in violation of the U.S. Constitution?


Yes, the Texas abortion law placed an undue burden on people seeking abortions in Texas in violation of the U.S. Constitution. The court of appeals’ ruling was reversed.


Justice Thomas

The Court rewrote the undue burden standard by holding that the benefits of the abortion law should be considered, that the courts can consider medical evidence instead of deferring to the legislature, and by requiring the law to have more than a reasonable relation to a legitimate state interest. Additionally, Justice Thomas argued that the Court’s scrutiny scheme has become a meaningless formula allowing the Court to create preferred and disfavored Constitutional rights.

Justice Alito

Petitioners did not make the required showing that the abortion law imposed an undue burden on abortion access. They relied on two assumptions: that all of the abortion clinics that closed after H.B. 2 was passed closed because of the law and not for other reasons, and that clinics in compliance with the requirements would not be able to meet the demand for abortions in Texas.


The Court of Appeals applied the wrong legal standard in its undue burden analysis. Under Casey, the court should have considered the whether the abortion law did or did not create medical benefits, in addition to whether it burdened abortion access. Additionally, courts, not just legislatures, can resolve questions of medical uncertainty based on evidence in the record and the proceedings.

Evidence showed that the admitting-privileges requirement of H.B. 2 placed a substantial obstacle to abortion access, and there was evidence that the admitting-privileges requirement did not provide any significant benefits. There was no evidence that H.B. 2 would prevent situations like the Kermit Gosnell scandal, which involved a physician that illegally conducted his medical practice.

The surgical-center requirement also placed an undue burden on abortion access. There was substantial evidence that this requirement was unnecessary and had no benefits to patients. Additionally, it would force people in Texas seeking abortions to travel long distances, and it would  crowd facilities. There was also evidence that abortion providers would incur significant financial costs to meet this requirement, which would cause a gap in available facilities.

Texas argued that, under Casey, a “large fraction” of Texas residents of reproductive age would not be affected by the abortion law. But according to the Court, Casey’s “large fraction” language refers to a narrower category than all people of reproductive age—it refers instead to the cases in which the law is relevant.

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