SALT LAKE CITY — Utah’s Republican Gov. Spencer Cox signed legislation Wednesday that would block clinics from providing abortions until next year, sparking confusion among clinics, hospitals and potential patients in the deeply Republican state.
Administrators of hospitals and clinics have not publicly detailed their plans to adapt to the new law, adding a layer of uncertainty on top of fears that, if clinics close, patients will be exposed to a variety of staff. Reasons may include not being able to seek care in hospitals and concerns of cost.
With the law set to take effect as early as May 3, both the Planned Parenthood Federation of Utah and the Utah Hospital Association declined to elaborate on how the increasingly fraught legal landscape for providers in Utah will affect abortion access.
The developments reflect the turmoil in Republican bastions across the United States that has taken shape since the US Supreme Court ruled in Roe v. Wade decision, changed the legal landscape and sparked a flurry of lawsuits in at least 21 states.
Utah lawmakers have previously said the law would protect the “innocent” and “unborn,” saying they don’t think the state needs abortion clinics after the high court overturned the constitutional right to abortion.
Although Planned Parenthood previously warned that the law could dramatically hinder its ability to provide abortions, the association’s lobbyist, Jason Stevenson, said Wednesday that it will now examine the wording of other provisions of the law that may limit clinics. may be allowed to apply for a fresh license to run the hospital. Equivalent services.
Based on Planned Parenthood’s interpretation, he said in an interview, clinics would no longer be able to provide abortions with their current licenses. However, they plan to provide most of their services, such as STI and pregnancy testing and cancer screening. Stevenson said they are “looking closely” at licensing options in the legislation, but would not say whether clinics would apply at this point.
Jill Vicori, a spokeswoman for the Utah Hospital Association, said in an email that it was “too early to comment” on whether hospitals may soon be the only abortion providers in Utah, taking into account each “how they choose, There will need to be determination on this to move forward.”
If clinics stop providing abortions, experts are concerned that the high cost of care and lack of staff for hospitals will make it harder to obtain legal abortions in Utah, even though the law does not explicitly ban those seeking them in the state. , where they remain valid for 18 weeks.
Dr. Carol Joff, a professor at the University of California, San Francisco, who has written about the social impacts of reproductive health care, said eliminating licensed clinics would provide decades of how abortion would be provided. Historically, patients with low-complication pregnancies have received abortions mostly at outpatient clinics, which are better able to provide them on average at a lower cost.
“Everything is more expensive in a hospital than in a clinic. To perform an abortion in a hospital, you need more personnel,” he said, adding that hospitals with teams of anesthesiologists, physicians and surgeons have historically provided them with emergency scenarios. provided in
Joffe said another challenge facing already overburdened hospitals is staffing, both in terms of recruiting and providing abortions to personnel. Especially in states where anti-abortion sentiment is strong, many physicians or nurses in hospitals may not want to provide them, he said.
“You have to draw from a pool that may or may not be sympathetic to abortion, unlike a clinic where you don’t go to work unless you’re committed to abortion as part of health care. ,” Joff said.
Abortion advocates say the vague language about the de-licensing process leads to confusion. The law prevents clinics from obtaining new licenses after May 2 and sets a full ban on January 1, 2024. However, advocates worry about a separate provision in the 1,446-line bill that specifies under state law that abortions can only be performed in hospitals. ,
Clinic-focused legislation has also raised questions about what types of facilities are best equipped to serve patients regardless of their socioeconomic status or location.
If clinics stop providing abortions — as early as May or as late as next year — it could drive thousands of patients out of hospitals and force administrators to draw up new policies for alternative abortions. To do this they will need to expand their services beyond the emergency procedures previously provided, raising questions about the impact of the change on capacity, staffing, waiting lists and costs. Roughly 2,800 abortions were performed in Utah last year.
The Utah Hospital Association said no hospitals offered elective abortions in the state last year.
The new restrictions are likely to have the greatest impact on those seeking to terminate pregnancies through medication, which account for the majority of abortions in Utah and the United States. The abortion drug is approved up to 10 weeks of pregnancy, prescribed mostly in clinics and, since a pandemic-era FDA rule change, increasingly offered via telemedicine.
The new law takes on additional significance amid the legal limbo surrounding other abortion laws that have been signed in Utah.
Last year’s Supreme Court ruling triggered two previously passed pieces of legislation—the 2019 ban on abortion after 18 weeks and the 2020 ban on abortion regardless of trimester, with several exceptions—including risks to maternal health. Report cases of rape or incest as well as to the police. The Planned Parenthood Association of Utah sued over the 2020 ban, and in July, a state court delayed enforcement until the legal challenges were resolved. The 18-week ban has since been de facto law.
Abortion-access advocates decried this year’s clinic ban as a backdoor that anti-abortion lawmakers are using to limit access during the courts’ deliberations. If abortion were restricted regardless of trimester for exceptional circumstances, the closure would have less of a cascading effect for patients seeking elective abortions from zero to 18 weeks of pregnancy.
The law also clarifies the definition of abortion to address legal liability concerns about the way exceptions are voiced in state law — a provision the governor and Republican lawmakers called a compromise.
