Texas Supreme Court Rejects Challenge to Abortion Laws

The Texas Supreme Court has unanimously rejected the most significant challenge to Texas’ new abortion laws yet, ruling Friday that the medical exceptions in the law were broad enough to withstand constitutional challenge. The court ruled against 20 women who said they were denied medically necessary abortions, saying the medical exceptions in the law were broad enough.

The Zurawski v. Texas Case

The case, Zurawski v. Texas, started with five women arguing the state’s near-total abortion laws stopped them from getting medical care for their complicated pregnancies. In the year plus it took to move through the court system, the case has grown to include 20 women and two doctors.

Zurawski v. Texas was a pioneering case in post-Roe America, the first challenge to a state’s abortion bans on behalf of women with complicated pregnancies. At least three other states have followed suit, and it led to a related case, in which Kate Cox, an actively pregnant woman in Dallas sued to be allowed to terminate her pregnancy. The Texas Supreme Court rejected Cox’s plea in December, which many saw as a likely foreshadow of how the court might rule in Zurawski v. Texas. On Friday, those suspicions were confirmed when the court offered a ruling very similar in nature to the Cox case.

How the Case Unfolded

The initial lawsuit was filed in March 2023. Unlike previous wholesale, pre-enforcement challenges to abortion bans, this case focused on a very narrow argument — women with complicated pregnancies were being denied medically necessary abortions.

In August, a Travis County judge issued a temporary injunction that allowed Texans with complicated pregnancies to get an abortion if their doctor made a “good faith judgment” that it was necessary. The Texas Office of the Attorney General appealed. The Texas Supreme Court overturned that ruling Friday, saying it “departed from the law as written without constitutional justification.”

While the opinion was unanimous, Justice Brett Busby issued a concurring opinion that left the door open to a broader challenge to the law.

Court's Stance on Medical Exceptions

The court wrote, “A physician who tells a patient, ‘Your life is threatened by a complication that has arisen during your pregnancy, and you may die, or there is a serious risk you will suffer substantial physical impairment unless an abortion is performed,’ and in the same breath states ‘but the law won’t allow me to provide an abortion in these circumstances’ is simply wrong in that legal assessment.”

Impact and Reactions

The Center for Reproductive Rights, which brought the suit, said in a statement that this ruling offers no reassurance for doctors facing the potential of criminal and civil penalties. Molly Duane, senior counsel for the Center for Reproductive Rights, stated, “Sadly, what we know is that there are anti-abortion advocates who will always question [a doctor's] decision. I don't know how all of this will actually function in practice ... the fact that true exceptions do not exist in practice will continue to be the norm.”

Key Developments in the Zurawski v. Texas Case

The following table summarizes the key events in the Zurawski v. Texas case: