Richard Wolf

USA TODAY

WASHINGTON — The Supreme Court delivered its most significant ruling on abortion in a generation Monday, striking down restrictions on Texas clinics and doctors that had created roadblocks for thousands of women and giving abortion rights advocates hope of beating back similar laws in other states.

The divided court, acting on the final day of a term in which the death of Justice Antonin Scalia left it shorthanded, ruled 5-3 that the Texas law's restrictions impose hardships on women seeking abortions without serving any medical purpose.

The ruling could have an impact beyond the Lone Star State by prompting legislatures and courts to reconsider other limits on abortion. Legislatures across the nation have imposed some 250 restrictions in the past five years.

Justice Stephen Breyer ruled for the majority that states cannot impose restrictions that pose an undue burden on women seeking abortions without sufficient health benefits. The Texas restrictions, which threatened to close all but nine clinics capable of complying with the tough new standards, could have left the state unable to handle an estimated 65,000 to 70,000 abortions a year.

"The closures mean fewer doctors, longer waiting times, increased crowding and significantly greater travel distances, all of which, when taken together, burden a woman's right to choose," Breyer said from the bench.

Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan provided the other four votes in favor of abortion rights. Kennedy, the swing vote on the case and the senior justice in the majority, assigned the opinion to Breyer.

The state had argued that the restrictions — requiring clinics to meet surgical-center operating standards and doctors to have admitting privileges at nearby hospitals — were necessary to protect women's health. Abortion rights advocates said that by adding delays and distance to the obstacles women face, the medical risks would only rise.

"We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes," Breyer wrote in his 40-page ruling. "Each places a substantial obstacle in the path of women seeking a pre-viability abortion, each constitutes an undue burden on abortion access ... and each violates the federal Constitution."

Obama applauds Supreme Court's abortion decision

President Obama hailed the ruling, which came just days after the court had failed to jump-start his immigration plan for undocumented immigrants on a 4-4 vote. "We remain strongly committed to the protection of women's health, including protecting a woman's access to safe, affordable health care, and her right to determine her own future," Obama said.

But Texas Attorney General Ken Paxton called it "exceedingly unfortunate that the court has taken the ability to protect women’s health out of the hands of Texas citizens and their duly-elected representatives.”

Chief Justice John Roberts and Justices Clarence Thomas and Samuel Alito dissented. Alito, as he had done last week in a decision upholding the use of affirmative action policies at the University of Texas, summarized his dissent from the bench. He accused the majority of refusing to apply "neutral legal rules," such as a prohibition on challenging the same law twice.

"Determined to strike down two provisions of a new Texas abortion statute in all of their applications, the court simply disregards basic rules that apply in all other cases," Alito said.

Thomas went further as usual. "This suit is only possible because the court has allowed abortion clinics and physicians to invoke a putative constitutional right that does not belong to them -- a woman's right to abortion," he said.

In Texas, going the distance for an abortion

The ruling could have an immediate impact on other cases working their way toward the Supreme Court from Louisiana, Mississippi, Wisconsin and several more states in which restrictions have been challenged by abortion rights supporters.

"Today's ruling is a game-changer," said Nancy Northup, president of the Center for Reproductive Rights, which represented Whole Woman's Health clinics in the case. "The impact will be felt beyond Texas."

Clinton: Abortion decision 'victory for women'

Restrictions on abortion imposed by conservative state legislatures range from 24-hour waiting periods and parental notification laws, mostly upheld by lower courts, to bans on abortion after six or 12 weeks, which courts have blocked.

The Texas case loomed large on the high court's docket this term. It offered the justices their best opportunity in a generation to define more clearly the types of restrictions states can impose under the court's 1992 ruling in Planned Parenthood v. Casey.

The Texas law was among the toughest in the nation. About half of the state's more than 40 clinics already had closed because of the admitting privileges restriction. Critics claimed further reductions under the surgical center restriction would tempt more women to self-induce abortions, undergo risky procedures or carry unwanted pregnancies to term.

While both restrictions had been upheld by the U.S. Court of Appeals for the 5th Circuit, the Supreme Court blocked enforcement last June while the case was under review. By then, however, many clinics had closed and were unable to reopen.

During oral argument, the court's four liberal justices left little doubt they would vote to strike down the law. Without Scalia, that meant at least a tie -- but a tie, while setting no national precedent, would have left the appeals court decision in place.

The justices have maintained a tenuous balancing act when it comes to limiting abortion rights. They have upheld most restrictions, including a federal ban on late-term abortions, while at the same time blocking the most severe consequences of Texas and Louisiana laws that had been upheld by the appeals court.

Had the high court allowed the Texas law to take effect, only 10 clinics would have remained to serve more than 5 million women of reproductive age. Nine of the clinics would have been clustered in Houston, Dallas-Fort Worth, Austin and San Antonio, with one heavily-restricted clinic allowed to stay open near the Mexico border in McAllen. Both clinics in El Paso would have been closed, forcing women to seek abortions in New Mexico.

The case was among the most controversial to reach the court this term. More than 1,000 demonstrators, mostly women, protested outside the court when the case was heard in early March. Among dozens of briefs submitted to the court were several in which women recounted their own abortion experiences — successful lawyers and professionals defending the decisions they made early in life, as well as others who said they came to regret the procedures.

Supreme Court closely divided on abortion case

The last major case involving abortion was decided in 2007, when the justices upheld a federal law banning late-term — so-called "partial birth" — abortions. Kennedy wrote the 5-4 opinion, famously asserting that "some women come to regret their choice to abort the infant life they once created and sustained."

This time, it was Kennedy once again who provided the decisive vote, though he did not write the decision.

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