With Texas’ strictest-in-the-nation abortion law on hold, what’s next, what’s likely to happen

AUSTIN, Texas — Even though a federal judge ordered Texas state officials Wednesday to suspend enforcement of a new law banning most abortions, that doesn’t mean abortion services in Texas will immediately resume.

That’s because doctors still fear that they could be sued without a more permanent legal decision.

The new law — which is the strictest abortion law in the nation — says abortions in Texas are prohibited once medical professionals can detect cardiac activity. That’s typically around six weeks, before some women even know they’re pregnant.

Enforcement is left up to private citizens, who are deputized to file lawsuits against abortion providers and others who help a woman get an abortion in Texas.

For the month after it took effect until U.S. District Judge Robert Pitman, who was appointed by President Barack Obama, granted the Biden administration a temporary hold on the law, it already was having an impact on clinics and patients.

Texas officials swiftly told the judge they will seek a reversal.

Here are some questions and answers about what’s next and the impact so far:

WHAT HAS BEEN THE IMPACT?

Abortion providers say the ramifications have been punishing and “exactly what we feared.”

More than 100 pages of court filings in September offered the most comprehensive glimpse at how the near-total ban on abortion in Texas has played out. Doctors and executives at Texas’ nearly two dozen abortion clinics described turning away hundreds of patients, and some who showed up for appointments could not proceed because cardiac activity had been detected.

One Planned Parenthood location in Houston normally performed about two dozen abortions daily, but, in the 10 days after the law took effect, the clinic had done a total of 52.

Clinics in nearby states say they are struggling to meet surging demand and care for their own residents is being delayed to accommodate women making long trips from Texas.

At one point at a Planned Parenthood clinic in Oklahoma City, more than 60% of the 219 appointments over the following next two weeks were for women from Texas. Doctors say recent patients from Texas have included rape victims — the Texas law makes no exceptions in cases of rape or incest.

Most Texas abortion providers say they are complying with the law. A San Antonio doctor who became the first to publicly reveal he performed an abortion in defiance of the new law was sued Sept. 20, though not by abortion opponents. Former attorneys in Illinois and Arkansas say they sued the doctor in hopes of getting a judge to invalidate the law.

WHAT WAS THE SITUATION IN TEXAS BEFORE?

More than 55,000 abortions were performed last year in Texas, which already had some of the nation’s strictest abortion laws, including a ban after 20 weeks of pregnancy.

HOW SOON COULD CLINICS REOPEN?

It could be done quickly, abortion providers say, but exactly how soon is likely to depend on several factors.

Abortion providers in Texas have experience when it comes to abruptly ramping up operations again. In the early stages of the COVID-19 pandemic last year, abortions in Texas were all but banned for weeks under orders by Republican Gov. Greg Abbott that postponed surgeries “not immediately medically necessary.”

But providers were reporting staffing issues and worried some clinics would permanently close. A decade ago, Texas had more than 40 abortion clinics. More than half of them closed for good during a protracted legal battle over a 2013 law that ended up being overturned by the Supreme Court.

Amy Hagstrom Miller, president of Whole Woman’s Health, said some of the 17 physicians at her four clinics were ready to resume normal abortion services if the law was put on hold.

But she said most of her physicians remain wary and fear lawsuits absent a permanent court ruling.

WHAT’S NEXT?

The Biden administration sued in early September, then asked for the temporary restraining order to put the law on hold while the lawsuit proceeds.

Texas Right to Life, the state’s largest anti-abortion group and a driver of the new law, has cheered the fact that it has stopped abortions every day it has been in effect.

Pitman’s ruling to grant a temporary hold doesn’t decide the constitutionality of the law. But once factor in suspending the law is whether the judge thinks the lawsuit — which calls it “clearly unconstitutional” — was likely to succeed.

Texas could quickly file paperwork officially asking the 5th U.S. Circuit Court of Appeals to reinstate the law. That New Orleans-based appeals court, which oversees Texas, is a conservative-leaning panel with a track record of staying lower-court rulings from Austin.