Abortion rights activists won a landmark case on ???? ????? ?????Monday when the Supreme Court ruled against a set of Texas abortion restrictions. 

The 5-3 decision in Whole Woman's Health v. Hellerstedt declared the regulations unconstitutional because they place an undue burden on patients and do not promote women's health and safety as proponents of the laws had argued. 

It was the court's most significant ruling on abortion in nearly a quarter century, and the first in decades that abortion rights activists could claim as a definitive victory. 

“Every day Whole Woman’s Health treats our patients with compassion, respect and dignity — and with this historic decision, today the Supreme Court did the same," Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, said in a statement. "We’re thrilled that today justice was served and our clinics stay open."

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Stephen G. Breyer wrote the majority opinion and was joined by Sonia Sotomayor, Elena Kagan and Anthony Kennedy. Ruth Bader Ginsburg wrote a concurring opinion. 

The decision requires states to provide convincing evidence that abortion restrictions protect women's health and do not pose an undue burden. That precedent may give abortion rights advocates a legal framework to challenge long-settled restrictions, such as waiting periods, mandatory sonograms and state-mandated counseling. 

Samuel Alito's dissent, joined by Chief Justice John Roberts and Clarence Thomas, focused on what he viewed as the majority's flagrant disregard of procedural rules that might have barred the court from ruling on the case and voiding the Texas laws in their entirety. In his own dissent, Thomas noted Alito's procedural concerns and wrote that he remains "fundamentally opposed" to the court's decision.   

"We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes." 

The Texas restrictions, known as H.B. 2 and passed in 2013, require physicians to obtain admitting privileges at a nearby hospital and force providers to build expensive ambulatory surgical centers. Major medical organizations opposed the measures, describing them not "medically sound." 

"We conclude that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes," Breyer wrote. "Each places a substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access... and each violates the Federal Constitution."  

Texas abortion providers argued that the laws were not only unnecessary, but also practically and financially onerous. Some applied for admitting privileges at many hospitals, including religious facilities, and were often denied or received no response.

The cost of converting or building a new ambulatory surgical center ranged from $1.5 million to more than $3 million, according to a brief submitted to the court by the Planned Parenthood Federation of America. 

“HB2 was an effort to improve minimum safety standards and ensure capable care for Texas women," Texas Attorney General Ken Paxton said in a statement on Monday. "It’s exceedingly unfortunate that the court has taken the ability to protect women’s health out of the hands of Texas citizens and their duly-elected representatives.”

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Dozens of states have passed regulations similar to Texas', and the court's decision will shape the outcome of challenges in federal courts to admitting privileges requirements in Alabama, Louisiana, Tennessee, Wisconsin and Mississippi, which is currently pending with the Supreme Court. It's likely that that lawyers arguing against the restriction in Mississippi will soon submit a brief to the justices citing the majority's opinion.  

Despite Monday's ruling, the effects of H.B. 2 on abortion access in Texas may be long lasting. Half of the state's abortion clinics closed following the implementation of bill, and the Supreme Court's decision in Whole Woman's Health v. Hellerstedt will not reopen them. The remaining 19 clinics serve more than 5 million women of childbearing age. 

Hagstrom Miller called the possibility of reopening those clinics a "daunting task," citing the challenges of renewing leases, hiring staff, applying for licenses and raising funds to purchase equipment and medicine.  

"Today’s decision marks a turnaround for Texas and for our country, but let me be clear: this win doesn’t mean the struggle is over," she said. 

This story has been updated throughout. 

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