The Supreme Court on Monday struck down a Louisiana abortion law, handing a win to abortion rights advocates who feared the conservative court would break with past rulings to rein in protections that emerged from the landmark decision in Roe v. Wade.
The justices voted 5-4 to invalidate Louisiana’s admitting-privilege law in the first major abortion ruling of the Trump era, which came after the court struck down a nearly identical Texas restriction four years ago.
The ruling, which underscored the razor-thin voting margin over abortion rights, with Chief Justice John Roberts joining the court’s four liberals, is likely to make future Supreme Court decisions over a woman’s right to terminate an unwanted pregnancy an even more pressing issue in the coming presidential election.
The decision is also the clearest indication yet that the court, which now tilts more conservative with the addition of President Trump’s two nominees, is pursuing a more restrained approach than many abortion rights advocates feared.
In a concurring opinion, Roberts said his vote was guided by deference to prior rulings, particularly the court’s 2016 decision in Whole Woman’s Health v. Hellerstedt, which struck down a nearly identical Texas law.
“The legal doctrine of stare decisis requires us, absent special circumstances, to treat like cases alike,” Roberts wrote. “The Louisiana law imposes a burden on access to abortion just as severe as that imposed by the Texas law, for the same reasons. Therefore Louisiana’s law cannot stand under our precedents.”
Justice Stephen Breyer, who penned the majority decision four years ago in Whole Woman’s Health, also wrote the majority opinion in Monday’s decision. In addition to Roberts, he was joined by liberal Justices Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan.
The Louisiana case arose from a constitutional challenge to a law passed in 2014 by the state’s Republican-led legislature. Known as Act 620, the law required physicians who perform abortions to hold “active admitting privileges” at a hospital within 30 miles of their facility.
In practice, this meant abortion-performing physicians had to be members of a nearby hospital’s medical staff, have the authority to admit patients there and be able to perform relevant diagnoses and surgery.
In their Monday decision, the justices reversed an appeals court that found that the Louisiana law did not impose a substantial burden on a large number of women.
Writing for the majority, Breyer said that the Louisiana law’s burden on a woman’s right to an abortion outweighed any medical benefit, applying a similar rationale the court used to strike down the Texas rule four years earlier.
“This case is similar to, nearly identical with, Whole Woman’s Health. And the law must consequently reach a similar conclusion. Act 620 is unconstitutional,” Breyer wrote. “The Court of Appeals’ judgment is erroneous. It is reversed.”
The court’s more conservative justices, Clarence Thomas, Samuel Alito, Neil Gorsuch and Brett Kavanaugh, each filed dissenting opinions, arguing largely on the grounds that the challengers to the Louisiana law — abortion-performing doctors and their clinics — lacked a legal right to sue on behalf of their patients.
White House press secretary Kayleigh McEnany called the outcome “unfortunate,” saying it “devalued both the health of mothers and the lives of unborn children.”
“Instead of valuing fundamental democratic principles, unelected justices have intruded on the sovereign prerogatives of state governments by imposing their own policy preference in favor of abortion to override legitimate abortion safety regulations,” she said in a statement.
Anti-abortion groups said the majority decision highlighted the importance of the upcoming presidential race.
“Today’s ruling reinforces just how important Supreme Court judges are to advancing the pro-life cause,” said Marjorie Dannenfelser, president of the anti-abortion group Susan B. Anthony List. “It is imperative that we re-elect President Trump and our pro-life majority in the U.S. Senate so we can further restore the judiciary, most especially the Supreme Court.”
The dispute over Louisiana’s abortion restriction was seen as an important test case for Roberts, as a gauge of both his role as the court’s new ideological center as well as his allegiance to past rulings.
In 2016, Roberts dissented on technical grounds from the majority opinion in Whole Woman’s Health. This teed up his vote in the Louisiana case as a crucial assessment of his image as an “institutionalist” justice dedicated to honoring prior Supreme Court opinions, especially recent ones.
Had the court reached different rulings on the nearly identical Texas and Louisiana abortion laws, many would have attributed the discrepancy to the court’s rightward shift in recent years.
Instead, Roberts’s tie-breaking vote to strike down the Louisiana law was hailed by abortion rights supporters, many of whom also noted that the close vote highlighted the electoral significance of the court’s composition.
“Great news for abortion rights,” tweeted Laurence Tribe, Roberts’s constitutional law professor at Harvard. “Chief Justice Roberts joins the four liberals to strike down Louisiana’s extremely restrictive abortion statute, reaffirm standing for doctors and clinics to invoke women’s rights, and make clear how much hangs in the balance this November 3.”
Updated at 12:36 p.m.