In March, the U.S. Supreme Court will hear arguments in June Medical Services v. Gee, the next big abortion rights case. Attorneys at Pennsylvania’s Women’s Law Project coauthored and filed an amicus curiae (“friend of the court”) brief highlighting the significant role antiabortion harassment and violence play in this case.

At issue in June Medical Services is Louisiana’s Act 620, which forces Louisiana abortion providers to obtain a type of business contract called “admitting privileges” with a local hospital. The primary purpose of such contracts is for hospitals to secure business. Ironically, because abortion is a safe procedure with a very low medical complication rate, admitting privileges have been denied to abortion providers because they don't generate enough patients for hospitals to bother with unnecessary paperwork.

Yet supporters of Act 620 are predictably insisting admitting privileges will improve patient safety in Louisiana.

If that sounds familiar, it should. Just three years ago in Whole Woman’s Health v. Hellerstedt, the U.S. Supreme Court ruled a nearly identical Texas law unconstitutional.

In Whole Woman’s Health, a 5-3 majority of the justices determined “nothing in Texas’ record” showed the law “protect[ed] women’s health." The court also concluded the Texas law would force clinics to close.

In other words, they determined admitting privileges are a ruse.

The playbook goes like this: First, pass an admitting privileges law. That’s simple enough, given lobbyists typically write the bills. Once the law is passed, all politicians have to do is wait for antiabortion extremists to threaten hospitals with “negative publicity” and harassment if they grant privileges to abortion providers.

We watched this strategy play out in Texas. After admitting privileges passed, antiabortion extremists published a step-by-step guide outlining how to find out where abortion providers applied for privileges and then threaten that hospital with disruptive protests until they give in to their demands. (From the guide: “Graphic images are highly controversial but this could be an appropriate location to hold graphic images if the hospital refuses to take action.”)

Hospital administrators have more to fear than a sidewalk protest on the evening news. They must consider their personal safety.

Antiabortion extremists in Louisiana have a long history of harassing doctors at work and at home. They’ve distributed propaganda to physicians’ neighbors. They even harassed one doctor for merely agreeing to provide emergency care if a complication occurred during an abortion. In 1996, a “pro-life” protester stabbed a physician 15 times outside a clinic in New Orleans.

Nationally, between 1977 and 2018, there were 11 murders, 26 attempted murders, 42 bombings, 188 arsons, 100 attempted bombings or arsons, and four acts of kidnapping committed against abortion providers, according to the National Abortion Federation. In 2017, threats of violence or death almost doubled at clinics from the year before.

In Whole Woman’s Health, the court cited a previous finding that under the law, some Texas clinics were unable to find local physicians in part due to “the hostility that abortion providers face.” Indeed, about half of Texas clinics closed after the Texas law, which included an admitting privilege provision and mandated that clinics adhere to guidelines written for ambulatory surgical facilities, was passed. Ruling the provision unconstitutional later didn’t magically enable Texas to restore abortion access anywhere near previous levels.

In our June Medical Services brief, we documented how the fear of harassment influences the decision-making of hospitals considering privileges requests as well as doctors left providing care. As more clinics close, antiabortion extremists intensify harassment of remaining providers and scare away new ones. As one physician explained, because of “extreme harassment and intimidation by antiabortion activists, most doctors are simply too afraid.”

We already know when abortion is criminalized or impossible to access because of, say, bogus laws designed to shut down clinics, the abortion rate stays about the same. Maternal mortality, however, increases. The U.S. maternal mortality rate is already the highest in the developed world, with a disproportionate impact on black women and other women of color.

It’s a familiar story. Once again, relatively wealthy white men are advancing laws that subject largely low-income and black women to harm while pretending to protect them. Admitting privileges are still medically irrelevant. They still do nothing but manufacture new targets for antiabortion harassment. They’re still just a ruse to force clinics to close.

The Supreme Court made this all clear in 2016. What’s changed — and what we have to watch — is the composition of the bench.

Tara Murtha is the director of communications and Christine Castro is a staff attorney at the Women’s Law Project, a public interest legal organization that is focused on protecting and expanding the rights of women, girls, and LGBTQ+ people in Pennsylvania and beyond.