The Texas law was declared unconstitutional in WWH in 2016,[1] on the basis that limiting clinic availability was an undue burden on women seeking legal abortions, a constitutional right as determined by the landmark ruling Roe v. Wade (1973).

June Medical Services had been considered a potentially important case on abortion rights in the United States, as it was the first abortion-related case to be heard by both Justices Neil Gorsuch and Brett Kavanaugh, two justices that are considered conservative, giving the Court a conservative majority, and potentially threatening the Roe v. Wade precedent.

By the time this part of the law came into effect in November 2013, only 19 of 42 abortion clinics remained open, leaving some women with their closest center more than 300 miles (480 km) away.

[11] The five affected doctors attempted to secure admitting privileges before September but were denied, leading the clinics to seek a preliminary injunction to prevent the law from coming into effect.

The three-judge panel unanimously agreed to vacate the District Court's injunction,[14] allowing Act 620 to in effect on February 15, 2016, which forced at least two clinics to immediately close.

deGravelles found in favor of the plaintiffs in April 2017 and deeming Act 620 unconstitutional, applying the Supreme Court's "undue burden" tests from WWH similarly to Louisiana's laws in his 117-page opinion.

[20] The majority also found that in contrast to the Texas's admission privilege's requirements, Louisiana's were less strict, making it easier for those doctors to obtain it.

Judge Patrick E. Higginbotham wrote in his dissent that in applying the undue burden test, the state shows no compelling medical benefit to override the right to an abortion.

[21][22] The plaintiffs sought an en banc hearing from the full Fifth Circuit, but this request was denied, with Act 620 set to come into effect on February 4, 2019.

Judges Jones, Smith, Owen, Elrod, Haynes, Willett, Ho, Engelhardt, and Oldham voted not to rehear.

Only Kavanaugh wrote an opinion alongside the order, stating that he believed that three of the doctors affected by the admitting privileges could still obtain these, and had not yet demonstrated it was impossible for them to get it, eliminating the undue burden on women.

[27] In addition to requesting an emergency stay on the Fifth Circuit's decision, the clinics also petitioned the Supreme Court to hear the case.

[33] Thomas maintained in his dissent that Roe v. Wade "is grievously wrong for many reasons, but the most fundamental is that its core holding—that the Constitution protects a woman’s right to abort her unborn child—finds no support in the text of the Fourteenth Amendment.

Kavanaugh's judicial opinions before joining the Supreme Court and his comments during his nomination process indicated that he views abortion rights with disfavor.

[43] On June 24, 2022, the Court overturned Roe and Casey in Dobbs v. Jackson Women's Health Organization, meaning that state restrictions on abortion providers are no longer subject to the undue burden standard.