Inside the secret war on abortion clinics that could shutter them across America

http://www.theguardian.com/commentisfree/2014/sep/09/secret-war-abortion-clinics-ohio-courts

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Targeted Regulation of Abortion Provider (Trap) bills in Alabama, Texas, Louisiana and more US states are designed by over-eager abortion opponents to deceive and conquer. In many of the states where they’ve been enacted, judges have ruled that such medically unnecessary laws, which would shutter most of the abortion clinics in a given state, are an undue burden to a woman’s right to access a legal, safe pregnancy termination.

So, in their ambitions to shutter most – if not all – of the abortion providers in a state in a single blow, anti-abortion activists find their bills blocked or left unenforced because they were too far-reaching.

Meanwhile, Ohio’s anti-abortion activists and legislators have engaged in a stealth war on abortion clinics with a far more effective ploy: they are picking off clinics one by one, with almost no interference from the local courts. In the wake of recent victories in Texas, Alabama and elsewhere, Ohio’s clinic closure blueprint could become a frightening model for shutting down clinics – and one that could get exported across the country.

When Ohio governor John Kasich, a Republican, was given a massive budget bill to sign in the summer of 2013, it included a number of abortion restrictions that legislators amended into the state budget during legislative debate. He could have line-item vetoed them – but he chose to approve them all, including one restriction that gave the Ohio department of health the expansive power to decide whether to license the state’s abortion providers at all.

Since that provision went into effect, six of the state’s 14 clinics have closed – in multiple cases, because they lacked transfer agreements (formal agreements that a particular hospital will take a patient in the rare case that there is a complication during or after an abortion procedure). Those mandated agreements formed the backbone of the bills recently blocked by the courts in Alabama and Louisiana.

But because Ohio is closing one clinic at a time – even as the state board of health continues pursuing closures – it remains far more difficult for a judge to point to any one case as a tipping point where abortion becomes too difficult to obtain. With yearly license renewals dependent upon transfer agreements more strictly enforced, and long-standard compliance exceptions or extensions eliminated, keeping any clinic in compliance with the new state regulations is a Herculean effort.

It is already virtually impossible for an abortion provider to find a hospital with which it can sign a transfer agreement: religious hospitals won’t allow them, as they’re seen as indirectly supporting abortions; and for-profit hospitals tend to avoid them, as there’s no financial benefit to such a relationship and any agreement would open the hospital up to harassment from the anti-abortion community.

Worse yet, another new Ohio law – also part of last year’s state budget amendments – forbids any university hospital or other hospital receiving state or federal funding from accepting an agreement with a provider, calling such newly-required agreements an indirect form of taxpayer-funded abortions.

Eight clinics remain in the state of Ohio – and even those eight are in danger of closing, completely under the radar. One, a Toledo clinic that is the last provider in the northeast half of the state, has exhausted almost all their legal options in their attempt to remain open; they are being forced to shut down by the state, which says that 50 miles isn’t “local” enough for a transfer agreement, though the clinic was turned down by every other hospital in the city. Another clinic, just outside of Dayton, remains open due to another transfer agreement variance identical to one that the department of health refused to reissue for another clinic by the same owner.

According to abortion opponents, the closures are all evidence that their plan is working. “The regulations are obviously having their intended effect in the closure of abortion clinics around the state,” said Ohio minister Rod Parsley after yet another clinic announced it would no longer provide pregnancy terminations just last week.

At this point, there are no clinics in Ohio with current, active licenses, making every single clinic officially out of compliance. If it chose to, the board of health could pick which clinic it wants to target for closure next, and continue to close clinics one by one until maybe, finally, a judge will say that too many clinics have been lost, and the right to an abortion in Ohio is in danger.

Of course, by that point, it will already be too late.

Abortion rights activists have rightfully celebrated the recent court victories halting clinic closures across the country: bills that originally would have left Texas and the Gulf region with only about a dozen clinics instead have been throttled by circuit judges who recognized that, if the laws all went into effect, there would be only a patchwork system of abortion access and many pregnant women would be forced to travel for hours, and even go out of state, to obtain constitutionally protected care.

But Ohio has long been a proving ground for anti-abortion tactics: if they work there, they’re often exported to other states with staunch anti-abortion legislators. Activists in Ohio are already convinced that the slow-and-steady method of abortion clinic closure can fool the courts for long enough to make permanent changes to the reproductive health care landscape – and they might be right.