Opinion ID: 2806532
Heading Depth: 2
Heading Rank: 3

Heading: El Paso Abortion Facility

Text: Reproductive Services operates a licensed abortion facility in El Paso that is not an ASC. The physician at this facility, Dr. Richter, applied for admitting privileges at three hospitals but was only able to obtain temporary 52 Case: 14-50928 Document: 00513071917 Page: 53 Date Filed: 06/09/2015 No. 14-50928 privileges at one hospital. These privileges were later revoked. 44 Reproductive Services has been unsuccessful in recruiting physicians with admitting privileges to work at the El Paso facility. After Dr. Richter’s temporary admitting privileges were revoked in April 2014, the El Paso facility stopped providing abortions and eventually closed. The closest Texas abortion facility that will remain open is in San Antonio, over 550 miles away. There is an abortion facility approximately twelve miles away in Santa Teresa, New Mexico. Prior to H.B. 2, more than half of the women who obtained abortions at the Santa Teresa facility were from El Paso. The State argues the closure of the El Paso abortion facility will not impose an undue burden because women in this area can travel to the Santa Teresa facility. The Plaintiffs contend that this argument is precluded by Jackson Women’s Health Organization v. Currier, 760 F.3d 448, 457–58 (5th Cir. 2014), petition for cert. filed, S. Ct. No. 14-997 (Feb. 18, 2015), where we held that a statute that would have the effect of closing the only abortion facility in the state could not be upheld based upon evidence of facilities in other states. In that case, although Mississippi’s admitting privileges requirement for abortion physicians was shown to cause the closure of the only abortion clinic in the state, women could travel to abortion facilities outside the state. Id. at 451, 455. The State argues that Jackson is distinguishable 44 Plaintiffs state that the hospital denied Dr. Richter admitting privileges because she was an abortion provider. As emphasized in Abbott II, Texas and federal law prohibit discrimination on this basis and Texas provides a private cause of action to challenge such discrimination. See 748 F.3d at 598 & n.13 (citing TEX. OCC. CODE ANN. §§ 103.002(b), 103.003, and 42 U.S.C. § 300a-7(c)). This undermines the argument that the admitting privileges requirement is the cause of the closure of the facility since the suggestion is that the cause is actually unlawful discrimination for which state law provides Dr. Richter a remedy. However, because we conclude that the closure of the El Paso facility, whatever its cause, does not create an undue burden on a woman’s right to choose an abortion, we need not address this issue further. 53 Case: 14-50928 Document: 00513071917 Page: 54 Date Filed: 06/09/2015 No. 14-50928 because, unlike in Mississippi, H.B. 2 will not cause the closure of all abortion facilities in Texas. The Plaintiffs did not respond to this argument in their merits briefs. The motions panel acknowledged Jackson and noted that “the situation in Texas is markedly different from that in Mississippi” because H.B. 2 would not close the last clinic in the state. Lakey, 769 F.3d at 304. However, the motions panel declined “to construe [Jackson’s] broad language so narrowly in [an] emergency stay proceeding.” Id. As discussed above, a motions panel proceeding is an abbreviated one; having now considered the matter in full, we conclude that Jackson is distinguishable. In Jackson, we relied on State of Missouri ex rel. Gaines v. Canada, 305 U.S. 337 (1938), an equal protection case in which the University of Missouri denied admission to Gaines because he was African-American and offered him a stipend to attend school in an adjacent state. We explained that “Gaines simply and plainly holds that a state cannot lean on its sovereign neighbors to provide protection of its citizens’ federal constitutional rights.” 760 F.3d at 457. In this case, unlike in Gaines and Jackson, the State has not completely shunted its responsibility onto other states. H.B. 2 does not result in the closure of all abortion providers in the state: at least eight ASCs will continue to provide abortions in Texas. See Lakey, 769 F.3d at 304 (“Given the panel’s reliance on Gaines, the panel may have meant to apply its limitation only to states where all the abortion clinics would close.”). In addition, the principle relied on by Jackson has little traction in this as-applied challenge because prior to H.B. 2, half of the patients at the Santa Teresa clinic came from El Paso, which is in the same cross-border metropolitan area as Santa Teresa. 45 45 We note that this analysis would likely be different in the context of an international border, and we disclaim any suggestion that the analysis here applies to a city across an international border from a United States city in question. 54 Case: 14-50928 Document: 00513071917 Page: 55 Date Filed: 06/09/2015 No. 14-50928 This demonstrates that Texas women regularly choose to have an abortion in New Mexico independent of the actions of the State. Given these facts particular and peculiar to El Paso, it would ignore reality in this as-applied challenge to “focus[] solely on the effects within the regulating state,” as we did in Jackson. 760 F.3d at 457. Unlike the city of Jackson, Mississippi, which is 175–200 miles from the borders of Tennessee and Louisiana, the evidence in this case shows that El Paso and Santa Teresa are part of the same metropolitan area, though separated by a state line, and that people regularly go between the two cities for commerce, work, and medical care. No such situation was presented by the evidence or considered by the panel in Jackson. Taking the Plaintiffs’ version of Jackson, a clinic just over the line in Texarkana, Arkansas, would not be a fact that could be considered by a court in Texarkana, Texas. An injunction is an equitable remedy, and it would be wholly inequitable to ignore the reality of metropolitan areas that straddle state lines and in which people regularly travel back and forth in commerce. See Weinberger v. Romero-Barcelo, 456 U.S. 305, 311–12 (1982) (explaining that “an injunction is an equitable remedy,” which does not “issue[] as of course or to restrain an act the injurious consequences of which are merely trifling” (citation and internal quotation marks omitted)). To the extent that Jackson can be read to so provide, it is dicta as that situation was simply not presented in that case. Therefore, although the nearest abortion facility in Texas is 550 miles away from El Paso, there is evidence that women in El Paso can travel the short distance to Santa Teresa to obtain an abortion and, indeed, the evidence is that many did just that before H.B. 2. Accordingly, because H.B. 2 does not place a substantial obstacle in path of those women seeking an abortion in the El Paso area, we hold that the district court erred in sustaining Plaintiffs’ as- 55 Case: 14-50928 Document: 00513071917 Page: 56 Date Filed: 06/09/2015 No. 14-50928 applied challenge in El Paso.