The decision in Hellerstedt has not been good law since the Supreme Court repudiated Roe v. Wade and the right to abortion in Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022).

[3] Whole Woman's Health, however, has deemed these requirements unnecessary and expensive as well as an attempt to limit abortion access rather than provide safety to women.

The court held a four-day bench trial and on August 29, 2014, Judge Yeakel issued a state-wide injunction barring enforcement of both provisions.

[13][7] On October 14, 2014, the U.S. Supreme Court vacated the Fifth Circuit, reimposing the injunction blocking the law, over a dissent by Justices Scalia, Thomas, and Alito.

[14][7] On June 9, 2015, Circuit Judges Edward C. Prado, Elrod, and Haynes, in an anonymous per curiam decision, found on the merits that the two provisions were constitutional.

Over eighty amicus curiae briefs were filed with the Court,[20] including one signed by prominent female lawyers stating that they had each had an abortion and the decision had paved the way for their legal careers.

[21][22] A competing brief in support of the Texas law was filed on behalf of women who said they suffered psychological or physical harm due to their abortions.

[30] According to the ruling, the task of judging whether a law puts an unconstitutional burden on a woman's right to abortion rests with the courts and not the legislatures.

Determined wrongdoers, already ignoring existing statutes and safety measures, are unlikely to be convinced to adopt safe practices by a new overlay of regulations.

"[33] In a two-page concurrence, Justice Ginsburg wrote, "Many medical procedures, including childbirth, are far more dangerous to patients, yet are not subject to ambulatory surgical-center or hospital admitting-privileges requirements.

When a State severely limits access to safe and legal procedures, women in desperate circumstances may resort to unlicensed rogue practitioners.

"[34] Justice Thomas filed a dissenting opinion, stating that the majority "reimagines the undue-burden standard" for abortion access, creating a "benefits-and-burdens balancing test" that courts should have instead deferred to the legislatures to resolve.

[28] Alito also stated that Texas might well have been motivated to protect women by the Kermit Gosnell case in Pennsylvania, in which a doctor had been convicted on three charges of murder and one of manslaughter.

"[37] Senator Ted Cruz expressed disappointment with the ruling, saying "the Supreme Court sided with abortion extremists who care more about providing abortion-on-demand than they do protecting women’s health."

"[35] A statement issued on behalf of the Catholic Church bishops in Texas said the decision "puts women at grave risk" because "Surgical abortion is an invasive procedure that poses numerous and serious medical complications.

The state has a legitimate interest in ensuring the maximum level of safety for the woman subjected to the procedure and that viable emergency care is available if complications such as hemorrhage, infection, uterine perforation, blood clots, cervical tears, or allergic reactions occur.

[39][40] Steve Vladeck, a professor of law at American University Washington College of Law, stated:[41] By clarifying exactly what the 'undue burden' test[40] requires, I suspect the majority was hoping to dissuade states like Oklahoma from continuing to pass laws that so directly challenge the central premise of Roe v. Wade -- that the Constitution protects a pregnant woman's right to an abortion in a meaningful percentage of cases, Vladeck also added that in the process, the Court today has called into question everything from categorical bans on abortions to so-called 'fetal heartbeat' restrictions, and perhaps plenty of other laws in between,[41] At the time of the decision, five states required abortion clinics to operate under "hospital-like" standards: Michigan, Missouri, Pennsylvania, Virginia, and Tennessee, though in the last of these[which?]

[46] Louisiana had passed Act 620 in 2014, modeled after Texas' law that would require doctors to have admission privileges at a hospital within 30 miles, effectively reducing the number of legal clinics to one at the time of passage.