For years, even before the Supreme Court struck down Roe v. Wade and abortion clinics closed across the country, Democratic state lawmakers have tried to regulate crisis pregnancy centers.
They have largely failed.
A series of legal rulings and enforcement decisions effectively neutralized state laws that had tried to take on so-called CPCs, who reproductive health rights groups say spread misinformation and misrepresent vulnerable women in search of of resources, including abortion care.
But the blue states remain determined to control controversial hubs, on which people have become even more dependent since the fall of Roe, and they are trying to do so with a much more targeted approach.
Reproductive rights advocates laud some of these novel and nuanced strategies, while continuing to lament the bigger picture that has largely left them unable to curb what they say are pervasive deceptive practices.
“Lawmakers want to find solutions that don’t violate CPC rights, but that protect patients’ rights. It’s very, very challenging, so you see different places do it differently,» said Callie Wells, Planned Parenthood policy advisor.
«But it’s been a long time since a provision limiting or regulating a CPC was upheld,» he said, adding that for years, «we haven’t seen much success through state legislation.»
A blockade of the Supreme Court
Over 2,500 Crisis Pregnancy Centers operate in the country outnumbering abortion clinics nearly 3 to 1 by some estimates. Critics, as well as supporters, have said the number of women seeking support from them has grown rapidly in the 11 months since the federal right to abortion was revoked, resulting in the closure of abortion clinics in dozens of states.
In their absence, CPCs have continued to proliferate. While some provide free services and counseling for women with unplanned pregnancies, many have been found to provide women with misinformation designed to convince them to keep their pregnancy. For example, when two NBC News producers visited state-funded CPCs in Texas last year to seek advice, they were told that abortions cause mental illness and implied abortions can also cause cancer and infertility.
Such experiences are not uncommon: nonpartisan medical experts have long documented how such centers distribute “misleading or false” information intended to discourage or prevent women from receiving abortion services.
Democratic lawmakers have tried for years to regulate CPCs, many of which are faith-based and funded by religious groups, though many also receive taxpayer money, but have run into significant roadblocks preventing them from enforcing the rule. legislation.
Those struggles come from a 2018 Supreme Court case that effectively overturned what had been at the time the most comprehensive state effort to regulate CPCs.
Signed into law by California Democrats, that law, called the Reproductive FACT Act, required unlicensed CPCs to disclose that they were not licensed medical facilities and required those licensed that did not provide a comprehensive range of reproductive health care services to revealed that the state provided free or free services. financial care related to prenatal services, including abortion care. The policy, which supporters at the time touted as a «truth in advertising» law, had been legally built around deceptive advertising practices.
but in a 5-4 majority decision in the caseconservative justices sided with claims by such centers, which are often affiliated with religious or faith-based institutions, that the law likely violated their First Amendment rights because it forced them to make statements they said They contradicted their beliefs.
The ruling largely silenced any significant state legislation designed to regulate such centers, until 2021, when Connecticut Democrats enacted a more limited law prohibiting deceptive advertising by CPCs, banning them, on their websites and in other materials. marketing, any effort that made them appear. such as abortion care or comprehensive reproductive health care providers.
But after a CPC sued over the law last year, the state’s Democratic attorney general revealed in January that his office had not taken any action against any of those centers in the state, prompting the center to drop its case and advertise that it would continue to operate.
Those two instances essentially killed off any further enactment, even in blue states, of significant state legislation targeting CPCs, advocates said.
“At this point, most of those kinds of shocking bills, which were aimed at limiting CPC misinformation or requiring disclosure of services provided, have been looked at by the courts in a way that has had quite a chilling effect. in Other States”, Wells. saying.
A fresh and hyper-targeted approach
Hampered by the broader legal landscape, Democratic state lawmakers introduced or advanced at least 26 bills in their 2023 legislative sessions that seek to regulate CPCs in much more specific ways, according to an NBC News review of state legislation related to the topic.
In Colorado, a law enacted last month regulates the administration of so-called abortion reversal pills, a cocktail of hormones that some CPCs have dispensed under the false claim that they can undo a medical abortion if taken at the right time.
The American College of Obstetricians and Gynecologists has criticized those pills as «not backed by science.»
colorado law classifies as “unprofessional conduct” any instance in which an employee of a CPC (there are 51 in the state) administers such medication and subjects it to the subsequent “discipline” recommended by the relevant state boards of professional conduct, generally including sanctions or license suspensions.
The law also makes it a “deceptive business practice” for CPCs to present themselves as providing abortion services or emergency contraception.
In Minnesota, which awards nearly $3 million a year in funding to 90 centers across the state, Democrats have advanced legislation in both houses of the legislature that would make public funding contingent in those centers that use only accurate medical information.
And the Democrats in New Jersey and Arizona have thrown banknotes that would require ultrasounds performed at CPCs to be performed only by licensed physicians.
Such bills amount to «ways to make sure CPCs are held to higher standards… without necessarily targeting them with a consumer protection piece.» [of legislation]which matches what the Supreme Court closed,” said Ashley Underwood, director of Equity Forward, a national group that conducts research on CPCs.
Lawmakers wary of factual legal challenges against Connecticut and California laws also have, in New Jersey, California and other states have issued consumer alerts that serve to raise awareness of many of the subject practices used by CPCs. Such alerts urge consumers to file complaints with certain state officials (in New Jersey, it’s the state Division of Consumer Affairs), but offer no immediate enforcement or punitive action.
Opponents of abortion, for their part, continue to defend the centers, saying they have been unfairly targeted by Democrats in blue states.
“Pregnancy Resource Centers exist to help women in need by providing free pregnancy tests, ultrasounds, medical exams, counseling, parenting classes, financial classes; items like food, diapers, and clothing; and financial assistance for housing and utilities,” said Kelsey Pritchard, director of state affairs for the anti-abortion group Susan B. Anthony Pro-Life America, in a statement.
“The twisted attempts to hinder the ability of pregnancy resource centers to serve women demonstrate that Democrats in California, Illinois, Colorado and Minnesota are not pro-abortion, but pro-abortion,” he added. Pritchard.
Meanwhile, advocates have acknowledged that even their specific approaches, if enacted, are bound to face legal challenges, but maintain that it is the right strategy for now.
«Essentially whatever states do, we accept that there will be litigation over it, if it’s directed at CPCs,» Wells said.
But, he added, «this is a damage that we want to talk about and we want to continue fighting, and we are not going to shy away from it.»