The making of an abortion market monopoly

The U.S. Supreme Court will hear arguments next week in one of the most important abortion cases it has considered in years. At issue are two provisions in HB2, a bill former Texas Gov. Rick Perry signed into law in July 2013. The bill requires abortionists to have admitting privileges within 30 miles of a hospital and mandates all abortion facilities meet ambulatory surgical center (ASC) standards. The law also bans abortions after 20 weeks (with certain rare exceptions, not including rape) and adds restrictions for chemical abortions.

The plaintiffs in Whole Woman’s Health v. Cole contend the new regulations cause “undue burdens” that place “substantial obstacles” on women seeking abortion. Perhaps more important to the plaintiffs, though, is the consequence of laws like HB2, which “burden” their abortion businesses with costly requirements.

But thanks in part to a seemingly endless supply of taxpayer money, Planned Parenthood—the nation’s largest abortion provider—is spending its way out of state regulations and expanding its market share in the process.

Unable to pay for improvements required under the new law, several Texas abortion facilities closed in the months after HB2 took effect. Building a new surgical abortion center typically costs between $6 million and $8 million, while retrofitting an existing building to meet ASC standards costs an estimated $1.5 million.

Whole Woman’s Health, an abortion business with facilities located mainly in the southwestern United States, blames the restrictions in HB2 for forcing the permanent closure of its centers in Austin and Beaumont, two of five it operates in Texas.

Planned Parenthood, on the other hand, is on a building spree around the country. Even in Texas, where pro-life governors and majority pro-life legislatures have enacted some of the toughest abortion regulations in the country, Planned Parenthood is expanding its business, thanks to multiple revenue streams.

Although the Hyde Amendment prohibits states from using federal Medicaid money to pay for abortions, states can use their taxpayer dollars to cover the procedures, adding money to Planned Parenthood’s coffers. The abortion juggernaut also has plenty of donors with deep pockets helping to fund new building projects.

“They generally have capital campaigns to raise money for expansion,” pro-life activist Abby Johnson told me. Johnson once worked for Planned Parenthood but walked away from her job as the director of its facility in Bryan, Texas, in 2009. (Planned Parenthood closed that center the day Perry signed HB2 into law.)

But Planned Parenthood’s Texas expansion began before HB2 and has continued after the law took effect. Just over five years ago, it opened a new, $26 million Houston center, alternately described as the largest or second-largest abortion facility in the world, with the capacity to abort well in excess of 7,000 babies annually.

In 2013, Planned Parenthood built a $6.5 million center in Fort Worth that also meets ASC regulations.

“Our facility in Fort Worth was not impacted by [HB2],” Kelly Hart, senior director of government relations for Planned Parenthood of Greater Texas, told the Fort Worth Star-Telegram in 2014. Planned Parenthood did not return multiple calls requesting comment for this story.

Last year, Planned Parenthood left its longtime San Antonio headquarters, which did not meet ASC standards, and moved into a new $6.5 million building that complies with the regulations. One report indicates the San Antonio center will be able to handle almost 3,000 surgical abortions a year.

Planned Parenthood’s new Texas construction projects come in spite of a recent drop in the state’s abortion rate. The annual number of abortions in Texas dropped from 77,374 in 2005 to just under 64,000 in 2013, the last year for which data was published.

Nationwide, in spite of closing more than 120 of its centers between 2005 and 2011, including some in Texas, Planned Parenthood increased the number of annual abortions it performed during that period from about 265,000 to 334,000.

In fact, Planned Parenthood appears to be cornering the market on abortion. While the annual number of abortions in the United States dropped by 100,000 between 2009 and 2011, the total number of abortions at Planned Parenthood centers across the country essentially remained steady. That means the abortion giant’s market share is rising. In 2009 Planned Parenthood performed 28.85 percent of the nation’s abortions. The next year, it performed 29.87 percent, and in 2011, the number rose to 31.55 percent.

With more than 700 centers around the country, Planned Parenthood has the resources to withstand local political fluctuations. While pro-lifers are praying for a victory at the high court, abortion restrictions in Texas and other states are having an unintended consequence: Planned Parenthood is poised to fill the vacuum left by closing centers, gobbling up abortion real estate its smaller competitors cannot afford to maintain.