Abhortion for the abolition of abortion
The Index Print
Cases/ U.S. Supreme Court/ 2016

Whole Woman's Health v. Hellerstedt

579 U.S. 582 (2016) · Docket No. 15-274

Full caption: Whole Woman's Health v. Hellerstedt, Commissioner, Texas Department of State Health Services

Superseded by Dobbs

Court
U.S. Supreme Court
Argued
March 2, 2016
Decided
June 27, 2016
Majority author
Breyer, J.
Joined by
Kennedy, Ginsburg, Sotomayor, Kagan, JJ.
Vote
5-3 (Justice Scalia had died February 13, 2016)
Case No. 19 of 28 All cases, indexed

Question presented

Whether Texas House Bill 2 provisions — requiring (1) abortion providers to hold admitting privileges at a hospital within 30 miles and (2) abortion facilities to meet ambulatory surgical center (ASC) standards — impose an undue burden on the right to abortion.

Holding

Both provisions are unconstitutional because they place a 'substantial obstacle' in the path of women seeking abortion without providing significant health benefits.

Key reasoning

Justice Breyer refined Casey's undue burden test to require courts to independently balance the burdens imposed by a law against the medical benefits claimed. The Court found that H.B. 2 had caused approximately half of Texas's abortion clinics to close (from about 40 to 20) with no measurable improvement in patient safety.

§ 1 Reasoning

Justice Breyer refined Casey's undue burden test to require courts to independently balance the burdens imposed by a law against the medical benefits claimed. The Court found that H.B. 2 had caused approximately half of Texas's abortion clinics to close (from about 40 to 20) with no measurable improvement in patient safety.

§ 2 Opinions

Majority

Breyer, J.

Kennedy, Ginsburg, Sotomayor, Kagan, JJ.

Both provisions are unconstitutional because they place a 'substantial obstacle' in the path of women seeking abortion without providing significant health benefits.

Concurrence

Ginsburg, J.

Not joined by any other justice

Emphasized that abortion is a safe procedure and that TRAP laws serve no medical purpose.

Dissent

Thomas, J.

Not joined by any other justice

Would reject the entire Casey framework.

Dissent

Alito, J.

Roberts, C.J.; Thomas, J.

Argued the majority misapplied the undue burden test and improperly weighed evidence.

“We conclude that neither of these provisions confers medical benefits sufficient to justify the burdens upon access that each imposes. Each places a substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access, and each violates the Federal Constitution.” Breyer, J. (majority) · slip op. at 1-2

§ 3 Key quotes

“The record evidence indicates that the admitting-privileges requirement placed a substantial obstacle in the path of a woman's choice, vastly increased the obstacles confronting women seeking abortions in Texas without providing any benefit to women's health.”
Breyer, J. (majority)slip op. at 25

§ 4 Practical effect

TRAP (Targeted Regulation of Abortion Providers) laws in numerous states were invalidated or vulnerable to challenge. The benefits-and-burdens balancing test was later narrowed by Roberts's concurrence in June Medical Services (2020) and abandoned by Dobbs (2022).

§ 5 Perspectives

The summaries below are descriptive, not evaluative — an attempt to represent fairly how each camp typically frames this case.

Abolitionist framing

Abolitionists criticize Hellerstedt as an example of judicial interference with democratic pro-life legislation. Since Dobbs, the case has diminished relevance.

Mainstream pro-life framing

Mainstream pro-life groups were sharply critical, arguing the Court had substituted its medical judgment for the legislature's. The 'benefits-burdens' test was seen as unworkable and hostile to any pro-life regulation.

Pro-choice framing

Celebrated as a major victory that restored teeth to Casey's undue burden test and pushed back against TRAP laws.

§ 6 Significance

5/ 10

Major pre-Dobbs precedent superseded by Dobbs. Some analytical framework remains relevant for challenges to state constitutional provisions.

Legal precedential weight6
Practical impact on access7
Movement relevance (abolitionist)3
Enduring relevance, 20262

§ 7 Sources

Cites earlier cases

Planned Parenthood v. Casey (1992)

Cited by later cases

June Medical Services v. Russo (2020) Dobbs v. Jackson Women's Health Organization (2022)
Editorial note The absence of a ninth Justice (post-Scalia death, pre-Gorsuch confirmation) shaped the outcome.