The success of the Texas Heartbeat Act was a major blow to Roe v. Wade,[21][22] as it provided a blueprint for states to outlaw abortion while insulating their laws from effective judicial review.

[32][33] In 2019, another six-week abortion ban was introduced as HB 1500, which was jointly authored by Representatives Briscoe Cain, Phil King, the late Dan Flynn, Tan Parker, and Rick Miller.

[57] Section 2 of the Act declares that Texas has never repealed, either expressly or by implication, its pre–Roe v. Wade statutes that outlaw and criminalize abortion unless the mother's life is in danger.

[71] Section 3 of the Act also insulates the state of Texas and its officials from being sued by preserving their sovereign immunity and forbidding them to enforce the statute in any way.

[65][72] The Act allows defendants to escape liability if they demonstrate that the relief sought by the plaintiff will impose an "undue burden" on women seeking abortions.

[65][73] But the Act also provides that this "undue burden" defense is unavailable if the Supreme Court overrules Roe v. Wade or Planned Parenthood v. Casey, even if the abortion occurred while those decisions were in effect,[65][73] and it establishes a four-year statute of limitations.

[3] In Texas, an estimated 85% of abortions had been performed after the six-week mark, which is often shortly after a pregnant woman misses her menstrual period, and before many women have confirmed or are aware of a pregnancy.

Since the law cannot be enforced by state officials but only by private individuals, it is difficult for abortion providers to identify the proper defendants to sue in a pre-enforcement lawsuit, which prevents them from challenging the constitutionality of the act prior to its taking effect.

[86] The Texas Heartbeat Act is intensely controversial because it was written to frustrate judicial review and thwart the judiciary from enforcing Supreme Court precedents that declared abortion to be a constitutionally protected right.

Law professors that supported Roe v. Wade, such as Laurence Tribe and Michael C. Dorf, have criticized the Act and its enforcement mechanism as "cynical"[87] and "diabolical".

In an op-ed published in The New York Times, law professors Laurence Tribe and Steve Vladeck acknowledged that the Act's enforcement mechanism "makes it very difficult, procedurally, to challenge the bill's constitutionality in court", but argued that abortion providers "should" still be able to challenge the law's constitutionality by suing state-court judges and court clerks.

Other legal scholars, such as Harvard's Stephen Sachs,[96][97][98] Yale's Akhil Reed Amar,[99] and Edward Whelan of the Ethics and Public Policy Center,[100] have argued that SB8's unique design precludes abortion providers from challenging the constitutionality of the statute in pre-enforcement litigation.

[106] An analysis by Johns Hopkins along with a study by JAMA Pediatrics published in 2024 suggests SB 8 is associated with an increase in infant mortality and newborn deaths.

[110] This action was nonsuited and refiled in Travis County (Austin, Texas), where it remains pending, along with numerous companion cases by abortion providers and funders, who are all represented by the same attorneys.

In late August 2021, district judge Robert L. Pitman rejected a motion to dismiss the case and scheduled a hearing on the temporary injunction requested by the plaintiffs.

[115] Late on September 1, 2021, nearly 24 hours after the Act had come into force, the Supreme Court denied the motion in an unsigned order,[116] though four Justices wrote or joined dissents that stated they would have granted the injunction pending legal evaluation.

The majority opinion on the motion stressed that the denial of immediate relief did not preclude other legal challenges in lower federal or Texas state courts.

Again, the plaintiffs filed a petition for a pre-judgment writ of certiorari at the Supreme Court based on the Fifth Circuit's order, again seeking an injunction on the enforcement of SB 8.

[123] The Court allowed the abortion providers' claims against state licensing officials to proceed beyond the motion-to-dismiss stage, and remanded the case back to the Fifth Circuit.

[66] United States Attorney General Merrick Garland announced on September 6, 2021, that the Justice Department (DOJ) will protect abortion seekers in Texas under the Freedom of Access to Clinic Entrances Act.

[129][130] District judge Robert L. Pitman, who was also overseeing the WWH v. Jackson case, issued a preliminary injunction blocking enforcing of the Act on October 6, 2021, ruling that the United States government does have standing to challenge Texas' law.

[139][140] Justice Sotomayor concurred in the decision to hear the case on an expedited basis, but dissented on the denial of an immediate stay order in the interim.

21-588,  United States, Petitioner v. Texas, et al., docketed October 14, 2021 in conjunction with consideration of application (21A85) to vacate Fifth Circuit stay presented to Justice Alito and by him referred to the Court is deferred pending oral argument on November 1, 2021.

[150] Their website came under denial-of-service and satirical attacks featuring copypastas and eroticized fan-art of Shrek based on the prevalent internet meme,[151] as well as profuse non-pertinent and misleading information.

[159][160] John Gibson, the CEO of the video game developer/publisher Tripwire Interactive, tweeted in support of the bill and the Supreme Court's decision to not block its enforcement on September 4, 2021.

The group subsequently hacked the website of the Republican Party of Texas, replacing it with text about Anonymous, an invitation to join Operation Jane, and a Planned Parenthood donation link.

[166] The Distributed Denial of Secrets (DDoSecrets) organization said later that day that they were working to curate the allegedly leaked data for public download, and said that it consisted of "180 gigabytes of user, registration, forwarding and other information".

She stated: "When laws that push access to reproductive health care out of reach take effect, it's always women of color and low-income communities that are most harmed.

"[174] Some Republicans, such as South Dakota governor Kristi Noem praised the act, while others (including 2021 Virginia gubernatorial candidate Glenn Youngkin and Senate minority leader Mitch McConnell) were more leery.

On December 11, 2021, a day after the Supreme Court effectively upheld enforcement of the law in Whole Woman's Health v. Jackson, Governor Gavin Newsom of California called for the state legislature to apply the legal framework from Texas' law to gun control, seeking a bill that would introduce a private right of action against manufacturers, distributors, and sellers of assault weapon or receiver blanks in the state.