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Criminalizing Care: The Case Against HB 7
Georgia Jensen
1 day ago
5 min read
By: Georgia Jensen
Photo by Brigette Supernova/Alamy Stock Photo
On September 17, 2025, Texas Governor Greg Abbott signed House Bill 7 into law, targeting access to medication abortion. HB 7 deploys civil enforcement to cut off access to medication abortion, which is unlikely to reduce abortions overall while worsening health outcomes for women at risk. This legislation joins several existing Texas abortion bans, which are considered the most extreme in the nation, and hopes to inspire similar legislation across the country.
Medication abortion consists of two drugs—mifepristone and misoprostol—taken consecutively to end a pregnancy. Despite claims made by Health and Human Services Secretary Robert F. Kennedy, Jr., medication abortion is considered highly safe and effective by both the FDA and clinical studies. It also accounts for 63% of abortions as of 2023 and is the primary method through which individuals living in abortion-hostile states access abortion care—one that HB 7 aims to cut off.
Losing access to these pills may have especially harmful consequences. Unlike surgical abortion, which, for those in Texas, requires traveling out of state to a clinic, medication abortion can be taken at home, offering privacy, affordability, and timeliness. Without this option, people face longer delays in arranging appointments or travel, increasing medical risks as the pregnancy progresses.
While HB 7 does not criminalize those seeking abortions directly, it permits private citizens to sue a broad array of individuals involved in supplying abortion pills in Texas. Those connected to the pregnant person, such as a family member, can file suit against the offender for $100,000, but anyone can sue for $10,000, with the remainder going to charity. HB 7 is modeled after Texas Senate Bill 8, which passed in 2021 and bans abortion once a fetal heartbeat can be detected. SB 8 also relied on private enforcement, allowing citizens to sue anyone who “aids or abets” abortion.
Historically, efforts to restrict abortion do not achieve their intended goal. A Guttmacher Institute study shows that, after the Dobbs decision overturned the constitutional right to the procedure, incidence reached a decade-high despite bans and heavy restrictions in numerous states. Historically, efforts to restrict abortion usually don’t accomplish the intended reduction. A Guttmacher Institute study shows that, after the Dobbs decision overturned the right to abortion, abortion incidence reached a decade-high incidence, despite abortion bans and heavy restrictions in numerous states. In 2023, 171,000 people traveled out of abortion-hostile states to get abortion care. The rates of self-managed abortion are rising as well. In other states, telemedicine practices and shield laws, which protect providers, patients, and others from legal repercussions, have allowed those seeking abortion to receive the pills via mail, evading their state’s bans.
However, in cases where abortion is medically necessary, these steep penalties have created ambiguity that discourages timely intervention, compromising reproductive and maternal safety. Together, SB 8 and Texas’s near-total abortion ban allow abortion care only to save the life of the mother. In these cases, however, physicians are afraid to provide medically necessary abortion care, impeding their ability to provide quality care in often-fatal pregnancies. This has significantly worsened women’s health in Texas, which now ranks second-last in the nation. Maternal mortality has risen 56% and infant mortality has increased 12.8% since SB 8 took effect in 2021, underscoring a trend of increased morbidity that conflicts with the bill’s intent of ‘protecting life.’
Once it takes effect on December 4, HB 7 will further criminalize abortion, making the process even more dangerous for those who depend on it. It also provides a heavy financial incentive to sue those involved in the distribution of pills, further isolating those seeking abortions. It will likely result in a decrease in providers willing to send abortion medication to Texas. It reaches across state lines to criminalize the behavior of individuals in other states, despite shield laws. Perhaps most critically, it can serve as a model for other abortion-hostile states. Texas has led the way in extreme abortion legislation, but other states have historically been quick to follow suit. HB 7 not only intensifies the reproductive health crisis in Texas, but also has the potential to export that crisis nationwide.
The views expressed in this publication are the authors' own and do not necessarily reflect the position of The Rice Journal of Public Policy, its staff, or its Editorial Board.
Verma, Nisha, and Daniel Grossman. “Self-Managed Abortion in the United States.” Current Obstetrics and Gynecology Reports, vol. 12, no. 2, 7 Mar. 2023, pp. 70–75. Springer, doi:10.1007/s13669-023-00354-x.
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