On June 19, a new abortion law went into effect in Pennsylvania. As Philadelphia Weekly reported back in the fall, the bill (Senate Bill 732) appeared to be yet another way for conservative legislators to try to shut down abortion clinics, or at least bleed them dry of as much money as possible.
On the surface, SB 732 (now called Act 122), which mandated that abortion clinics upgrade their facilities under the same guidelines that regulate surgical facilities (ASF), sounded perfectly reasonable. Who can argue with improving the safety of a medical procedure?
Thing is, safety isn’t the issue here. According to the state Department of Health, abortion in Pennsylvania is already a safe procedure: Of the 36,778 abortions performed in Pennsylvania in 2010, there were only 12 reports of infection. That’s a .03 percent infection rate.
So what was the real goal of this legislation?
Well, thanks to leaked internal memos, advocates have long known that mandatory ASF upgrades were just a part of state-by-state pro-life strategy designed to financially threaten the existence of abortion clinics. And now, thanks to state Rep. Mike Turzai (R-Allegheny County), the world at large knows that Pennsylvania was no exception. Recently, Turzai publicly referred to Act 122—which his party insisted was about health and safety—as “pro-life legislation.”
The chicanery was also obvious when not a single medical association in the state supported the bill.
When similar laws passed in Kansas, it was estimated that two of the state’s three clinics would shut down—until a federal judge stopped the state from enforcing the law, citing concern for women’s health. When less severe legislation was passed in Texas—it only applied to clinics performing abortions beyond 16 weeks of gestation—no providers were able to comply for a couple years. By the time they earned accreditation, the cost of an abortion skyrocketed from $200 to $1,000.
Pennsylvania already has a scant number of abortion clinics relative to our population. If we don’t count the five clinics that can administer only medical abortions (via pill), Pennsylvania currently has 14 freestanding clinics providing surgical abortions.
A few weeks ago, that number was 15, but in response to Act 122, a clinic associated with the University of Pittsburgh has closed.
The 14 clinics left are clustered around Philadelphia and Pittsburgh. A woman living in Potter County, for example, along the northern rim of the state, already has to drive four hours to get to a clinic. Additionally, per the Pennsylvania Abortion Control Act, women have to wait a mandatory 24 hours between their first appointment and the procedure.
Of those 14, only one clinic—Hillcrest Women’s Center in Harrisburg—is fully licensed under Act 122. A spokeswoman from Hillcrest said while they don’t have exact figures yet, the Center spent a “considerable” amount of money on renovations and upgrades in order to earn accreditation.
“We had people working day and night on it just trying to get everything ready,” the spokeswoman said.
The 13 remaining clinics in question have so far been granted only provisional licenses because of late paperwork, according to Pennsylvania Department of Health spokesperson Christine Cronkright. According to a rep at the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), that’s not unusual due to the amount of work involved in upgrades required for compliance.
Under the new guidelines, Pennsylvania abortion clinics are required to have either Class A or Class B licenses. The difference between the licenses is the type of anesthesia used: Class A facilities will be able to use local anesthesia, while class B can use full anesthesia.
According to the Health Department, five clinics—one each in Lehigh, Berks, Bucks, Chester and York counties—have been granted three-month provisional Class A licenses. The remaining eight clinics—two in Allegheny, one in Lehigh, one in Chester and four in Philadelphia—have been granted six-month provisional Class B licenses.
Most of the clinics have applied for exemptions from the more burdensome requirements—like installing wider elevators or consulting with a minor’s primary-care physician prior to having an abortion—and are waiting to hear back if they are approved. The Department of Health’s standard for exemptions is “if compliance would create an unreasonable hardship and an exemption would not impair or endanger the health, safety or welfare of a patient or resident.”
So, the real impact of Act 122 is still up in the air. Call it legislative Stockholm Syndrome, but clinic administrators and pro-choice advocates are cautiously optimistic. Sure, the unnecessary mandates (trust that we will review next year’s infection rates to see if millions of dollars of investment resulted in fewer than 12 infections a year) have drained resources that could have otherwise gone to providing health services. But to their credit, the Pennsylvania Department of Health so far has been far more rational in implementing the law than state lawmakers were in writing and passing it.
Here at The Breakdown, we’ll keep you informed of the progress on each of the clinics and license approvals. Because right now, there is officially only one abortion clinic operating under the new law—and legislative attacks on reproductive rights in Pennsylvania show no sign of slowing down.