Court upholds key parts of Texas' strict anti-abortion law

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AUSTIN, Texas (AP) -- A federal appeals court upheld key parts of Texas's strict anti-abortion law on Tuesday, a decision that could leave as few as seven abortion clinics in the nation's second largest state.

The decision by the 5th U.S. Circuit Court of Appeals comes in a lawsuit challenging some of the toughest abortion restrictions in the country, including requirements that all abortion-providing health clinics employ hospital-level operating standards.

Owners of small clinics argue that those standards demand millions of dollars in upgrades they can't afford. They and other abortion-rights supporters say the law is a thinly veiled attempt to block access to abortions in the state, but Republican Gov. Greg Abbott and other conservatives supporting the law say the standards protect women's health.

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Court upholds key parts of Texas' strict anti-abortion law
College students and abortion rights activists hold signs during a rally on the steps of the Texas Capitol, Thursday, Feb. 26, 2015, in Austin, Texas. The demonstrators are urging an easing of strict limits on abortion that prompted massive protests but were overwhelmingly approved last session. (AP Photo/Eric Gay)
Two signs that read "Who Lobbied For This?, " and "We Need Healthcare Options, Not Obstacles", are held by attendees to a rally in front of city hall where a group of nearly 200 gathered to protest the approval of sweeping new restrictions on abortion, Monday, July 15, 2013, in Dallas. The gathering came as part of the National Day of Action that included similar rallies planned in several cities. (AP Photo/Tony Gutierrez)
Activists tie on hospital gowns as they prepare to protest House Bill 3994 in the rotunda of the Texas Capitol, Friday, May 22, 2015, in Austin, Texas. Part of the bill would require women to present a government-issued ID before receiving abortion services. (AP Photo/Eric Gay)
FILE - In this Aug. 19, 2014 file photo, a group holds signs about Texas Gov. Rick Perry as he leaves the Blackwell Thurman Criminal Justice Center after he was booked and released, in Austin, Texas. Austin has made itself a painful exception to Republican rule in Texas. The big college town is home to the grand jury that indicted Perry while he was in office and to judges who authorized a gay wedding and struck down abortion restrictions and GOP cuts to public schools. Republican Gov. Greg Abbott this month is signing laws that will draw power away from solidly Democratic Travis County and weaken its local jurisdiction over state business done inside its borders. (AP Photo/Eric Gay, File)
FILE - In this July 12, 2013 file photo, Cecile Richards, daughter of former Texas Gov. Ann Richards and president of the Planned Parenthood Federation of America, greets abortion rights advocates as they leave the State Capitol rotunda in Austin, Texas. Abortions have declined in states where new laws make it harder to have them - but they’ve also waned in states where abortion rights are protected, an Associated Press survey finds. Nearly everywhere, in red states and blue, abortions are down since 2010. "Better access to birth control and sex education are the biggest factors in reducing unintended pregnancies," said Richards. (AP Photo/Tamir Kalifa, File)
A man walks past the former site of a clinic that offered abortions in El Paso, Texas, Friday, Oct. 3, 2014. Abortion services for many Texas women require a round trip of more than 200 miles, or a border-crossing into Mexico or New Mexico after federal appellate judges allowed full implementation of a law that has closed more than 80 percent of Texas' abortion clinics. (AP Photo/Juan Carlos Llorca)
Texas Gov. Greg Abbott, center, talks with news reporters during a round table talk in his office at the Texas Capitol, Wednesday, June 3, 2015, in Austin, Texas. (AP Photo/Eric Gay)
Rep. Mike Schoefield, R-Katy, packs up his desk after the House adjourned on the final day of the legislative session in the House Chamber at the Texas Capitol, Monday, June 1, 2015, in Austin, Texas. Guns, tax cuts and border security: new Republican Gov. Greg Abbott made those priorities his first six months on the job, and after the Texas Legislature ends Monday, he'll claim plenty of victories. (AP Photo/Eric Gay)
Texas Gov. Greg Abbott shares a laugh with news reporters during a round table talk in his office at the Texas Capitol, Wednesday, June 3, 2015, in Austin, Texas. (AP Photo/Eric Gay)
A man walks into a clinic that offers abortions in Santa Teresa, N.M., Friday, Oct. 3, 2014. Abortion services for many Texas women require a round trip of more than 200 miles, or a border-crossing into Mexico or New Mexico after federal appellate judges allowed full implementation of a law that has closed more than 80 percent of Texas' abortion clinics. (AP Photo/Juan Carlos Llorca)
Texas Rep. Matt Krause, R- Fort Worth, left, talks with Rep. Geanie Morrison, R-Victoria, right, in the House Chamber, Wednesday, May 13, 2015, in Austin, Texas. Morrison has proposed a bill making it more difficult for girls younger than 18 who face extreme circumstances to have abortions without their parents' consent. (AP Photo/Eric Gay)
Anti-abortion supporters march to the Texas Capitol during a Texas Rally for Life, Saturday, Jan. 24, 2015, in Austin, Texas. (AP Photo/Eric Gay)
A man walks into a clinic that offers abortions in Santa Teresa, N.M., Friday, Oct. 3, 2014. Abortion services for many Texas women require a round trip of more than 200 miles, or a border-crossing into Mexico or New Mexico after federal appellate judges allowed full implementation of a law that has closed more than 80 percent of Texas' abortion clinics. (AP Photo/Juan Carlos Llorca)
Texas Lt. Gov. Dan Patrick, left, talks with Sen. Juan "Chuy" Hinojosa, D-Brownsville, right, in the Senate Chamber, Tuesday, May 5, 2015, in Austin, Texas. Under a bill that has cleared the Republican-controlled Senate Tuesday, most abortions in Texas could not be covered by insurance purchased through the Affordable Care Act. (AP Photo/Eric Gay)
FILE - In this Feb. 26, 2015 file photo, college students and abortion rights activists hold signs and pray during a rally on the steps of the then Texas Capitol, to urge an easing of strict limits on abortions, in Austin, Texas. Abortions have declined in states where new laws make it harder to have them - but they’ve also waned in states where abortion rights are protected, an Associated Press survey finds. Nearly everywhere, in red states and blue, abortions are down since 2010. (AP Photo/Eric Gay, File)
Anti-abortion supporters carry signs and a life-sized photo of Pope John Paul II as they march to the Texas Capitol during a Texas Rally for Life, Saturday, Jan. 24, 2015, in Austin, Texas. (AP Photo/Eric Gay)
Anti-abortion supporters march through downtown as they head to the Texas Capitol during a Texas Rally for Life, Saturday, Jan. 24, 2015, in Austin, Texas. (AP Photo/Eric Gay)
AUSTIN, TX - JULY 01: Supporters of Texas women's right to reproductive decisions rally at the Texas State capitol on July 1, 2013 in Austin, Texas. This is first day of a second legislative special session called by Texas Gov. Rick Perry to pass an restrictive abortion law through the Texas legislature. The first attempt was defeated after opponents of the law were able to stall the vote until after first special session had ended. (Photo by Erich Schlegel/Getty Images)
AUSTIN, TX - JULY 01: Supporters of Texas women's right to reproductive decisions rally at the Texas State capitol on July 1, 2013 in Austin, Texas. This is first day of a second legislative special session called by Texas Gov. Rick Perry to pass an restrictive abortion law through the Texas legislature. The first attempt was defeated after opponents of the law were able to stall the vote until after first special session had ended. (Photo by Erich Schlegel/Getty Images)
AUSTIN, TX - JULY 01: A pro-life supporter in the Texas State capitol on July 1, 2013 in Austin, Texas. This is first day of a second legislative special session called by Texas Gov. Rick Perry to pass an restrictive abortion law through the Texas legislature. The first attempt was defeated after opponents of the law were able to stall the vote until after first special session had ended. (Photo by Erich Schlegel/Getty Images)
AUSTIN, TX - JULY 01: Texas Sen. Wendy Davis (D-Ft. Worth) leads a rally in support of Texas women's right to reproductive decisions at the Texas state capitol on July 1, 2013 in Austin, Texas. This is first day of a second legislative special session called by Texas Gov. Rick Perry to pass an restrictive abortion law through the Texas legislature. The first attempt was defeated after opponents of the law were able to stall the vote until after first special session had ended. (Photo by Erich Schlegel/Getty Images)
AUSTIN, TX - JUNE 25: Reproductive rights advocates fill the Texas capitol celebrating the defeat of the controversial anti-abortion bill SB5, which was up for a vote on the last day of the legislative special session June 25, 2013 in Austin, Texas. A combination of State Sen. Wendy Davis' (D-Ft. Worth) 13-hour filibuster and protests by reproductive rights advocates helped to ultimately defeat the controversial abortion legislation at midnight. (Photo by Erich Schlegel/Getty Images)
FILE - In this Aug. 11, 2014 file photo, the Hilltop Women's Reproductive clinic is photographed in El Paso, Texas. A federal judge Friday, Aug. 29, 2014, threw out new Texas abortion restrictions that would have effectively closed more than a dozen clinics in the state. U.S. District Judge Lee Yeakel sided with clinics that sued over one of the most disputed measures of a sweeping anti-abortion bill signed by Republican Gov. Rick Perry in 2013. (AP Photo/Juan Carlos Llorca, File)
File - In this Oct. 29, 2013 file photo, Dottie and Tom Knodell, opponents of abortion, hold signs outside a Planned Parenthood Clinic, in San Antonio. A U.S. appeals court on Thursday, Oct. 31, 2013, issued a ruling reinstating most of Texas' tough new abortion restrictions, which means as many as 12 clinics will not be able to perform the procedure starting as soon as Friday. (AP Photo/Eric Gay, File)
FILE - In this July 12, 2013, file photo, abortion rights supporters rally on the floor of the State Capitol rotunda in Austin, Texas. A sharply divided Supreme Court on Tuesday, Nov. 19, 2013, allowed Texas to continue enforcing abortion restrictions that opponents say have led more than a third of the state's clinics to stop providing abortions. (AP Photo/Tamir Kalifa, File)
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The New Orleans-based appeals court, considered one of the most conservative panels in the nation, allowed Texas to enforce the restrictions when abortion providers first sued in 2013. But the U.S. Supreme Court temporarily sidelined the law last year.

Texas currently has about 17 abortion providers, down from 40 clinics in 2012. That sharp decline began after the 5th Circuit upheld another part of the 2013 law that required doctors to have admitting privileges at nearby hospitals.

Under the new restrictions, the only remaining abortion facilities in Texas would likely be in major cities. One exception would be in McAllen, near the Texas-Mexico border, which the 5th Circuit exempted from some restrictions.

But for women in El Paso, the closest abortion provider in Texas would require a 1,200-mile round trip to San Antonio, or they would have to cross the border into New Mexico.

Attorneys for the state dismissed opponents' arguments about women being burdened by fewer abortion facilities, saying that nearly 9 in 10 women in Texas would still live within 150 miles of a provider.

A new slate of conservative leaders in Texas has vowed to continue stifling abortion-rights efforts. George P. Bush, the son of expected 2016 presidential hopeful Jeb Bush and nephew of former President George W. Bush, made an anti-abortion rally at the Capitol his first public event since being sworn in as land commissioner, along with Abbott's wife, Cecilia.

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