This is the second installment of a two-part story on abortion rights in San Antonio. To read part 1, go to "Aborting the Right to Choose."
"She has a 2 o'clock appointment," said the quite-pregnant girl in the red shirt, shaking the pins and needles from her leg as she escorted her young friend inside Planned Parenthood's inner clinic doors.
"I regret my abortion," read the black-and-white sign carried by the middle-aged white woman dressed in an American flag sweater, her matching "I [heart symbol] USA" socks pacing the steps outside the Travis County District Courthouse.
"How many babies did that car cost?!?!?" screamed the man outside the clinic, waving a large sign with an image of a bloodied fetus, as his son stood quietly, bearing a more beatific message: "Jesus Forgives and Heals."
The man chose anger, the boy chose silence, the woman chose regret. One girl chose life, and the other was, perhaps, about to make the hardest choice of her young life. They have nothing in common, and they most likely have never met. But the strangers share the fleeting freedom of choice - perhaps for the last time in Texan history. As committees hammer out the details of the new anti-choice statutes, a regulatory revolution is stripping away practical access to abortion care.
LULL BEFORE THE STORM
In the wake of the favorable decision postponing Texas Department of Health's (TDH) defunding of Planned Parenthood in the Rider 8 case, state agencies and abortion providers are shoring up for the battles that will ensue once 2003's slate of anti-choice bills become law September 1.
Although The Woman's Right to Know Act (HB15) provided that "informed consent" materials (complete with false breast-cancer-link allegations), would be given to abortion providers at no charge, TDH is considering raising licensing fees for abortion facilities to cover the costs, according to Planned Parenthood's Vice President of Client Services Rachel Goeres. Disbursed equally among the state's 41 licensed abortion providers, Goeres notes, the licensing fees could increase by as much as $5,000.
Private doctors, exempt from the $2,500 annual license requirement, are capped at performing 10 abortions per month, which is less than half of the 300 per year previously allowed. They are also prohibited from advertising or listing themselves in a directory of providers. According to Jeffrey Hons, CEO and President of SA's PP, the increased regulations "make it all the more unlikely that an OB-GYN would capacitate their office to provide first trimester abortions ... The license is just to be sure that abortion care remains marginalized." Ten thousand women went to their doctors for abortions in 2001. But with the number of abortions private doctors can perform halved next year, thousands of women will be shunted to the state's already overburdened Planned Parenthoods, which are still waiting to hear whether Rider 8 will eliminate nearly half of their funding. LifeDynamics.com, a militant right-to-life organization, summarizes the tactic: "In the medical world, people who deal in abortion are seen as the whores of medicine. By reinforcing this stigma, the prolife movement is saving babies' lives, because without physicians willing to work as abortionists, the death camps can't survive."
HB15 exempts ambulatory surgical centers (ASCs), a type of outpatient facility, from the licensing requirement - and mandates that after 16 weeks gestation, abortions can only be performed in ASCs and hospitals. Should an unfortunate woman receive devastating amniocentesis results (which are available only in the second trimester), her options for termination are few: Only one ASC in Texas performs abortions, and it's in Dallas - an 11-hour drive from El Paso, and 10 from Brownsville. Plainly put, those who seek second term abortions - among them scared teens, the poverty-stricken, and the uneducated - are often the ones who can least afford a hospital stay or a cross-Texas journey that requires an overnight stay (due to the 24-hour waiting period).
None of Bexar County's surveyed ASCs planned to add abortion care. Most specialize in bones, eyes, ears, noses, and throats. To upgrade abortion facilities (already regulated by stringent Health and Safety Statutes) to ASC standards is prohibitively expensive. According to Hons, PP has ruled out that option: "We're scrambling, looking around: Who will our referral be?"
Legislators, not insensitive to the plight of women who might be forced to carry to term an unwanted or genetically defective child, recently passed HB341, mandating that, post bundle-of-joy, women will be provided with a list of postpartum "counseling resources."
Behind the scenes of the legislating, right-to-lifers are working to present a regulatory fait accompli to the pro-choice community. In the name of budget cuts, the Health and Human Services Commission is being transformed into an autocratic pyramid of political nepotism, with no safeguards against Cheney-Halliburton-esque profiteering-as-policy. HB2292 completely overhauled the HHSC, creating a centralized chain of command in which all umbrella organizations must adhere to the policies set by the governor-appointed Executive Commissioner, Albert Hawkins, and his Perry-appointed council. Old restrictions that prohibited persons with financial stakes in areas governed by the department have been cut, and a new standard for job review has been set: The agency head "serves at the pleasure of the Executive Commissioner."
The TDH, one of the umbrella organizations, will no longer set its own standards for abortion regulations, but instead will have to conform to the policies set by the Council and Hawkins. Agency heads, including TDH's Eduardo Sanchez, will become a "liaison between the agency and the commission," and will report directly to the governor and Hawkins. (This top-down hierarchy of yes-men must seem vaguely familiar to Hawkins, the former Secretary to the Cabinet, who has spent his life in the political service of George W. himself.)
The power change couldn't come at a more precipitous time, as the Abortion Facility and Licensing Standards are up for their four-year review this fall. Goeres, who attended the public meeting of the Rules Revision committee in late July, characterized the meeting as "organized, very balanced," even "mundane." The Board of Health, all Perry or W. appointees, is expected to take the committee findings under advisement. Quelling any suspicion of pro-forma duplicity, TDH Associate Commissioner for Consumer Health Richard Bays states: "We wouldn't have brought them together if they weren't important. We value input, and we use that input."
FUTURE'S SO BRIGHT
As Lady Justice weighs the merits of the Planned Parenthood suit, and oversees regulatory and statutory reform in Texas - with both her eyes and her breasts bound tightly - she might do well to notice the rumblings under her immobile feet. W.'s rabid anti-choice candidates for federal court, Priscilla Owen and William Pyror, are receiving the continued support of a Republican-dominated Congress. The Supreme Court - divided 5-4 on the issue of abortion - hangs in delicate balance, "even though," as Hons puts it, "Pat Robertson is praying for the death of three people."
As tenuous as abortion rights seem today, the future seems almost gossamer in comparison. "Here's the scary thought," states Hons. "You put George Bush re-elected next fall. A right-wing president who never has to face a ballot box again. He doesn't have to worry about holding on to some bizarre, fictitious notion that he is a centrist person. He can do whatever the hell he wants. Any woman who votes for George Bush next fall needs to really take her temperature."Laura M. Fries writes for San Antonio Current, where this feature first appeared. Send comments to firstname.lastname@example.org