The Supreme Court struck down Louisiana's admitting privileges law as unconstitutional in a 5-4 decision, allowing doctors at Louisiana's three remaining clinics to continue to provide care. While we celebrated this victory, we also understood the increasing threat this case posed to abortion rights.

The majority opinion was a plurality opinion written by Breyer and supported by the other liberal members of the court. Chief Justice John Robert joined in the result, agreeing that the law was unconstitutional and should be struck down because it's identical to the Texas law examined in Whole Woman's Health, and it establishes a similar level of burden; thus, he could not justify coming to a different result. However, Robers did not join the analysis of the other four justices, because he does not agree that Whole Woman's Health established a new and better standard for determining constitutionality through a balancing test.

The liberal justices believed that Whole Woman's Health clarified the Casey decision by establishing a balancing test, where the courts should consider the purported medical benefits of the law and the potential burdens; if the burdens of the law outweigh the benefits, then it should be considered unconstitutional. But Roberts rejected the idea of a balancing test, and he refused to apply that standard. His decision relied on Casey and explicitly uses that case as the framework for his opinion, rather than Whole Woman's Health. For June Medical v. Russo, Roberts simply thought that the burden of the law in this specific case was sufficient enough to declare the law unconstitutional.

Interestingly, while the four more conservative members of the court voted to overrule Whole Woman's Health and uphold the Louisiana admitting privileges law, their dissenting opinions seemed to express that Whole Woman's Health did establish a balancing test standard. Thus, they did not present a united front to support whatever Roberts was trying to accomplish with his opinion.

While Casey solidified that an undue burden was unconstitutional, Whole Woman's Health gave some clarity to what that meant. Following Whole Woman's Health, the balancing test standard meant that several laws could potentially be challenged. Now, the June Medical decision has thrown that into flux. If the courts choose to follow Roberts' logic and disregard the balancing test, then how will they determine if a law presents an undue burden? Consequently, although this case did not overrule Whole Woman's Health, it will definitely encourage more litigation, and the courts will have room for their own ideological interpretations of the ruling. It's likely that the Fifth Circuit will conclude that the balancing test is no longer the standard.

While June Medical was indeed a victory for Louisiana, Whole Woman's Health made it harder for restrictions to be upheld and was a stronger standard for pro-choice advocates. There are no longer five votes on the court for applying a balancing test standard. Roberts believes that this is a ruling based on these specific facts and this specific law in Louisiana. He believes the analysis of constitutionality is a state-by-state analysis. Moving forward, the court will look at abortion restrictions, they'll require an extensive factual record, and then they'll judge whether or not it represents an undue burden; but they will not have to apply the balancing test standard to make that determination. How this will turn out in practice is impossible to say. There are arguments that either side can utilize. Our opposition is going to say, "It's a very narrow decision that's limited to this law and these facts." So anything else—including other admitting privileges requirements in other states—might meet another fate.

Additionally, the Supreme Court issued a solid 5-4 decision that abortion providers and clinics do have third party standing to bring forth challenges on behalf of their patients. Roberts joined in the entire rationale in saying that abortion providers have standing to represent their patients, and his reasoning was two-fold: (1) Roberts believes that third party standing has been well supported by existing Supreme Court precedent. (2) Roberts believes that the state waived the argument by failing to raise it at the correct time. The latter is basically just a procedural argument, which lends itself to being somewhat precarious. It begs the question, "If the state had asked the district or appeals court to reassess the validity of standing, then would the precedent have been enough to uphold third party standing?" The four more conservative justices are firmly against third party standing and don't think the precedent is strong. So, the wording of this decision is not enough to deter states from trying to make this argument in the future.