WASHINGTON — Liz Murrill, Louisiana's solicitor general, stood in front of the nine justices of the U.S. Supreme Court Wednesday to defend a state law that could have sweeping consequences for abortion rights nationwide.
Outside, hundreds of protesters chanted and waved signs, highlighting the nation-wide stakes of the legal battle over the law, which would require doctors who perform abortions to have admitting privileges at a local hospital.
The U.S. Supreme Court's decision over whether to allow the Louisiana law to take effect could come down to a technical issue — or it could signal a monumental shift in how abortion cases are handled by the high court in the Trump era.
The ruling likely won't come for several months. As with most cases they hear, the justices didn't exactly tip their hands either way when the arguments for and against Act 620 took center stage on Wednesday.
Murrill argued that the law would ensure a woman who gets an abortion could go to a hospital if there are complications and still keep the same doctor.
"It's about continuity of care," she told the justices.
Opponents of the law, led by Center for Reproductive Rights attorney Julie Rikelman, argued that the admitting privileges standard is obstructive and unfair. Hospitals set their own standards for admitting privileges. They can include a quota for number of patients brought to a facility or other restrictions.
The hearing mostly centered on technical issues of the Louisiana law and didn't test whether abortion should continue to be legal.
Justice Ruth Bader Ginsburg, one of the more left-leaning justices, repeatedly noted that most abortion complications happen outside of the clinic, when a woman has made it home, and wouldn't be addressed by the law. At multiple times during the hour-long hearing, she questioned why 30 miles was the limit set.
At times, Murrill seemed visibly frustrated by the questioning. She argued that abortion clinics in Louisiana have created "life-threatening life safety" issues for women seeking to terminate pregnancies.
Louisiana currently bans abortion after 20 weeks and requires two doctors visits, 24 hours apart, before the procedure can be performed.
Act 620 overwhelmingly passed the Louisiana Legislature in a bipartisan vote in 2014 and has since become the crux of the reproductive rights debate nationally.
Both sides agreed that the arguments made Wednesday wouldn't be the final say in the decision.
"We're not gonna solve this in oral arguments," Justice Stephen Breyer said at one point, noting the volume of briefings that have been filed.
As the high court spent about an hour listening to the arguments for and against the law, groups rallied outside on both ends of the abortion rights debate.
They waved signs supporting reproductive rights and restrictions on abortions. Priests, celebrities and others who sought to voice their views on abortion filled the sidewalks outside the court building while the arguments were heard inside.
Both supporters and opponents say Louisiana's law, if upheld, could pave the way for states to pass laws that tightly restrict, or potentially even ban, abortion — upending or undermining the court's landmark 1973 Roe v. Wade decision.
That decision said abortions are legal up to the point of fetus viability.
The Supreme Court struck down a Texas law in 2016 that was nearly identical to Act 620, ruling that it would create a “substantial obstacle in the path of a woman’s choice.”
But the court's make-up has significantly changed, and the state's legal team, under Attorney General Jeff Landry's leadership, argues that there are enough differences from the Texas law that should allow Louisiana's to pass muster.
Justices Neil Gorsuch and Brett Kavanaugh, both Trump appointees who have taken conservative positions in recent rulings, were not on the bench for the court's 5-3 Texas decision.
The law has not yet taken effect. The Supreme Court narrowly decided to put it on hold until it ruled on the case. Gorsuch and Kavanaugh both argued it should have gone into effect, but Chief Justice John Roberts sided with the more liberal wing of the court in agreeing to a delay.
Roberts, who asked several questions during Wednesday's oral arguments about precedent, voted in favor of allowing the Texas law in 2016.
If the admitting privileges law is allowed to take effect, it could signal a willingness by the court to sign off on other reproductive rights issues making their way through the legal system, such as fetal heartbeat laws that would end abortions after about six weeks, and laws that would require patients wait 72 hours between their first clinic visit and when a pregnancy can be terminated.
There are only three clinics across the state — one each in Shreveport, New Orleans and Baton Rouge, and there were fewer than 10,000 abortions in the state in 2017, according to the most recent figures available through the Guttmacher Institute, a research and policy outfit that supports abortion rights and tracks statistics. The number has been relatively stable since 2014, when there were 10,150.