More GOP-led states enact abortion ‘trigger laws’

NASHVILLE, Tenn. — Three more Republican-led states have banned almost all abortions this week as yet another slate of laws severely limiting the procedure takes effect following the U.S. Supreme Court’s decision to overturn Roe v. Wade.

To date, 13 states have passed so-called trigger laws that were designed to outlaw most abortions if the high court threw out the constitutional right to end a pregnancy. The majority of those states began enforcing their bans soon after the June 24 decision, but Idaho, Tennessee, and Texas had to wait 30 days beyond when the justices formally entered the judgment, which happened several weeks after the ruling was announced.

That deadline was up Thursday. North Dakota’s trigger law was scheduled to take effect Friday, but a judge’s ruling Thursday put its implementation on hold.

All of these states except North Dakota already had antiabortion laws in place that largely blocked patients from accessing the procedure. And the majority of the clinics that provided abortions in those areas have either stopped offering those services or moved to other states where abortion remains legal.

Texas has banned most abortions once fetal cardiac activity has been detected, which can be as early as six weeks into pregnancy, before many women know they’re pregnant. The ban has been in place for almost a year.

While clinics were severely limited in the services they could provide during that time, they officially stopped offering abortions on the day of the Supreme Court ruling. Republican Attorney General Ken Paxton argued that state laws that banned abortion before Roe v. Wade could be enforced ahead of the implementation of the trigger law.

Much like Texas’ current abortion ban, the trigger law does not include exceptions for rape or incest. Instead, it has a loophole if a woman’s life or health is in danger.

The political response to the change was swift: Democrat Beto O’Rourke chose Thursday to unveil the first TV ads in his campaign against Republican Gov. Greg Abbott, who signed off on the statute.

One of the ads includes a voice-over saying some women will die because of the law.

Meanwhile, Texas has challenged a legal interpretation put forth by the federal government that was aimed at requiring Texas hospitals to provide abortion services if the life of the mother is at risk. On Wednesday, a federal judge temporarily blocked the government from enforcing that interpretation.

A similar situation played out in Idaho, but there a federal judge ruled Wednesday that the state’s abortion ban violated federal law.

U.S. District Judge B. Lynn Winmill said the state could not enforce its abortion ban in cases where pregnant patients were experiencing a medical emergency that seriously threatened their lives or health. Idaho's abortion ban makes all abortions felonies, but allows physicians to defend themselves in court by arguing that the procedure was necessary to save the life of the mother or done in cases of rape or incest.

The federal government argued that Medicaid-funded hospitals in Idaho must provide “stabilizing treatment” to patients experiencing medical emergencies despite its trigger law.

Much of Idaho’s law went into effect Thursday, but due to the judge’s ruling, the state cannot prosecute anyone who is performing an abortion in a medical emergency. Most abortions in Idaho were effectively banned on Aug. 12, when the Idaho Supreme Court allowed a different law to go into effect allowing potential relatives of an embryo or fetus to sue abortion providers.

In Tennessee, just two of the six clinics that provide abortions continued to offer the service after Roe was overturned. They did so even as Tennessee enacted a “heartbeat law” similar to the one passed in Texas. Under both the new trigger law and the previous heartbeat law, doctors who violate the law risk felony convictions and up to 15 years in prison.

Operating after the high court's abortion ruling has been at times a “painful” experience, said Melissa Grant, chief operations officer of carafem, which has had a Nashville clinic since 2019. The legal environment has required difficult conversations between staffers and patients who may be unaware how early in pregnancy cardiac activity can be detected.

Because Tennessee requires patients to wait 48 hours before getting an abortion, Grant said, her staff has seen some patients qualify for the procedure during an initial visit only to be turned away two days later because an ultrasound picked up fetal cardiac activity.

In North Dakota, lawyers for the state’s only abortion clinic, which recently moved a few miles to Minnesota, won a delay Thursday as they pursue a lawsuit challenging the ban. Burleigh County District Judge Bruce Romanick said he was not ruling on the probability of the clinic winning the lawsuit, rather that more time is needed to make a proper judgment.