NC's new abortion bill follows Texas, Ohio

The anti-abortion omnibus bill that emerged without warning late Tuesday, House Bill 695, has much in common with anti-abortion laws and proposals in other states, including the bill in Texas that has mobilized thousands to protest in Austin last week.

Senate Republicans passed the legislation Tuesday evening after only 90 minutes' public notice. The revamped bill, which started as a Sharia Law ban sent over from the House, wasn't even available to the public online until just before the floor debate started. 

Because of the Roe v. Wade case and subsequent decisions, states can't ban abortion outright. But they can make it more difficult to get, and the current trend is to accomplish that by targeting clinics and doctors through what some call "TRAP" laws – Targeted Regulation of Abortion Providers.

Hospital privileges

A bill filed earlier this session, Senate Bill 308, would have required abortion providers to have admitting privileges at local hospitals. That lets hospitals decide whether to extend those privileges. 

Being sensitive to protests and political pressures over funding, hospitals often decide not to enter into those agreements with abortion providers. With no privileges, the doctor can't provide abortions, so the clinic closes. 

That strategy has been used to try to close down the last clinic in Mississippi, although that case is now in federal court. The proposal in Texas also requires admitting privileges. 

The latest version of the North Carolina proposal requires clinics to have "transfer agreements" with hospitals, a similar strategy. Hospitals can be pressured to not to enter into those agreements. That strategy has resulted in the closure of at least two clinics in Ohio.

Ohio's latest bill, signed into law Monday by Republican Gov. John Kasich, bans public hospitals from entering into transfer agreements.  

According to the Guttmacher Institute, an abortion rights advocacy group, seven other states also have "transfer agreement" requirements, including Virginia and Tennessee.

Proponents of the requirement say it ensures speedy treatment for a patient who suffers complications, but opponents say hospitals are required to accept emergency patients with or without an agreement. 

Ambulatory surgical centers

Another commonly used "TRAP" provision is to require all abortion clinics to meet the same standards as ambulatory surgical centers. Proponents say the aim is to ensure the safety of patients, but the licensing and engineering requirements for surgical centers, governing everything from hallway width to parking spaces, are far more stringent than most existing abortion clinics can meet. 

Pennsylvania and Ohio have similar laws, and the provision is included in the Texas proposal as well.

Physician attendance 

The North Carolina proposal would require the physician to remain present with the patient throughout the procedure, whether surgical or medical (drug-induced). Melissa Reed with Planned Parenthood of North Carolina says about half of all abortions are medical.

Proponents say the intent is to protect patients from unlicensed providers like those in the Pennsylvania case of Kermit Gosnell clinic, who was sentenced to life in prison in May after being convicted of performing illegal abortions.

Reed says the requirement would make abortion services all but impossible to provide. A surgical abortion can take two visits on two separate days. A medical abortion with RU486 involves doses of  two drugs over the course of three days.

The doctor would be required to be in the room with the patient when each dose of the drugs is administered. It's unclear whether the proposal would require the doctor's presence throughout the entire three-day treatment.

Reed says the effect is to discourage doctors from providing the service, and notes that state law doesn't require the same level of physician involvement for similar medical procedures.

Texas's bill would require that even nonsurgical abortions take place in a surgical center under physician supervision. North Carolina's proposal doesn't go that far.