Texans share emotional testimony on bills to further restrict abortion pills, travel

This story has been updated with new information.

Texas Senate Republicans are working to crack down on abortions by pill, to give the state attorney general more power to seek criminal charges in abortion cases and to block taxpayer-funded abortion travel, laying the groundwork for a legislative battle that will test the state's enforcement power across state lines.

At the same time, with Democratic House members' support, they're pushing to give doctors more leeway to end pregnancies in medical emergencies, a response to reports of increased sepsis rates and several avoidable maternal deaths.

The Senate State Affairs Committee heard the bills Thursday, marking Texan's first chance to address lawmakers about the ban on all but lifesaving abortions three years after Gov. Greg Abbott signed it into law.

'I honestly didn't think Texas law could get much crueler'

The most sweeping of the proposals, Senate Bill 2880, would allow private citizens to sue organizations that mail drugs like mifepristone and misoprostol into Texas. It includes a total of seven legal mechanisms for officials and citizens to enforce the near-total abortion ban in and out of Texas. The law cannot, however, be enforced against the person whose pregnancy is terminated.

The bill would implement criminal penalties for people and organizations who fund others' abortions, even when those procedures take place outside the state. It also authorizes Texas Attorney General Ken Paxton to prosecute Texans accused of performing illegal abortions if their district attorneys do not, a measure that would significantly increase his office's power to seek criminal charges.

The State Affairs Committee chair, Sen. Bryan Hughes, R-Mineola, filed the Senate version of the proposal, with Rep. Jeff Leach, R-Plano, carrying the bill in the House. Both lawmakers are committee chairs with close ties to their chambers' leaders, increasing the chances that they'll secure buy-in to pass the legislation.

Ashley Leenerts, the legislative director for anti-abortion group Texas Right to Life, said in a news release that the bill would "save pre-born babies and make our state the leader against the underground abortion industry."

The unprecedented interstate battle has already begun, as a New York court made clear Thursday morning. A judge blocked a Texas state District Court from summoning Dr. Margaret Daley Carpenter, an OB-GYN in New York, in a lawsuit over her alleged prescription of abortion pills to a North Texas woman in Collin County, The New York Times reported. Paxton first sued the doctor in December.

Public commenters at Thursday's hearing argued the bill may run into conflict with the Constitutional protections for free speech and interstate commerce and travel.

"Texas can't prevent people from financially supported travel to engage in conduct that occurs outside of Texas borders," Andrew Henderson of the American Civil Liberties Union said.

In opposition to the bills, abortion rights advocates also cited studies that found that drugs like mifepristone are safer than many common medicines, including penicillin.

But a number of the bill's supporters said abortion pills are dangerous and decried the lack of physician follow-up from out-of-state physicians who furnish them to Texans.

Chelsey Youman of anti-abortion group Human Coalition broke down in tears when she described how "women are not prepared for what they're going to feel, see or experience when they have these abortions."

"Without follow-up care on the back end, we're having women call us in emergency situations, spiking fevers, septic because they had perhaps incomplete abortions, which is another complication we're seeing," Youman, whose group seeks to reach women seeking abortions online and through "telecare," said during invited testimony. "We've had women completely unprepared for seeing their dead child."

Another proponent, SB 2880, Mark Cavaliere, said a woman passed a pregnancy in the toilet and brought the remains in a plastic bag to the Guiding Star Southwest pregnancy center in El Paso, where he is the CEO. Another, he said, came to the center "dizzy, with her vision blurred" from loss of blood.

Several opponents of SB 2880 said potential complications associated with abortion pills are more reason to legalize the procedure, rather than a justification for further restricting it.

Incidents like the one Cavaliere described "would not be necessary if people were not afraid to go to hospitals when they are experiencing complications, or people were not afraid to seek out medical care in the first place if they're thinking about getting an abortion," said Celine Laruelle, a second-year law student at the University of Texas. "None of this is necessary."

Some commenters also expressed shock that lawmakers were considering further restrictions.

"I honestly didn't think Texas law could get much crueler," said Kaitlyn Kash, who was a plaintiff in Zurawski v. Texas, a lawsuit filed by 20 women and two OB-GYNs over vagueness in the state's abortion ban exception.

Bill to clarify abortion ban 'will save women's lives'

The Senate panel is also contemplating the “Life of the Mother Act,” or SB 31. The proposal from Hughes would strike language in Texas’ post-Roe abortion ban that requires pregnant patients to have a “life-threatening condition” before doctors could legally induce an abortion, which some physicians say has caused unnecessary suffering and heightened medical risks, according to the bill's text. 

It also would clarify that Texans can access abortions when they're at risk of a "substantial loss of a major bodily function," such as their fertility, if the pregnancy is carried to term. And the bill would require Texas physicians to receive training on the state's abortion law and would provide free legal education resources for attorneys in the state.

In laying out the bill, Hughes said it will "remove any excuse" for doctors not to terminate pregnancies when they "know the mother's in danger." He alluded to "reports" that this occurred at some hospitals, potentially referencing articles by nonprofit investigative news outlet ProPublica, which found at least three Texas women died after doctors declined to give early treatment of miscarriages and sepsis.

Texans have varied views on abortion, Hughes said, but "when we're talking about the mom and her life, her condition, that's something most of us agree on." Anti-abortion groups Texas Right to Life and Texas Alliance for Life have given their wholehearted support for the proposal.

OB-GYN Dr. Julie Ayala of Tyler expressed the Texas Medical Association's full-throated endorsement of the proposal in invited testimony.

"This bill will clear up confusion, and this bill will save women's lives," Ayala, who called herself a "proud constituent" of Hughes, told lawmakers Thursday morning. "This bill will also help us to recruit and to retain OB-GYNs in the great state of Texas, and that is currently a huge challenge."

Democratic House leaders on abortion rights and several House Republicans have put their weight behind the lower chamber's version of SB 31, House Bill 44, led by Republican Rep. Charlie Geren of Fort Worth.

Rep. Donna Howard, D-Austin, told the American-Statesman that it's a necessary step forward.

"The bill removes the criminal or civil penalties and protects all health care professionals involved in the decision-making process," Howard, who chairs the House Women's Health Caucus, wrote in a statement March 14, when the bill was filed.

At the same time, Howard said, the proposal "does not mean the battle has been won. ... We need clarification now, and in the future, we need to restore access to abortion health care for all Texans.”

Some opponents of the proposal said doctors might face uncertainty about when the exception for "serious risk of substantial loss of a major bodily function" applied.

Others felt the bill — which has no exception for fatal fetal anomalies — doesn't go far enough to help Texans facing complicated pregnancies. One was Lauren Miller, who said the proposal "would have done nothing" to help her after one of the twins she was pregnant with was found to be not viable, which put the other twin at risk.

"There is no defining point at which we must forfeit our autonomy to state control," Miller said.

Samantha Casiano described how she waited for the "forced birth" of a baby that had been diagnosed with anencephaly, a fatal condition that prevents a child’s brain and skull from forming properly.

"She was here for four hours in agony. Her eyes proceeded to bleed before death, changing colors right in front of me," Casiano said, choking up with tears. "The right to be a mother was not even available to me. My own way of grieving and my mental health was planned by strangers and people of power."

And several abortion rights advocates, including Amanda Zurawski, warned that it contains a "Trojan horse" provision that could allow lawyers to argue a 19th-century abortion ban is enforceable. That law bars Texans from terminating pregnancies or “furnish(ing) the means" to do so, a vague phrase that could apply to a wide range of activities. Though the law is still on the books, a judge in 2023 forbid the state from enforcing it.

"If this bill had existed when I nearly died, would I have been criminalized for seeking care to save my own life?" said Zurawski, who became septic after doctors did not give her an abortion following a premature water break that doomed her pregnancy.

Following the testimony and reporting about the provision, state Rep. Gene Wu, D-Houston, said the House Democratic Caucus was standing by the bill.

"We will not trade the lives of Texas women and infants for righteous political posturing," Wu said in a statement to the American-Statesman. "We cannot control what anti-choice extremists will do. What Texas House Democrats can do is fight to ensure that no more Texas mothers die from preventable pregnancy-related causes."

The live broadcast of the committee hearing is being streamed here.

Priority bill, SB 33, would block taxpayer-funded abortion travel

Another bill, Senate Bill 33, would bar Texas cities from using public money for out-of-state abortion travel. Another priority for Patrick, the proposal targets cities like Austin, which passed an ordinance to help residents terminate pregnancies in states that allow them to do so.

Paxton sued Austin in September over its allocation of funds for this purpose. The litigation remains unresolved.

Sen. Donna Campbell, R-New Braunfels, authored the bill to ensure "local governments comply with Texas pro-life laws" and maintain "fiscal integrity and moral accountability," she said Thursday.

Several abortion funds testified that state government should not overrule the will of local governments, and said the funds were necessary to help lower-income Texans access abortion care.

Other public commenters expressed strong support for the proposal, saying they didn't want their tax revenue used to terminate pregnancies.

The senators left all three bills pending after roughly four hours of public testimony.