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What Comes Next For Law That Regulates Clinics Providing Abortions?

A woman advocates for abortion and reproductive rights at a Moral Mondays protest rally at the capitol.
Matthew Lenard

Earlier this week, Governor Pat McCrory signed a bill that would impose stricter regulations on clinics that provide abortions.

Among other things, the law requires state health officials to develop more regulations that will govern the clinics. It also contains a clause in which health officials may issue temporary rules during that rule making process.

As Governor McCrory signed Senate Bill 353 into law earlier this week, drivers cruising past the governor’s mansion honked their approval at a few dozen protesters standing across the street. Michelle Roberts was wearing a pink shirt and holding up a pink sign saying “my body, my choice.”

"We’re happy to see so much support from the people in the area, but at the same time it’s not the outcome we’re hoping for," said Roberts. She says her greatest fear is that the law will result in shutting down clinics across the state and limit women’s access to abortions: "I think that’s a shame, and I think that’s the wrong direction the state needs to be taking right now."

But it’s hard to know exactly how the law will affect clinics that provide abortions. The measure tasks North Carolina’s Department of Health and Human Services with developing regulations for clinics based on those for ambulatory surgery centers. That could mean requiring wider hallways, for example. A spokesman for DHHS said no one was available to comment on how those rules will be drawn up. In other states with similar laws, it has taken a long time to come up with those regulations.

"What we typically see is that abortion opponents are really active and in charge of the process," said Elizabeth Nash, the state issues manager at the Guttmacher Institute, a reproductive health think tank that supports abortion rights but whose research is respected by both sides. She said North Carolinians should expect that process to include a comment period, much back and forth between various governmental bodies, and probably public hearings. Nash said in Virginia, the clinic regulation process turned out to be very political. "It was not based on medical evidence," said Nash, "and was really about making it incredibly hard to open and operate an abortion clinic."

On the other hand, in Maryland, Nash said, the process was transparent and open. It included input and consensus from everyone from abortion providers to the Catholic Church. But that’s not the norm.

Although it’s not clear which way the rule making process will go here, the new law has enacted some concrete restrictions on abortion. It prevents the state from offering coverage for the procedure in future health exchanges set up under the Affordable Care Act. And it bars city and county employees from coverage in their health plans, except in cases of rape, incest, or medical emergencies. Todd McGee is the public affairs director for North Carolina’s association of county commissioners.

"We opposed it not on the grounds of anything related to abortion, but just on the grounds of this should be a decision that counties make. We felt the state was kind of overreaching to tell the local governments what they can and cannot offer in their benefits packages." said McGee.

McGee doesn’t know how many counties provide regular abortion coverage to employees. He says his association no longer offers a health insurance plan to counties. "The precedent of the thing of it is probably much more concerning to us," said McGee. "Will they start saying there’s other things that we can’t provide coverages for?"

The state League of Municipalities does offer a health insurance plan to cities, and about 6,500 employees are covered. A spokesman for the League said abortion coverage is limited to cases of rape, incest or medical emergencies, which is already how the State Health Plan works. Before the new law was passed, cities who got their insurance through the League could opt for a less restrictive policy, but none ever did.

In the meantime, abortion rights advocates are hoping state health officials will keep an open mind as they begin the process of composing regulations for abortion clinics. As she stood in front of the governor’s mansion earlier this week, Planned Parenthood official Melissa Reed said she wasn’t happy with the way the law was put together.

"Not a single women’s health care provider has been consulted and the American Congress of Obstetricians and Gynecologists has come out against it. I’m hoping that the department will see clear to actually consult a provider or a women’s health expert when they determine what regulations are appropriate," said Reed.

At least one opponent of abortion rights said she thinks the regulations will be based on whatever problems DHHS uncovers at clinics. But with abortion rights supporters vowing a fight, whatever regulations are written may end up in court.

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