Roberts, in a separate concurring opinion, cited the court's decision just four years ago to reject a similar law in Texas.

"The Louisiana law imposes a burden on access to abortion just as severe as that imposed by the Texas law, for the same reasons," Roberts wrote. "Therefore Louisiana's law cannot stand under our precedents."

The case, the first abortion challenge heard by the Supreme Court since the addition of President Donald Trump's two appointees, has been closely watched by activists on both side of the abortion debate, partly because of its close similarities to the Texas case from 2016. Today's decision suggests the ruling in the Texas case should be applied more broadly, limiting the ability of anti-abortion states to mandate admitting privileges.

The ruling in June Medical Services v. Russo comes just months ahead of a heated presidential election in which anti-abortion and abortion rights groups are spending tens of millions of dollars to mobilize voters. Once again, the court's ability to shape abortion rights has played prominently in their messaging, with Trump promising to appoint anti-abortion judges and Joe Biden, the presumptive Democratic nominee, pledging to expand access to the procedure.

Louisiana abortion providers, represented by the Center for Reproductive Rights, contended the state's admitting privileges law would hurt Louisiana residents by forcing two of the state's three abortion providers to shut down. Further, they argued the requirement was unnecessary since patients would be able to get hospital care regardless of whether their provider had admitting privileges.

The Louisiana law was passed in 2014 but only implemented briefly in 2016 before it was halted by federal courts - including the Supreme Court in early 2019 - while legal challenges were underway. While the law was in effect, most of the state's abortion clinics suspended appointments and referred patients to a single facility in Shreveport, which had admitting privileges at a nearby hospital.

The Supreme Court found the circumstances around the Louisiana requirements were similar enough to the Texas law it struck down 5-3 just four years ago. In that decision, retired Justice Anthony Kennedy joined with the court's liberal wing in finding the state's admitting privileges law placed an "undue burden" on a woman's constitutional right to an abortion. The court noted that the restrictions offer "few, if any health benefits for women," since abortion-related complications that require hospitalization are very rare.

The court came to the same conclusion on the Louisiana law, writing Monday that "the state introduced no evidence showing that patients have better outcomes when their physicians have admitting privileges or of any instance in which an admitting privileges requirement would have helped even one woman obtain better treatment."

While the case didn't directly challenge Roe v. Wade, the ruling comes as a wave of recent state laws seeking to overturn the right to an abortion are being reviewed by lower courts.

The Supreme Court also rejected Louisiana's argument that abortion providers do not have legal standing to challenge restrictions on behalf of their patients. A ruling for the state on that point could have upended a nationwide pipeline of abortion litigation, since clinics typically lead such lawsuits.

"Abortion providers in this case have standing to assert the constitutional rights of their patients," the majority wrote.


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