Texas: Anti-Choice Activists’ Sneaky Ambulatory Surgical Center Legislation


by Maggie Jo Buchanan

Buchanan is currently a legal intern with NARAL, a volunteer for Jane’s Due Process, and a 3L at The University of Texas School of Law. She has previously worked for the Texas Democratic Party and as a law clerk in the U.S. House of Representatives and Senate.


Three Texas Republican legislators have introduced a bill (SB 537) that would require all abortion clinics in Texas to meet the standards set for ambulatory surgical centers (ASCs). If the bill is passed, all but five clinics in Texas will be forced to close.

Five clinics to serve a state of 268,581 square miles and a population of over 26 million.

The anti-choice line on this bill is that abortion is unregulated in Texas and oversight is needed to promote women’s health.

Abortion clinics, of course, do not lack oversight or regulation—and certainly not in Texas. Texas has a physician-only law and the clinics themselves are already subject to inspections and audits to ensure patient safety. Further, the physicians who perform abortions are all licensed medical professionals who are subject to state board regulation. Abortion clinics in Texas must already report a variety of statistics on every procedure performed in their clinic. And all abortions in Texas past 16 weeks must be performed in a hospital setting.

And then one can’t forget the counseling requirement, the 24-hour wait requirement, the sonogram requirement, and the booklet every woman must be given when considering an abortion.

Now, ASCs can be fantastic outpatient clinics for a variety of medical conditions, especially for Medicare recipients—Medicare started providing funds to ASCs in 1982. For reference, ophthalmological outpatient surgeries are the conditions most often served in ASCs.

Because they frequently receive government funds, however, ASCs are also heavily regulated. Through the Social Security Act, the federal government specifies various requirements ASCs must meet, and then each state can set its own licensing standards to work in concert with the feds. These regulations range from what type of alcohol-based hand sanitizers a clinic may use to exact specifications on how the air conditioning units must be designed and maintained.

In 2011, Dr. John D. Roizin, the Medical Director of a clinic in Pennsylvania, explained to that state’s legislature that requiring abortion clinics to be ASCs, “would provide no additional safety measures for a patient in the event of a complication…regulations would increase costs due to the building and staffing requirements, and these costs would have to be passed on to patients as an onerous surcharge. This would only serve to decrease access to safe abortion providers.”

SB 537 is not about safety. Abortion is one of the safest outpatient procedures available in Texas, with only 0.5% of women experiencing any complications. The physicians who perform the abortions, and the clinics the abortions are performed in are already heavily regulated and subject to state oversight.

SB 537 is, however, about shutting down clinics and access to safe abortion.

The public hearing for the bill is set for March 19.

[Editor's note: more people than just cis women need and want access to abortion care.]


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