Texas conservatives test how far they can extend health care restrictions beyond state lines

Texas conservatives test how far they can extend health care restrictions beyond state lines

By Eleanor Klibanoff and William Melhado, The Texas Tribune

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In the months since Texas outlawed abortion and prohibited adolescents from receiving gender-transition care, women have flooded abortion clinics in nearby states and parents with transgender children have moved to places where puberty blockers and hormone therapy remain legal.

So now, Texas conservatives are testing the limits of their power beyond state lines.

Some cities and counties have passed so-called travel bans aimed at stopping Texans from driving to abortion appointments in other states. Meanwhile, Attorney General Ken Paxton has demanded medical records from at least two out-of-state clinics that provide gender-affirming care to minors.

“This request from the Texas Attorney General is a clear attempt to intimidate providers of gender-affirming care and parents and families seeking that care outside of Texas and other states with bans,” Dr. Izzy Lowell, a Georgia physician who received one such demand letter, said in a statement.

These recent efforts to restrict or scrutinize what Texans do out-of-state raise an important question: Just how far does Texas’ authority over its residents extend?

The question of extraterritoriality — when and whether a state can impose its laws beyond its borders — is largely unresolved, legal experts say. It just hasn’t come before the courts that often. And while the right to travel is well-established in the U.S. Constitution, the local travel bans are enforced through private lawsuits, a legal loophole the U.S. Supreme Court has so far allowed to stand.

When the U.S. Supreme Court allowed states to set their own laws on abortion, it put them on a political crash course with each other. These recent legal maneuvers from conservatives in Texas indicate a willingness to wade into a Constitutional morass the country hasn’t dealt with since the lead-up to the Civil War.

“Slavery is probably the best historical parallel to what we’re seeing now,” said Kermit Roosevelt, a law professor at Penn Carey Law at the University of Pennsylvania. “Obviously, that didn’t end well. Well, it did, because we abolished slavery federally, but it was a tough road.”

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