UT's Texas Policy Evaluation Project (TxPEP) has devoted various studies to identifying barriers to accessing reproductive healthcare that HB2 created, particularly for low-income women. According to TxPEP, abortions decreased by 14 percent in Texas from 2013, the year the bill passed, to 2014. This time around, the group set out to determine whether increased travel distances to the nearest abortion clinic directly contributed to that decline.
And they found that it did.
According to TxPEP, among Texas's 254 counties, there were 41 abortion facilities in 17 counties in 2012; by 2014, there were only 21 facilities in six counties. But while TxPEP suspected the distances might have something to do with the decline, up until this point, there was no concrete evidence. In fact, Dr. Daniel Grossman, who worked on the study, said even federal judges expressed skepticism that driving distance would deter any woman who truly wanted to get an abortion.
"There was a lot of discussion during the trial around HB2 by lawyers and some justices on the Fifth Circuit Court of Appeals saying that women would drive whatever distance necessary to get the abortion if they wanted it," Grossman said. "There were even statements about how roads in Texas are very straight, making it easy to drive long distances."
So TxPEP intended to set the record straight. In their study, they found that, the farther away a clinic became, the greater the drop in abortions in those counties.
Of Texas's 254 counties, 56 of them, mostly in West Texas and the Rio Grande Valley, had a change in distance to the nearest clinic that was greater than 100 miles. In those areas, abortions decreased by 50 percent. In 33 other counties, which saw an increase in travel distances between 50 and 99 miles, abortions decreased by 36 percent. And so on (see the below table and map).
"We know abortion is a service disproportionately sought out by low-income women," Grossman said. "This is primarily a population with limited resources. We heard from women around the time of the clinic closures due to HB2 that they faced a lot of barriers in terms of accessing care, both in terms of logistics to arrange an appointment, and also in terms of the costs."
While counties that had no increase in distance and where no clinics shuttered, such as in Harris and 78 others, saw only a 1.3 percent decrease, Grossman said TxPEP intends to take a look at these clinics next time. Fewer clinics led to higher demand for services at the ones remaining, thus leading to an increase in wait times, a previous TxPEP study discovered. Next, researchers hope to study whether HB2 directly contributed to an increase in second-trimester abortions.
While HB2 may not be returning, Grossman said the barriers to accessing care that it created still remain.
Of the 20 clinics that closed after HB2, not a single one has reopened. In fact, Grossman said, three additional clinics have closed.