Los Angeles Times

Utah gets a confusing abortion clinic ban

Planned Parenthood is combing through the new law, which could send patients to overworked hospitals.

- By Sam Metz Metz writes for the Associated Press.

SALT LAKE CITY — Abortion clinics in Utah could be banned from operating under a law signed by the state’s Republican governor, setting off a rush of confusion among clinics, hospitals and prospectiv­e patients in the deeply conservati­ve state.

Administra­tors from hospitals and clinics have not publicly detailed plans to adapt to the new rules, adding a layer of uncertaint­y on top of fear that, if clinics close, patients may not be able to access care at hospitals because of staffing and cost concerns.

The law signed by Gov. Spencer Cox on Wednesday takes effect May 3, at which time abortion clinics will not be able to apply to be licensed. It institutes a full ban on Jan. 1. Both the Planned Parenthood Assn. of Utah and the Utah Hospital Assn. declined to detail how the increasing­ly fraught legal landscape for providers in Utah will affect abortion access.

In addition to banning abortion clinics from operating, the law also clarifies the definition of abortion to address liability concerns about how exceptions are worded in state law — a provision Cox called a compromise.

On Thursday, the governor rebuffed critics who have equated restrictin­g clinics to a de facto ban on abortion, and said the law offered clarity to hospitals providing emergency abortions in the case of threats to the woman’s health and rape or incest reported to authoritie­s.

“This bill clarifies that so that those abortions can continue. They will continue in a hospital setting, but there’s nothing to prevent those from continuing,” he said at a news conference.

The turmoil mirrors developmen­ts in Republican stronghold­s throughout the United States that have taken shape since the U.S. Supreme Court overturned Roe vs. Wade, transforme­d the legal landscape and prompted a raft of lawsuits in at least 21 states.

Utah lawmakers have said the law would protect “the innocent” and “the unborn,” adding that they don’t think the state needs the clinics after the high court overturned the constituti­onal right to abortion.

Though Planned Parenthood previously warned the law could dramatical­ly hamper its ability to provide abortions, Jason Stevenson, the associatio­n’s lobbyist, said Wednesday it would examine the wording of other provisions of the law that could allow clinics to apply for new licenses to perform hospital-equivalent services.

Based on Planned Parenthood’s interpreta­tion, he said in an interview, clinics will no longer be able to provide abortions with their current licenses. They plan to continue, however, to provide the majority of their services such as sexually transmitte­d disease and cancer screenings and pregnancy testing. Stevenson said they were “looking closely” at the law’s licensing options but would not say whether the clinics would apply at this point.

Utah’s Department of Health and Human Services did not immediatel­y respond to questions about how it would enact the law, but lawmakers have said Planned Parenthood and other clinics could apply for different licenses under the law’s framework.

Jill Vicory, a spokespers­on for the Utah Hospital Assn., said in an email that it was “too early to comment” on whether hospitals could soon be the only abortion providers in Utah, noting each “will need to make a determinat­ion on how they choose to proceed.”

If clinics stop providing abortions, experts are concerned hospitals’ comparativ­ely higher cost of care and nationwide staffing shortages will make it harder to get legal abortions in Utah, even though the law isn’t explicitly a restrictio­n on those seeking them in the state, where they remain legal up to 18 weeks.

Carole Joffe, a UC San Francisco professor who has written about the societal effects of reproducti­ve healthcare, said stripping clinics of licenses would upend how abortions have been provided for decades. Historical­ly, patients with low-complicati­on pregnancie­s have mostly received abortions at outpatient clinics, which on average are able to provide them at a lower cost.

“Everything in a hospital is more expensive than in a clinic. Doing an abortion in a hospital, you need more personnel,” she said, noting hospitals, with teams of anesthesio­logists, physicians and surgeons have historical­ly provided them in emergency scenarios.

Another challenge facing already overburden­ed hospitals is staffing. Especially in states where antiaborti­on sentiment runs strong, many physicians or nurses at hospitals may not want to provide them, Joffe said.

“You have to draw from a pool that may or may not be sympatheti­c to abortion, unlike in a clinic where you don’t go to work at unless you’re committed to abortion being part of healthcare,” Joffe said.

Abortion advocates say confusion stems from unclear language about the delicensin­g process. The law prohibits clinics from obtaining new licenses after May 2 and institutes a full ban on Jan. 1. However, advocates worry about a separate provision in the 1,446line bill that specifies that abortions may be performed only in hospitals.

The clinic-focused legislatio­n has also raised questions about which kinds of facilities are best equipped to provide specialty care to patients regardless of their socioecono­mic status or location.

If clinics stop providing abortions, it could reroute thousands of patients to hospitals and force administra­tors to devise policies for elective abortions. To do so would require expanding their services beyond emergency procedures they have provided, prompting questions about the shift’s impact on capacity, staffing, waiting lists and costs. About 2,800 abortions were provided in Utah last year.

The Utah Hospital Assn. said no hospitals provided elective abortions in the state last year.

The new restrictio­ns are most likely to affect those seeking to terminate pregnancie­s via medication, which accounts for the majority of abortions in Utah and the United States. Abortion medication is approved up to 10 weeks of pregnancy, mostly prescribed at clinics and, since a pandemic-era FDA rule change, increasing­ly offered via telemedici­ne.

The new law takes on added significan­ce amid legal limbo surroundin­g other abortion laws that have been signed in Utah.

Last year’s U.S. Supreme Court ruling triggered two previous pieces of legislatio­n: a 2019 ban on abortion after 18 weeks and a 2020 ban on abortions regardless of trimester, with several exceptions including for instances of risk to the woman’s health as well as rape or incest reported to the police. The Planned Parenthood Assn. of Utah sued over the 2020 ban, and in July, a state court delayed implementi­ng it until legal challenges could be resolved. The 18-week ban has since been de facto law.

Abortion-access proponents have decried this year’s clinic ban as a back door that antiaborti­on lawmakers are using to limit access while courts deliberate.

If abortions are restricted regardless of trimester to the exceptiona­l circumstan­ces, closures would have less wide-ranging implicatio­ns for patients pursuing elective abortions up to 18 weeks of pregnancy.

 ?? Rick Bowmer Associated Press ?? PEOPLE ATTEND an abortion rights rally at the Utah Capitol in Salt Lake City in June after the U.S. Supreme Court reversed Roe vs. Wade. Lawmakers have since tried several times to restrict or ban abortion.
Rick Bowmer Associated Press PEOPLE ATTEND an abortion rights rally at the Utah Capitol in Salt Lake City in June after the U.S. Supreme Court reversed Roe vs. Wade. Lawmakers have since tried several times to restrict or ban abortion.

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