WASHINGTON – Three years after handing down a major decision in favor of abortion rights in a Texas case, the Supreme Court is faced with a nearly identical case from a neighboring state.

The biggest difference? There's a new president in town – and a new Supreme Court.

That makes the justices' upcoming verdict on a Louisiana law requiring abortion providers to have admitting privileges at nearby hospitals significant beyond the state's borders. Their decision could reveal much about the court's respect for its own precedents, as well as its willingness or hesitancy to wade into hot-button political issues.

Unless they intercede, Louisiana's law will take effect Monday, even though the high court struck down a nearly identical Texas law in 2016. The Louisiana law was upheld by a federal appeals court dominated by conservatives, including five appointed by President Donald Trump.

In a last-ditch effort, abortion rights proponents asked the Supreme Court to block the law's implementation pending further review. But since the Texas case was decided, former associate justice Anthony Kennedy – who was in the majority – has retired. Now, two new justices named by Trump likely hold the key to what happens next.

If the court refuses to block the law – or if it stops the clock but ultimately upholds it – the president will have something to show for his 2016 pledge to appoint "pro-life justices."

First came Associate Justice Neil Gorsuch, who succeeded the late Justice Antonin Scalia in the spring of 2017. In December, he sided with two other conservatives who unsuccessfully sought to hear a case allowing states to defund Planned Parenthood.

Then came Associate Justice Brett Kavanaugh, who succeeded Kennedy in October. During his confirmation hearing, he referred to landmark Supreme Court decisions legalizing and affirming abortion rights in 1973 and 1992 as "precedent on precedent."

But Kavanaugh previously had praised former chief justice William Rehnquist's dissent from the 1973 Roe v. Wade decision legalizing abortion. And in 2017, he dissented from his appeals court's decision allowing an undocumented teenager in federal custody to get an abortion.

With Gorsuch and Kavanaugh on the bench, abortion opponents are cautiously optimistic that the reconstituted court will let the Louisiana law stand. The state argues – and the U.S. Court of Appeals for the Fifth Circuit agreed – that the impact on clinics and providers would be less severe than in Texas, and women seeking abortions would not be so adversely affected.

“This is the most significant abortion petition before the court since Justice Gorsuch came on to the court," says Steven Aden, general counsel at Americans United for Life. "This case is the one to watch.”

But abortion rights groups say the Texas decision in favor of Whole Woman's Health clinic set a precedent from which the justices cannot retreat. The Louisiana law, they say, will leave just one clinic and doctor in business to serve an estimated 10,000 women.

“There is very little to say other than, 'We meant it when we said it,'" says Travis Tu, senior counsel at the Center for Reproductive Rights, which challenged both states' laws. If the court were to "come out the opposite way" this time, he says, "what is the public left to think?"

'This is not a hard case'

Abortion cases are among the most controversial to come before the court, which may be why they don't get there very often.

It took almost 20 years after Roe v. Wade was decided before the justices reinforced both the right to abortion and states' justification in imposing some restrictions. Between 2000 and 2007, the court struck down a state law banning late-term abortions, then upheld a similar federal law.

The Texas ruling was the most important in nearly a quarter century. The opinion by Associate Justice Stephen Breyer, in which Kennedy joined the court's liberals, said the law would force too many abortion clinics to close, leaving the state unable to handle up to 70,000 abortions annually. That burden on women, he said, was unconstitutional without equal or greater health benefits.

Following the 5-3 ruling, laws requiring hospital admitting privileges have been struck down or unenforced in several other states, including Alabama, Mississippi, Oklahoma, Tennessee and Wisconsin. Only Missouri, North Dakota and Utah still have similar laws on the books.

Louisiana's law was passed in 2014 but struck down by a federal district judge after trial three years later. It was resurrected in a 2-1 ruling by a federal appeals court panel, and the full appeals court later voted 9-6 against hearing the abortion rights group's appeal. Trump's judges all voted with the majority.

"The Fifth Circuit is thumbing its nose at the Whole Woman's Health decision,” says Nancy Northup, president of the Center for Reproductive Rights. “This is just not a hard case. This is a straightforward case.”

'Missing the circus'

The abortion rights group's request is pending before Associate Justice Samuel Alito, who wrote the Supreme Court's 43-page dissent in the Texas case. He can rule on it himself or ask his colleagues to weigh in.

The justices already must decide whether to hear another abortion case challenging an Indiana law that bans abortions sought because of race, sex or disability. Another part of that law requires fetal remains to be buried or cremated. It was signed by Gov. Mike Pence before he became vice president.

Following Kavanaugh's calamitous Senate confirmation, which he survived by a narrow 50-48 vote amid allegations of sexual assault during high school, Chief Justice John Roberts has tried to keep the court far away from controversy. But that effort hasn't been entirely successful.

The court also will hear two cases in March challenging partisan election maps in North Carolina and Maryland. A case challenging the Trump administration's effort to add a question on citizenship to the 2020 Census may be granted for April or May. Gun rights are on tap for the fall, and cases on immigration and LGBT rights may be next.

Abortion opponents who were on the losing end of the 2016 decision say the justices should not be shy about weighing in again.

"If the Supreme Court is avoiding controversy by staying out of the abortion area," Aden says, "it’s missing the circus.”

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