Transcripts For CSPAN Key Capitol Hill Hearings 20160628

Get abortions here in texas. Now we must redouble our efforts across the country to end similar restrictions across the state that push abortion out of reach for so many women. It is time to pass proactive state laws so that a woman has access to quality clinics in her community, can afford abortion, and does not face shame or stigma when she six hour care seeks our care. From day one, whole Womens Health rejected hb2 and we fought back. We took on the politicians and we struggled everyday since then against antichoice, progressive politics in our oppositions best effort to shut us down and we won. [cheering] today we make history and tomorrow we get back to work so that every woman who seeks Abortion Services can get the health care she deserves with the dignity and respect that we all deserve. [cheering] [indiscernible] we would all like to be able to contribute to restore access throughout the state of texas. It is a complicated process. Most of us have had to let our leases go and buildings go. Staff have found other jobs. We have to get relicensed governor forced to surrender our license. I think this rebuilding process is but we will undertake it will be very complicated. It will not happen right away. This is one of the reasons it is important for us to fight laws like this in the first place. When we had 44 clinics in the state, they were there to serve in the communities that needed them. Now have to rebuild the infrastructure across the state. Were you surprised by the decision . The decision was powerful. It was a boom. It was delightful. The decision was a complete and total vindication of the plaintiffs claims and we are not surprised. The trial record was strong, the facts are there, it is clear that the law was passed with the intent to shut down clinics. It had the devastating effect and we are very pleased that the Supreme Court could see through what was happening and may clear. This will make a difference. There are cases and cases across the nation in which we have been attacking these kind of underhanded laws and todays victory will make a huge difference and be able to push this. We hope the politician who have been passing these underhanded laws will start to do the responsible thing and let women have their health and rights. [cheering] [indiscernible] there was some gasping. Some handholding. There was a little bit of head and hand and a lot of smiling. [indiscernible] i think that the 53 decision is that the majority of the court agreed with the District Court and the clear evidence that you cannot use sham justifications to take womens rights away in the facts are so clear. Justice breyer went through them in summarizing his opinion and we are just delighted. Thank you. Thank you. [cheering] today, babies lost and their mothers lost. Texas try to exercise their authority to protect women but the Supreme Court sided with abortion. We came here today as members of the Prolife Movement say we will not give up. If anything, we are more resolute. This next election is about between 14 Supreme Court justices, hundreds of Lower Court Justices and 5000 appointees to our government. We at the prolife Community Must vote. This is a call to action. We will not give up. We will continue to stand resolute, stand with our members. We will be voting in november and working to elect a prolife president. Hillary clintons position on abortion is that it should be legal at any point in pregnancy and should be paid for by the tax payer. She is in lockstep with planned parenthood. She recently spoke to them. Others parenthood and profited today, but women lost. As an organization, i cannot endorse a candidate. Let me just say that as an individual clearly there are , only two candidates to vote for and ive already spoken Hillary Clintons edition. She is poor left believing abortion should be legal for any reason at any point in pregnancy. Paid for by the taxpayer. Donald trump has told us he is prolife. I would urge prolife americans to vote prolife up and down the ticket. Thank you so much. Im kristan hawkins, the president for students for life of america. We are the nations largest prolife Youth Organization and we were out here camping out. Reserving our space, organizing this rally here today. Today, women lost. Today the Supreme Court put politics over the health and safety of women in the country. They told our state that they dont have the right to protect half of their citizens. The abortion industry of planned parenthood knows who profit off the despair of women, the betrayal of women. They want today. Won today. These are common sense requirements. Half of americans agree with this. The majority of millennials agree with what was passed with texas laws. These are lost the require laws that require the hallways be wide enough for him. Soapre certain number of dispenser. These are common sense laws. What a woman goes in for a colonoscopy or liposuction, they have to have these regulations in place. Today the Supreme Court said were going to put access for abortions over the lives of women. He was operating a legal Abortion Facility in the state of pennsylvania for more than four decades. Doctors in pennsylvania stopped referring their patients to him because after their abortions, they were coming back with diseases because the surgery implement he was using. Doctors had asked the state Health Department to investigate his Abortion Facility, but no one would. Because they were afraid. They were afraid because it was an Abortion Facility. What happened . A woman died. She died. They got to the facility too late. They cannot get her out of the hallway and time. She died at the facility. Every time a woman goes into an Abortion Facility, she will wonder if she comes out alive. Now Supreme Court oral argument in whole Womens Health hellerstedt. Firstchallenging a texas law that limited abortion access. The law required dr. Supporting abortions performing the abortions have been missing ambitious. This is 90 minutes. Argument this morning in case 15274. Made please the court, the texas requirement undermines the careful balance between state regiment interest by regular teen abortion and fundamental liberty to make personal decisions about their pregnancies. They are Unnecessary Health regulations that create substantial obstacles to abortion access. There is a preliminary question, if you could address that talk of this claim was precluded. Claim thatfirst the , looked assumer they are separate claims. Admitting privileges. That was argued and decided. Why isnt it precluded . Youre on a calmer your honor, it is not precluded because it developed subsequent entry of judgment. You could have asked for supplemental briefing . The new action was filed six days after the Supreme Court issued its decision in this case. You could have asked for supplemental briefing. The point is brought the new fax to the attention of the court of appeals said they would only consider evidence in the trial record in entering and help the decision the evidence of the try was speculative. There was not sufficient basis. Any clinic would be forced closed as a result of the admitting privileges requirement. You made allegations concerning the same claims. Is your argument that we have allegations on a facial challenge and facial challenges result against you and all you had to do was come up with new evidence and start over again . Materialidence must be and it must be newly developed. Newly discovered evidence would not be sufficient. Evidence available at the time of the first feet of the plaintiff merely had not discovered the evidence or did not bring it forward. That would not provide the basis for a subsequent suit. Evidence that developed after suit is in the first material to the claims does provide sufficient basis. What is key . The evidence is the clinic closures that resulted from enforcement, actual enforcement of the admitting privileges requirement. The first suit was a preenforcement challenge. It was before the law took effect. The court concluded that there is not sufficient evidence that any doctor would be unable to obtain admitting privileges or that any clinic very little specific evidence in the record of this case with respect to why any particular clinic closed. Basically, your argument is that the law took effect and after that point, it decreased. The number of clinics. Suppose you win and the state examines what happened in each of these clinics and comes up with evidence showing that in quite a few instances, the closure was due to other factors and could they take the decision the position that the decision of this Court Holding that law as unconstitutional is not binding on us . You would have to sue them again and make the same argument, is that correct . No, your honor. The difference . First of all, the state had the opportunity to bring forward evidence. Was that their burden . No, your honor. The plaintiff came forward with evidence and the seat did not offer anything to do for the to rebut the audience evidence. The decision to support the District Courts finding that it was the cause of the clinic closure. What evidence is that . There are couple of things. Prior to hb2, the number of clinics in the state remained fairly stable. In any given year, there may 2 clinic variant. Following the enactment, more than 20 clinics closed within a short period of time. What is the evidence in the record that the closures are related to the legislation . The timing is part of the evidence, your honor. The testimony of the plaintiffs about the reasons why the clinics closed. The plaintiff testified that clinics closed in anticipation of enforcement and in some cases because of actual enforcement of the requirement. Can we go on to the second piece about the ambulatory Surgical Center . That was not part of the last case and your position is that that is a discrete claim. Is that your position . That is correct. The claims against the afc requirement were not right at the time that the case was filed. The final implement in regulation to the statutory requirement had not been adopted. Certainly in the federal system and i assume in many states as well, regulation sometimes take years. I dont know of any rule that says we have to wait for regulations to be promulgated unless theres something anticipated. And the key objections you are making were clearing the statute anyway. I would disagree that the extent of the burden of the loft law would impose is clear on the base of the statute. Until those implement and regulations were adopted, the statute provided a deadline for the adoption of those regulations. Until they were adopted, the plaintiffs could not have known whether waivers or grandfathering would have been permitted. If they were permitted as they have been in every other asc requirement that has been adopted for abortion providers, the burdens would have been much less. The plaintiffs would have first andmpted to get license have seekeat appropriate waivers before filing the suit. You think you can separately challenge the admitting privilege and that asc provision . Yes, your honor. If you can simply challenge them, if you challenge just the admitting privileges provision, how would you factor in, presumably you would have to assume the asc provision is not count. In assessing the burning, he would look at just the admission privilege and vice versa, if you are challenging just the asc separately, you would have to assume you would assess the the burden solely caused by that provion. If used to me that the separation of the two provisions would make your case much harder. I would disagree. Each of these requirements is externally burdensome on their own. The admitting privileges requirement which is partially in effect has been responsible of the closure of nearly half of all abortion facilities in texas to date. Theasc requirement , respondents have stipulated that it would close any remaining licensed abortion facilities that was able to comply with the admitting privileges requirement. Independently each requirement , is burdensome. Collectively, the onetwo punch of the requirements would be responsible for the closure of nearly 30 i think what he asked, i think the question was, one of the two lines asked, in the district opinion on page seven, the District Court has said that if the asc regulation goes into effect, there would be one the silly left in austin, two in dallas and other what are two in san antonio. Before that, said the enforcement of the appointment admission would 40 downhe number from to about 20. I think the question was, what evidence did those bindings rest upon . As you have heard the other side, i think they have said there is none such evidence. The court of appeal said there is no such evidence. Can you give a brief account or page numbers that will show those bindings . The diminishment of the number from about 40 to about eight witches with the District Court found rested upon evidence. What was that evidence . Yes, your honor. Initially, 20 clinics closed in the wake of hb2. Eight closed prior to initial enforcement of the admitting privileges and 11 closed on the day the admitting privileges requirement took effect. Respondents quibble with the evidence concerning the first eight. There is basis in the record for the District Court to confer infer. Where the record is that evidence . In the plaintiff testimony about reasons why the clinics closed. Each of the plaintiffs testified that the clinics closed in anticipation of enforcement knowing that the clinic would not be able to continue operating when the requirements took affect and as a result, they needed to move resources to remain clinics to ensure that some clinics would continue to operate. Could you give us any record references later . Or on the rebuttal . Yes. How many of the total that closed do you have direct evidence about the reason for the closure . 11 of them closed on the day these admitting privileges took effect. How many are you claiming total closed . As a result. Today, roughly 20 clinics. How many do you have direct evidence . Approximately 12. Direct evidence. If you go through this, we are not talking about a huge number of facilities, i dont understand why you cannot have put evidence about these particular clinic to show why the clinic closed and as to some of them, there is information that they closed for reasons that have nothing to do with this law. Maybe when you take out all of those, there would still be a substantial number and enough to make your case. I dont understand why you did not put direct evidence. I can give you examples. Planned Parenthood Center for choice, is that when you are talking about . Yes, your honor. There is a news report that this was closed as result of the 2011 texas Womens Health program bill which cut funding for Family Planning services. Not the law we are talking about here. That evidence is not the record. I understand that. You put quite a bit of evidence not in the record on the brief. My point is why is there not direct evidence about that particular clinic . You said you had wrecked direct evidence for 12 clinics. Us could supply witness with those later. Yes, absolutely. It is important to keep in mind. Could make sure i understand. You said 11 were closed when the admitting privileges took effect. Correct. And the two week requirement that over a dozen facilities shut the doors. And when that was lifted, they reopened again immediately, is that right . That is correct. It was like a perfect controlled instrument. Experiment. Affect, 1200aw to you take the law out of affect, they reopen. That is correct. That is what the state stipulated. The stipulation is direct evidence of the impact of the asc requirement. The state, i think, is going to talk about the capacity of the remaining clinics. Would it be a proper and be helpful for this court to ask for further findings . I dont think that is necessary. I think there is sufficient evidence in the record that we have support the District Courts findings that the remaining clinics wch would number fewer than 10 not have capacity. There have been some changes none of the clinic, adjective they use in san antonio, suppose there was evidence that there was capacity and the capability to build this kind of clinics. Would that be of importance . Then it which show this law has an effect. There were any doubts, three manned with provide the opportunity to supplement the evidence on record. The evidence on record shows that it supports the District Courts findings that because of the asc requirements, the cause of it are so prohibitive that it will deter new clinics from opening. The number of ambulatory Surgical Centers performing abortions has increased by 50 since the law went into effect. Effect,aw has taken three new ascs have opened and theres evidence about that at the trial in the trial court and that would happen. They put that into account. But nevertheless, there was substantial evidence including texass experience in 2003 following the asc law for later abortions, post 16 week abortions showing showing that the margin of her adjusted and the rate at which those procedures occurred in texas was drastically diminished. One quick question about capacity, i dont want to take your rebuttal time, but your cocanceled cocounsel is also litigating a case like this in louisiana. In that case the plaintiffs were , able to put in evidence of the exact number of abortions were performed in all the facilities. What could that not have been done here . Theres evidence in the record about the number of abortions performed on an annual basis, the geographic distribution of those abortions. Statisticscts those and they are part of the record in this case. We have absorbed so much of your time with the threshold question. He could have some time to address the marriage. But you take an extra five minutes. Thank you, mr. Chief justice. Fundamentally, these laws impose heavy burdens on abortion axis that are not medically justified and for that reason they impose an undue burden. Do you think there is a rational basis for the law based on the benefits that the legislature sought . Saw . I do not. We did not preserve our rational basis claim. The District Court denied the claim. We have not preserved it here. Here we are focusing on the undue burden. We would not concede that the law has a rational basis because in fact it undermines. We have to assume it does because you are not raising the challenge. Because the law undermines the state interest rather than advancing it by causing an increase in later abortions and selfinduced abortions, we would not concede that it is rationally related to the state s interest in health. Even if the test is undue burden. That is correct, your honor. In order to determine whether a law imposes an undue burden, we must first consider the magnitude of the burden it imposes and compare the burden for what the law is intended to achieve. How is this logical . The question is whether there is undue burden or substantial obstacle. What difference does it make what the purpose of the law is in assessing whether the burden is substantial or undue . Theeems once you get past assumption that the law has a rational basis, then you look at the burden or obstacle. The purpose that the law is directed to does not make a difference. It is either a potential obstacle or undue burden or does not. In order to determine whether a burden is undue, we have to consider what the burden is in relation to. In casey for example, in upholding the of forms and consent requirement, the state interest being served by the requirement and in that case the state interest in potential life and concluded that the requirements are designed to serve that purpose by making the abortion decision or informed. I thought it went to whether it was undue to the womans right to exercise the right to an abortion. Not with respect to the state interest. Well, your honor, it is both. Casey sought to balance with the state interest in regulating abortion at the womans fundamental right with her liberty to access the procedure and it concluded that the state could not impose unwarranted burden. Read the state had a good reason to impose a restriction and that restriction did not impose burdens that were undue, then the restriction could stand. But where a restriction is unreasonable or in the language of casey, medically unnecessary, and its going to impose burdens on access to then that restriction cannot be sustained under the fourteenth amendment. Justice sotomayor can i walk through the burden a moment . Theres two types of early abortion at at play here. The medical abortion, that doesnt involve any hospital procedure. A doctor prescribes two pills, and the women take the pills at home, correct . Ms. Toti under texas law, she must take them at the facility, but that is otherwise correct. Justice sotomayor im sorry. What . She has to come back two separate days to take them . Ms. Toti thats correct, yes. Justice sotomayor all right. So now, from when she could take it at home, its now she has to travel 200 miles or pay for a hotel to get those two days of treatment . Ms. Toti thats correct, your honor. Justice sotomayor all right. Let me ask you something about that twoday wait, okay, or or that travel time. How many other states and how many other recognized medical people have testified or shown that there is any benefit from taking pills at the facility as opposed to taking the pills at home, as was the case . Ms. Toti there is theres absolutely no testimony in in the record and and no evidence, you know, in in any of the amicus briefs that there is a medical benefit to having a medication abortion at a multimilliondollar surgical facility. The American Medical Association and every other mainstream leading medical association to consider these requirements has concluded that they are not medically justified for a variety of reasons, including that they impose these onerous burdens on medical abortion, which is the earliest form of abortion, and that these burdens are also imposed on early surgical abortion, procedures prior to 16 weeks. And as a result, women are going to be delayed later in pregnancy. And there is evidence in the record that following implementation of the admittingprivileges requirement, in the sixmonth period following, there was an increase in both the number and the proportion of abortions being performed in the second trimester. So by delaying womens access to abortion, these requirements are actually increasing the risks that women face. Justice sotomayor if the chief may permit me to finish my twopart question . Chief Justice Roberts sure. Justice sotomayor the second is the d c, the dilation and whats it called . Dilation and ms. Toti curettage. Justice sotomayor curettage. What is the risk factor for a d c related to abortion and a nonabortion d c . D cs are performed in offices for lots of other conditions besides abortion. Is there any evidence in the record that shows that there is any medical difference in the procedures that would necessitate an abortion being in d c or not, or are abortions more risky than the regular d c . Ms. Toti no, your honor. The evidence in the record shows that the procedures are virtually identical, particularly when d c is performed to complete a spontaneous miscarriage. So when a woman miscarries and then follows up with her doctor, the doctor will typically perform a d c. And thats virtually identical to an abortion, but its not subject to the the requirements of hb 2. Justice sotomayor so your point, im taking, is that the two main Health Reasons show that this law was targeted at abortion only . Ms. Toti thats absolutely correct. Yes, your honor. Justice sotomayor is there any conditions chief Justice Roberts thank you, counsel. Justice sotomayor im sorry. Is there any other medical condition by taking the pills that are required to be done in hospital, not as a prelude to a procedure in hospital, but an independent, you know i know there are cancer treatments by pills now. How many of those are required to be done in front of a doctor . Ms. Toti none, your honor. There there are are no other other outpatient procedures that are required by law to be performed in an asc. Chief Justice Roberts thank you, counsel. General verrilli. General verrilli mr. Chief justice, and may it please the court the effects of the texas law at issue in this case are much more extreme than those of any abortion law that this court has considered since casey. This law closes most abortion facilities in the state, puts extreme stress on the few facilities that remain open, and exponentially increases the obstacles confronting women who seek abortions in the state. And it does all of that on the basis of a medical justification that cannot withstand any meaningful scrutiny that the American Medical Association has told you is groundless, and that the District Court found will actually operate in practice to increase health risks to women and not decrease. Justice alito is this true of every provision of the of the asc law . General verrilli no, i dont think it is true about every provision in the regulations, Justice Alito. Justice alito not the Justice Alito not the regulations yes, in the regulations. General verrilli yes. Justice alito every single provision. Then why was the whole thing held to be unconstitutional . General verrilli so i agree with the premise of your honors question. There are some parts of the regulation that i think, operating alone, wouldnt have the substantial obstacle effect. In fact, some parts of the regulation actually restate and reauthorize regulations that were already on the books. And so i suppose one could say that with respect to that set of regulations, that the District Court could have severed them under the severability clause. One could say that. Of course, theyre already in the preexisting regulations Justice Alito but there are there are things that go that go i havent checked everything as compared the abortion the prior Abortion Clinic licensing law against the asc requirements, but there are some where theres an increase in whats required. It seems pretty reasonable. Under the under the the old the old law, there had to be a nurse, but not necessarily a registered nurse. Under the new law, there has to be a registered nurse who has a cpr certificate. So do you think thats unreasonable to say that there has to be a registered nurse who knows how to do cpr . General verrilli so i i dont want to state an opinion one way or the other about that. But i do want to what i but i think getting to the point of your honors question, i think the problem the District Court confronted here, and i think the reason the District Court acted reasonably, despite the presence of the severability clause and the severability clause provides an instruction that that every provision, every clause, every word, every application, every individual should be severed. And the problem is the problem with the kind that the court noted, i think, in the ayotte case, for a court trying to apply that, the courts got to go in and decide which collection of the many, many requirements there ought to stand and which shouldnt, and its its going to be invading Justice Alito well, its all general verrilli the states regulatory problems. Justice alito its work, but maybe the District Court should have done that work. I mean, i read through this, and i was surprised. I read through these regulations. I was surprised by how many are completely innocuous. And many of them have nothing to do they have to do with basic safety. They dont even have anything to do, in particular, with abortion. So the entrances to the clinic have to be at grade level. You have to have an elevator. The corridors have to be wide enough so that you could bring in a stretcher if somebody has to be taken to the hospital. And and things of that nature i dont know why things couldnt have been severed out, if there were some that were general verrilli i i think some could have been, if the court believes a remand is appropriate for the for the remedy to be more carefully tailored in the way that the court did in the ayotte case. We think that would be appropriate. But we do think that the basic point remains that this is a substantial obstacle. And i would like to address two points that arose during petitioners argument. First, closures, and then, capacity. With respect to closures, heres where i think the record will show you taking the asc requirement first. There is a stipulation, ja 183, that all all clinics that werent already closed as a result of the admittingprivilege requirement would would not be able to meet the asc requirements, and therefore would have to cease operations. Justice kagan noted they did cease operation during the period in which the law was in state. Theres evidence in the record with respect to the seven clinics that are operated by whole Womans Health that they that it was physically impossible to meet the asc construction requirements because it couldnt fit on the real estate footprint that they had. They couldnt meet them. Theres expert testimony in the record from dr. Layne farrar, the economist, that the cost of retrofitting these clinics to meet the requirements would be between 1. 6 million and 2. 3 million, which would be prohibitive. That the cost of building a new facility would be at least 3. 5 million which would be prohibitive. That the additional operating cost of an asc would be between 6. 3 and 6. 9 million a year more. So i think with respect to those, theres ample evidence. With respect to the with respect to the admitting privileges requirement, we know that of the clinics that closed between the date when the law was enacted and the Effective Date of the admittingprivileges requirement closed on the date that that requirement became effective. Seems to me the only reasonable inference you can draw with respect to those is that that law caused the closure. With respect to the others, i dont think theres evidence with respect to each one, but with respect to several, there is evidence that they closed in advance of the Effective Date, because they were otherwise going to have to pay a licensing fee to stay open for another year, which they knew they were not. And they knew they werent going to be able to stay open, and they didnt want to flush the money away. So i think theres ample evidence in the record with respect to causation. Now, with respect to capacity, i really think this is key, because i do think this is the locus of the substantial obstacle problem here. With respect to capacity, before this law took took effect, there were approximately to , 6570,000 abortions a year annually. The asc clinics that will be written able to remain open, will perform about 14,000 year. Thats what the record tells you. Its dr. Grossmans expert testimony. Its in the ja from pages 225 to 259. Justice kennedy about 20 . General verrilli 20 . So theyd have to increase four or fivefold in a very short period of time with the against the backdrop of having to meet the problems that the admittingprivileges requirement causes. Now, i understand that the fifth circuit said that was ipse dixit, but with all due respect, thats not binding on you and its just wrong. And if you look at the expert testimony at the ja pages i identified, youll see that what dr. Grossman said first was something that is just common sense, that these clinics arent going to be these facilities arent going to be able to increase by four or five times. And second, he didnt just rely on common sense. He looked at the period of time between when the admittingclosures requirement resulted in the closure of clinics. He looked at that period of time, and he studied the number of abortions that occurred at the remaining asc facilities during that period of time. And one would expect, given that half the facilities in the state closed, that there would be a substantial increase Justice Kennedy do you think the District Court would have had discretion the District Court having substantial equitable powers that Appellate Courts dont, to say were going to stay this requirement for twoandahalf, three years, to see if the capacity problem can be cured. Could a district judge do that . General verrilli you know, i i apologize, Justice Kennedy. I havent given that question thought, and im loathe to opine on that without having given it thought. But i do think Justice Kennedy i mean, district judges often think they can do anything. [laughter] general verrilli but but i do think, as i said, with respect to the capacity problem, the key thing here is that when, in addition to these asc clinics not providing more abortions once half the clinics in the state closed, you had and this is, again, in dr. Grossmans testimony significant increases in the overall number of abortions, particularly in the parts of the state that were far away from the major cities, the northern Justice Alito there is no evidence theres no evidence of the actual capacity of these clinics. And why was that not put in . Particularly since, if we look at the louisiana case, we can see that its very possible to put it in. And some of the some of the numbers there are quite quite amazing. There is one dr. There, performed three dozen abortions in a year. So we dont really know what the capacity of these of these asc clinics general verrilli well, i think i think you have expert testimony in that regard. Justice alito yeah. But what is it based on . Its based you know, he its not based on any hard any hard statistics. General verrilli well, it is. Its common sense that you cant Justice Alito well, common sense general verrilli but beyond that, as i said, Justice Alito, they studied the period of time in which half the clinics in the state were closed. And you would expect that those clinics that the additional ascs can handle the the capacity, they would have, and they didnt. Justice alito he said that that the number of the percentage of abortions at the ascs went down by 4. 4 , and there was an increased demand for abortion. But theres no statistic showing that there actually was an increased demand for abortion in texas. Justice breyer i thought that the grossman affidavit, which i have i grant you, its going on the briefs but it said at table affidavit page 9, table two, says that the number of abortions that are, on average, performed annually at the remaining clinics is 2,000. So lets multiply by two, and you get 16. Lets multiply by three, you get 24. There were 70,000, approximately, women who needed these procedures. So i had taken that. Is it that accurate . General verrilli yes. Justice breyer okay. General verrilli in in the short time i have remaining, id like to finish with one point, if i could. I think, ultimately, the question before you is whether the right here is going to retain real substance, and whether the balance whether the balance struck in casey still holds. If that right still does retain real substance, then this law cannot stand. The burdens it imposes, the obstacles, are far beyond anything that this court has countenanced. And the justification for it is far weaker than anything that this court has countenanced. It is an undue burden. It is the definition of an undue burden. And, mr. Chief justice, you in response to your question, undue means excessive or unwarranted. Could be excessive or unwarranted as compared to the the obstacle it imposes, certainly. But also, as compared to its need. Chief Justice Roberts i would have thought casey and gonzales also said substantial obstacle. And i would have thought thats something you could look at in an objective manner. Why and actually, i dont understand why youre arguing the opposite. I think whether its an obstacle or a burden would exist without regard to the strength of the state interest. The strength of the state interest, it would seem to me, is evaluated on whatever test there is with respect to that legislation, and then youd look at what the impact was. General verrilli well, i think its actually in the interest of government to look at it the way that were suggesting it ought to be looked at. And i if i you know, if could take two minutes to explain why. Chief Justice Roberts sure. General verrilli and i think, mr. Chief justice, that is because, you know, it is one thing to say that youre going to impose a requirement that does work as much as to be the kind of obstacle that this requirement that these requirements do, when you have justification thats frankly flimsy and the American Medical Association has told you was groundless. But if if the government were able to come in if it were us or if it were state were able to come in and say, well, actually, this requirement is going to make a difference in saving hundreds of lives, that might be a burden that you would think would be acceptable, given the medical benefit. Thats why we think the the test that makes sense, the best understanding of undue burden, the understanding of undue burden that works best for the government is the one were suggesting. But i think whichever way you look at that, whether you look at it our way or whether you look at it as two separate inquiries, this law, hb 2, cant pass it, for the reasons i said. And i think, therefore, that if you do find that this law is upheld, what you will be saying is that this right really only exists in theory and not in fact, going forward, and that the commitments that this court made in casey will not have been kept. Thank you. Chief Justice Roberts thank you, counsel. Mr. Keller. Mr. Keller thank you, mr. Chief justice. Chief Justice Roberts i suppose i should before you get started, well afford you an additional eight minutes. I think thats roughly fair. Mr. Keller an extra thank you, mr. Chief justice, and may it please the court. Res judicata bars the facial challenges. In any event, texas acted to improve abortion safety, and planned parenthood provides this increased standard of care and has opened new ascs. Abortion is legal and accessible in texas. All the texas metropolitan areas that have Abortion Clinics today will have open clinics if the court affirms, and that includes the six most populous areas of texas. Justice ginsburg well, how many women are located over 100 miles from the nearest clinic . Mr. Keller Justice Ginsburg, ja 242 provides that 25 of texas women of reproductive age are not within miles of an asc. But that would not include mcallen that got asapplied relief, and it would not include el paso, where the santa teresa, new mexico facility is. Justice ginsburg thats odd that you point to the new mexico facility. New mexico doesnt have any surgical asc requirement, and it doesnt have any admitting requirement. So if your argument is right, then new mexico is not an available way out for texas because texas says to protect our women, we need these things. But send them off to mexico new mexico new mexico where they dont get it either, no admitting privileges, no asc. And thats perfectly all right. Well, if thats all right for the the women in the el paso area, why isnt it right for the rest of the women in texas . Mr. Keller the policy set by texas is that the standard of care for Abortion Clinics should rise to the level of ascs for clinics, and admitting privileges for doctors. Texas obviously cant tell new mexico how to regulate, but the substantial obstacle inquiry examines whether there is the ability to make the ultimate decision or elect the procedure. And when there is Justice Ginsburg then why should it count those clinics . Mr. Keller well, here, the evidence in the record showed that this particular clinic was mile across the border that was still in the el paso metroplex, and women in el paso often used that facility to obtain abortions. So that would go into the contextual analysis of this particular asapplied challenge. This doesnt go to the facial challenge, but the asapplied challenge and whether women in el paso do have access to abortion. In any event, over 90 of texas women of reproductive age live within miles of an open clinic as of today. Within 150 miles of an open clinic as of today. Justice kagan mr. Keller, the the statistics that i gleaned from the record without 900,000 women lived more than 300 miles. Three quarters of a million further than 200 miles. That is compared to just in 2012, where fewer than 100,000 lived over 150 miles, and only 10,000 lived more than 200 miles away. So we are going from like, 10,000, two three quarters of a million living more than 100 miles away. Mr. Keller well, Justice Kagan, first of all, i believe the statistics that ja 242, which is their expert testimony, would not account for mcallen or el paso, but in looking at the fraction of women affected. And that would be the facial challenge standard, that at a minimum, a large fraction of cases, there would have to be invalidity even if there was an undue burden. The travel distance of even in casey, the District Court found over 40 of pennsylvania women were going to have to travel at least one hour, sometimes over three hours, and there was a 24hour waiting period. Texas reduces that waiting period to two hours for traveling over miles. And in casey, that was not a facial substantial obstacle. Here, that relevant fraction is is lower. Under casey, the facial challenge would not succeed. And petitioners have a heavy burden, and they havent shown any capacity evidence Justice Sotomayor when theres a need. Meaning, where are you taking an account in the undue burden analysis the value of the need being of being imposed . Meaning, even if i grant you that in some circumstances, travel time is necessary, because you cant get any kind of Abortion Clinic to go into a particular area, so you might have to impose a burden that might be undue in other circumstances. Where do we evaluate the benefit of this burden . What whats the need . You seem your brief seemed to be telling us that theres no role for the court to judge whether theres really a Health Benefit to what youre doing. Mr. Keller well, there would be three elements of the doctrine. Theres the rational basis test Justice Sotomayor im not talking about the doctrine. Im talking about the question i asked, which is, according to you, the slightest Health Improvement is enough to impose on hundreds of thousands of women, even assuming i accept your argument, which i dont necessarily, because its being challenged, but the slightest benefit is enough to burden the lives of a million women. Thats your point . Mr. Keller and what casey said is the substantial obstacle test examines access to abortion. Now, if a law had no Health Benefits, presumably it would be irrational. But even their expert and this is that ja 256 and 258, acknowledged that some doctors do believe that there are benefits for the asc and admitting privileges requirement Justice Ginsburg what what is the benefit of the medical, the two pills that you take, what is the benefit of having an ambulatory Surgical Center to take two pills when theres no surgical procedure at all involved . Mr. Keller two responses, Justice Ginsburg. First, the complication rates are greater. When theres a complication rate from a druginduced abortion, then a surgical abortion is needed as a followup. Justice ginsburg on that complication, that complication is likely to arise near the womens home, much more likely to arise near her home, which the miles has nothing to do with. Mr. Keller well, first of all, the two travel distances, that was about the drug protocol. Thats a different part of the bill. That was in the petitioners first lawsuit, and they have not raised any challenge to that in this lawsuit. In any event Justice Ginsburg im not talking about the prior lawsuit. Im talking about this lawsuit. You need to have access to a hospital within 30 miles. 30 miles of what . 30 miles of the Surgical Center when the woman lives at a much greater distance . And if shes going to go to any hospital, it will be in her local community, not near the Surgical Center. Mr. Keller of course, most abortions are surgical abortions in the state. Justice ginsburg well, im asking just about the medical. Mr. Keller thats right. Justice ginsburg and and just i cant imagine. What is the benefit of having a woman take those pills in an ambulatory Surgical Center when there is no surgery involved . Mr. Keller well, there would be surgery in a complication. And all Abortion Clinics in texas perform surgical abortions, and thats why petitioners probably didnt defend that aspect of the judgment. Justice ginsburg if it is a complication, it is not going to occur on the spot. I mean, you have to concede that in the case of the medical abortion, the complication generally arises after the woman is back at home. And then the nearest hospital has nothing to do with the Surgical Center. Mr. Keller although when the significant majority of women are living within miles of the clinic, in most situations they are going to be in the facility. And it is beneficial to have continuity of care, to check for clinical competence, to prevent miscommunication and patient abandonment to have the admitting privileges requirement. In any event, the facial challenge is certainly barred by res judicata. Justice kennedy before you get is it is the underlying premise of of your argument, mr. Keller, and of the states position, that the thrust, the impetus, the effect of this law is to increase surgical abortions as distinct from medical abortions, and that that is within the states authority to do . Because my reading indicated that medical abortions are up nationwide but down significantly in texas. Mr. Keller it would certainly be permissible to regulate both surgical and druginduced abortions, and in druginduced abortions, since there are greater complications. In the first lawsuit, fifth circuit noted expert testimony. That was a 6 rate, which Justice Kennedy but i thought an underlying theme, or at least an underlying factual demonstration, is that this law has really increased the number of surgical procedures as opposed to medical procedures, and that this may not be medically wise. Mr. Keller yeah. Insofar as Justice Kennedy you might say that this is within the authority of the state to do, but mr. Keller given the higher Justice Kennedy and i want to know what your position is on that. Mr. Keller and Justice Kennedy, given the greater complication rates from druginduced abortions, the legislature would be permitted to act in that way. In any event, petitioners have not challenged that particular part of the District Courts holding that gave them asapplied relief on the druginduced abortion part. In the fifth circuit, they havent raised that. What theyre trying to do on the effects prong is say that the remaining clinics will lack capacity. But the fifth circuit correctly noted that there is no capacity evidence in the record. They didnt even try to take discovery from the nonpetitioner clinics. And indeed, grossmans ipse dixit was in fact ipse dixit. What he did is he looked at the number of abortions and percentages that were being performed. And a year earlier, ascs had actually performed more abortions, and so the inference that they were at capacity cannot be drawn. Chief Justice Roberts what what evidence would you have put in on the capacity issue if you had been afforded that opportunity . Mr. Keller well chief Justice Roberts evidence that would rebut the statistically significant showing on the other side about capacity, and also the circumstantial evidence about the timing of the of the closures. Mr. Keller well, this is not in the record, but in petitioners first lawsuit this is exhibit k to their application to vacate the stay in this court in the first lawsuit, the abbott litigation, they went clinic by clinic in a chart excuse me and they tried to estimate the number of abortions that could be performed in those facilities. The District Court didnt even make a factfinding there. But the houston planned parenthood asc they estimated could perform 9000 abortions annually. 9000. That is 175 a week. Justice kennedy before before the act . Mr. Keller well, yes, yes, because the houston planned parenthood operates five of the nine ascs. Planned parenthood is is not in this lawsuit. They were in the first lawsuit. They have complied with the law. They have doctors with admitting privileges, and they have facilities in each of the five most populous texas cities. And so if one asc can perform 9000 abortions annually, and there are going to be at least eight other ascs in texas, plus the tenth facility, the mccallen facility, that obtained asapplied relief, it does not stretch credulity to believe that those remaining facilities would suffice to meet the demand for abortions. Justice breyer and you asked to put in this evidence, and then the court said no, we will not let you put in the evidence . Mr. Keller we didnt put in the evidence because petitioners bore the burden Justice Breyer i asked, did you ask to put in this evidence . Mr. Keller no. Justice breyer no. Thank you very much. Okay. Id like to go back to the the question that Justice Ginsburg was asking, which is about what is the benefit of this procedure. There are two laws. I am focusing on the first law. The first law says that a doctor at the Abortion Clinic must have admitting privileges in a hospital 30 miles nearby, right . Mr. Keller correct. Justice breyer okay. Prior to that law, the law was that the clinic had to have a working arrangement to transfer such a patient, correct . Im just reading it from this. Mr. Keller thats correct. Justice breyer okay. So i want to know, go back in time to the period before the new law was passed, where in the record will i find evidence of women who had complications, who could not get to a hospital, even though there was a working arrangement for admission, but now they could get to a hospital because the doctor himself has to have admitting privileges . Which were the women . On what page does it tell me their names, what the complications were, and why that happened . Mr. Keller Justice Breyer, that is not in the record. Justice breyer so, judge posner then seems to be correct where he says he could find in the entire nation, in his opinion, only one arguable example of such a thing, and hes not certain that even that one is correct. So what is the benefit to the woman of a procedure that is going to cure a problem of which there is not one single instance in the nation, though perhaps there is one, but not in texas. [laughter] mr. Keller Justice Breyer, the National Abortion federation previously recommended that women use abortion doctors Justice Breyer i didnt ask that. Im sure there are people who had all kinds of reasons that would like to have this and so forth. And im not im just asking you, where we have a judicial duty to say whether this is an undue burden upon the woman who wants the abortion, there are two parts. Is she burdened and what is the benefit . And now on the first one, ive asked you to give a single example of an instance where there was a benefit, and you say, i think quite honestly, there is no such burden. So lets turn to the second. The second one, according to the amicus briefs here, which i guess i could validate, that even without the Surgical Center, leave it out, there are risks quite correct. Those risks are roughly the same as the risks that you have in a Dentist Office when you have some surgery, where you dont have an ambulatory Surgical Center. There are times less than a risk of a colonoscopy, where you dont have ambulatory Surgical Center. There are like hundreds of times they are like hundreds of times less youve seen these briefs. Okay. So i read them, and you read them. And so what is the benefit here to giving, i mean, the woman, her risk, i cant say its zero here, this ambulatory Surgical Center when the risk is minuscule compared to common procedures that women run every day in other areas without ambulatory Surgical Centers . Mr. Keller that has never been the test under casey about substantial obstacle. And this court in simopoulos, even before casey upheld an asc requirement, and there virginia did not require that brain surgery be performed in a hospital or an asc. That is at 5043 of the simopoulos oral argument transcript. Its because in looking at the laws, its whether the legislature has a legitimate purpose in acting. Legislatures react Justice Sotomayor thats interesting. Justice kagan well, can the Legislature Say anything, general . I mean, if the Legislature Says we have a a healthrelated abortion regulation here, weve looked around the country and we think that there are ten great hospitals in the country, you know. Massachusetts general, brigham and womens, and were going to make all our abortion facilities conform to the standards of those hospitals, and that will, you know, that will increase medical care. True, we dont make anybody else doing any kind of other procedure conform to those standards, but we think it will increase Health Benefits if abortion facilities conform to them. Would that be all right . Mr. Keller under this courts precedent, abortion can be treated differently. Thats simopoulos. Thats mazurek. Justice sotomayor well, wait a minute Justice Kagan so every Abortion Facility has to hit the standards of mgh. That would be all right . Mr. Keller well, there would have to be medical evidence. It is at a minimum disputed. And here, their experts have conceded that doctors believe this this is precisely where theres a medical disagreement, even if you dont accept our medical testimony, although it was admitted into the record. Justice kagan im sure that theres medical evidence that if every hospital, if every facility was as good as massachusetts general, they would be better facilities. Im sure that you could find doctors to say that, because mgh, its a great hospital. But that would be okay, even though its not applied to any other kind of facility doing any other kind of procedure, even though we know that liposuction is 30 times more dangerous, yet doesnt have the same kinds of requirements. Mr. Keller and that was the holding in simopoulos. And in mazurek, the court Justice Sotomayor well, do you think would you put Justice Alito would it not be the case that would it not be the case that a state could increase the the standard of care as high as it once, so long as there is not an undue burden on the women seeking abortion . So, you know, if they could if they could increase the standard of care up to the very highest anywhere in the country and it would not be a burden on the women, that would be a benefit to them. Would there be anything unconstitutional about that . Mr. Keller no. Provided that women do are able to make the ultimate decision to elect the procedure. Justice kennedy but doesnt that show that the undue burden test is weighed against what the states interest is . I mean, are they are they are these two completely discrete analytical categories, undue burden, and we dont look at the states interest . Mr. Keller what casey noted was that the undueburden test is, is there a purpose or an effect of the substantial obstacle to access . And thats a question about access. As to whether what the states interest would be, that would be going to a rational basis review or maybe a purposebased analysis. But you need the clearest proof under the courts general doctrine about unconstitutional purpose. To infer that there is an unconstitutional purpose when there is a legitimate interest in promoting patient health, which is what texas did here and even roe v. Wade said that states can ensure maximum safety for patients. Justice ginsburg but what is the legitimate interest in protecting their health . What evidence is there that under the prior law, the prior law was not sufficiently protective of the Womens Health . As i understand it, this is one of the lowest risk procedures, and you give a horrible from pennsylvania, but absolutely nothing from texas. As far as we know, this is among the most safe, the least risk procedures, an early stage abortion. So what was the problem that the legislature was responding to that it needed to improve the facilities for Womens Health . Mr. Keller in petitioners first lawsuit, planned parenthood admitted that over women annually are hospitalized because of abortion complications. Here at Justice Ginsburg as compared to childbirth, many, many much riskier procedure, is it not . Mr. Keller well, the American Center for law and justice and former abortion providers amicus brief dispute that. But regardless, there is evidence Justice Ginsburg is there really any dispute that childbirth [laughter] is a much riskier procedure than an early stage abortion . Mr. Keller Justice Ginsburg, those amicus briefs point out what when you look at record linkage statistic, instead of complication reporting, there may be a difference. And the reason why reporting is important is theres evidence in the record here that abortion complications are underreported. Thats at ja 844, and a 70872. In fact, petitioner Justice Sotomayor by hospitals . Underreported, most of the complications youre talking about were reported at hospitals, correct . Yes, there is some evidence of not reporting other things outside the hospital, but you know the number of hospitals are accurately reporting. Mr. Keller well, Abortion Clinics are have to report complications in texas. And petitioner whole Womans Health Justice Sotomayor complications within their clinic . Mr. Keller thats right. And in ja , petitioner whole Womans Health Justice Sotomayor whats the percentage of my math is pretty horrible. Its pretty small. Mr. Keller in the statistic at ja is it is lower than 1 . However, when there are two to three women Justice Sotomayor i dont mean to to negate that one should try to avoid injury to anyone, and and dont take my question as that, but there are people who die from complications from aspirin. It may be unusual, but theres a certain percentage that do that. Yet, we dont require that people take aspirins in asc centers or in hospitals. Mr. Keller but in examining Justice Sotomayor there has to be some tie between the benefit and the burden, doesnt there . Mr. Keller in examining not effect, but the purpose. The constitutional analysis would be did the Texas Legislature have an invalid purpose . And if Justice Sotomayor well, dont you think that you can read that from the fact that there are so many other medical treatments whose complication rates are so disproportionately higher, and the legislature is only targeting abortion when there is nothing about the figures before it that show a risk so unusual that it needs greater attention . Mr. Keller but that would have been simopoulos, it would have been mazurek. And this is why petitioners are trying to upset the balance that was struck in casey. Justice breyer i dont see where this fits in, i mean, to the argument. I dont question their purpose. I wont question their purpose. Mr. Keller good. Thank you, Justice Breyer. [laughter] Justice Breyer but the the what their purpose is, that theyre worried about these complications and they want to make life safer for the women. All right . Lets take that as the purpose. You said there arent very many complications. Now, would you say if you reduce the number of clinics, as has been argued, maybe it isnt exactly that, but you suddenly have at least 10,000, maybe a few less, and maybe a few more, women who have to travel 150 miles to get their abortion, maybe more, maybe stay overnight, maybe try to scrape together the money, you understand the argument. Are there going to be more women or fewer women who die of complications due to an effort to create an abortion . I mean, you read the briefs, and youve read the same articles i have. And of course, the argument is if you lead to selfinduced abortion, you will find many more women dying. So if the concern is this tiny risk of dying through a complication in a clinic, is this a remedy that will in fact achieve the legislatures healthsaving purpose . Mr. Keller Justice Breyer, about selfinduced abortion, the evidence in the record on that were two points of testimony, both from mcallen where petitioners prevailed, asapplied challenges could be brought in areas for instance, if there could be shown a substantial obstacle based on travel distance, the four clinics that closed in west texas between el paso and san antonio, all those closed before the admitting privileges requirement took effect. They were all planned parenthood facilities. In petitioners Justice Ginsburg Keller Keller as applied challenge is a real problem with that. Because suppose you bring in that as applied challenge and youre successful. You cant have a creation of an ambulatory Surgical Center on the spot. I mean, these once, theyre closed, and they cant start up tomorrow. So how the asapplied challenge i mean, the womans problem would be long over before this clinic, the kind of clinic they had before, could be restarted. Mr. Keller Justice Ginsburg, the mcallen clinic reopened, and as Justice Kagan mentioned, clinics did reopen. The lubbock facility, though, which is one of the facilities in west texas, in petitioners first lawsuit they told this court in their application that that clinic was going to close regardless. And seven of the eight clinics that closed before the admitting privileges requirement to the vet, and went from 41 to 43, seven of those eight were planned parenthood clinics. Planned parenthood is complying with the law and providing that increased standard of care. And also, the eleven clinics that closed the day that the admitting privileges requirement took effect, when it went from 33 to 22, i dont believe six of those clinics can be deemed to have ceased performing abortions because of that requirement. The lubbock facility was going to close anyway. Killeen had admitting privileges. Justice ginsburg there was a stipulation there was a stipulation that is no currently licensed Abortion Facility meets the asc requirements. Each will be prohibited from performing abortions after the day the law goes into effect. Thats a stipulation, not a question of what evidence there was for. Texas stipulated that no currently licensed facility meets asc requirements, and each will be prohibited from performing abortions. Mr. Keller and that would go to the asc requirement as opposed to the facial challenge of the admitting privileges requirement. But four of the facilities that reopened four facilities reopened of those eleven when the admitting privileges requirement went into effect. That was dallas, two at ft. Worth, one in austin. That is ja 131, 715, and 1111, and 1436. Two of those were ascs. Now, when it comes to the count of ascs, there are nine ascs performing abortion today in texas. Three opened up after house bill was passed. House bill two was passed. So in examining the facial challenge to that requirement, when ascs exist Justice Sotomayor can i ask, where they opened as result of the law, or were they planned to be opened before the law went into effect . Because i think that makes a difference to me that they were planned to be opened. It takes quite a while to dig up the money, get the investors, buy the land, do the building. It seems to me that they must have been planned for a while. And if they were, it was because there was a need independent of the number of abortions. Mr. Keller well, Justice Sotomayor in other words, its fortuitous that theyve come into existence, but it was in their need was not there was independent of the reduced number of facilities elsewhere. Mr. Keller legislature provided months to come into compliance. In addition, you could lease space. Texas has over there are 433 general ascs in texas at the time of trial. Justice sotomayor most of them dont choose to provide abortions. Mr. Keller thats correct. Of course, space could be leased in those. Justice sotomayor so what you dont know is what do you have enough resources to open up an asc if youre going to do abortions . Are you going to get enough developers to to invest in your work . Mr. Keller yeah. The point being that there are going to be at least ten clinics Justice Sotomayor can i ask about mcallen . There was testimony in the record that at least four doctors had from that spot had asked for admitting privileges. Well, the fifth circuits remedy only provided for one doctor, dr. Lynn, whos past retirement age, to be the only doctor performing abortions in that clinic. Now, if the clinic had i dont know how many it had, but it had at least four people before it it seems rather callous to say as a remedy that were going to make that one doctor do the work of four, or maybe more doctors who didnt get admitting privileges. Why is even the fifth circuits remedy reasonable . Mr. Keller because, Justice Sotomayor, that was the only named plaintiff for the as applied Justice Sotomayor but that but yes, as applied, the asc law is affecting this clinic because it cant get its doctors certified. So why does it require a named plaintiff to relieve that clinic of the obligation of going without admitting privileges . Mr. Keller well, that wasnt the only one of the four doctors that joined this lawsuit, because most of the doctors and clinics in texas are not part of this lawsuit Justice Sotomayor but you just lift the requirement because you know that its the only clinic in the area. So if any doctor whos licensed appropriately can get admitting privileges, they should be permitted to work in that clinic. Why does dr. Lynn have to become an indentured slave to ensure that women in her area are provided with their fundamental right to choose . Mr. Keller Justice Sotomayor, it would not be an indentured situation. If there were new facts that came into being that the doctor Justice Sotomayor but she wants to mr. Keller didnt perform abortion, then another doctor could bring in a future as applied challenge Justice Sotomayor all right. Justice kagan general, could i go back to a question that something that you said earlier . And tell me if im misquoting you. You said that as the law is now, under your interpretation of it, texas is allowed to set much, much higher medical standards, whether it has to do with the personnel or procedures or the facilities themselves, higher medical standards, including much higher medical standards for abortion facilities than for facilities that do any other kind of medical work, even much more risky medical work. And you said that that was your understanding of the law; am i right . Mr. Keller correct, in this courts in simopoulos. Justice kagan and i guess i just want to know why would texas do that . [laughter] mr. Keller when there are complications from abortion thats in the record, texas can enact laws to promote safety. Justice kagan no, i know, but but the assumption of the question, and i think you havent challenged this assumption, is that there are many procedures that are much higher risk. Colonoscopies, liposuctions, we could go on and on. And and youre saying, thats okay, we get to set much Higher Standards for abortion. And i just want to know why that is. Mr. Keller Justice Kagan, this bill was passed in the wake of the Kermit Gosnell scandal that prompted texas and many other states to reexamine their abortion regulations. Justice kagan but, of course, the i mean, texass own regulations actually have made abortion facilities such that that can never happen, because you have continual inspections, i mean, to your credit. So that was really not a problem in texas, having a kind of rogue outfit there. Texas has taken actions to prevent that. So, again, i just sort of im left wondering, given this baseline of regulation that prevents rogue outfits of like that, why it is that texas would make this choice. And you say youre allowed to make this choice, and we can argue about that. I just want to know why texas would make it. Mr. Keller i think the amicus brief for 121 texas legislators that canvasses the medical evidence and canvasses statements confirms that that that there were complications that these laws do have benefits. And even the bill opponents said Justice Alito isnt it true Justice Kagan are you are you not really contesting that there are greater complications in abortion facilities than there are with a great deal of medical procedures, that are not subject to the same standard of regulation. Mr. Keller yeah, brain surgery, for instance, just like simopoulos, would almost certainly have it it would have higher risk of complication. But the point is Justice Alito general, as to as to rogue facilities, which Justice Kagan just mentioned, one of the amicus briefs cites instance after instance where whole womans facilities have been cited for really appalling violations when they were inspected. Holes in the floor where where rats could come in, the lack of any equipment to adequately sterilize instruments. Is that not the case . Mr. Keller stories similar to that are also raised in the 121 texas legislators amicus briefs. Justice alito these are not stories chief Justice Roberts Justice Alito. Justice alito these are, as i understand it, actual reports of of inspections of those facilities. Mr. Keller the amicus briefs do discuss that, and the complications from whole Womans Health were underreported to the state. Justice ginsburg random texas, under the prior law, has the right to make random inspections. Was the problem in pennsylvania was this filthy clinic hadnt been looked at by anyone from the state in years. But texas can go into any one of of these clinics and immediately spots a violation . It says you cant operate till you come up to speed. So texas has had, as Justice Kagan pointed out, its own mechanism for preventing that kind of thing from happening. Mr. Keller texas did have existing regulations, but increasing the standard of care is valid, particularly not only in light of Justice Sotomayor its valid only if its taking care of a real problem. Mr. Keller and there were the abortion complications and underreported Justice Sotomayor well, no, no, no. A real problem, meaning, gosnell, the governor of pennsylvania, said was a regulatory failure. And only in that, not this clinic had not been inspected for 15 years. He the doctor was fabricating his reports. That could happen almost in any setting. Anyone who intends to break the law is going to break the law, whatever the regulatory rules are. Youre going to have doctors, as happened pre our laws, who were performing abortions without permission in their offices or without licenses. And i dont want to suggest that we should presume thats going to happen, but it will happen. Mr. Keller the constitutional standard for whether a state can make abortion safer cant be that it can only prevent the gosnell situation, and there are complications. Justice sotomayor well, but yeah, but but you have to see, as Justice Breyer asked you earlier, why are the problems . Isnt this a selfcreated problem . What happened in texas independent of gosnell that raised the gosnelllike situation in texas that made legislature so concerned after so many years about taking care of this greater risk in abortions, as opposed to all the other procedures that are performed in nonasc facilities . Mr. Keller because there are complications in abortion sotomayor but theres complications in colonoscopies, and colonoscopies are, what, 15 times 28, Justice Breyer just corrected me. [laughter] Justice Sotomayor 28 higher. I mean mr. Keller but legislatures react to topics that are of public concern. The court noted after dr. Haskells procedure for partial birth abortion became more of a nationwide concern, states reacted. When the legislature sees that theres a problem, and maybe that there wouldnt rise to the same level of a gosnell problem, but the legislature can still act to make abortion safer, which is precisely what texas did here. If i can address my friends contention of the record as to what clinics closed preemptively. There is evidence in the record that killeen, mccallen and el paso, three clinics, closed preemptively. They brought asapplied challenges in mccallen and prevailed. They brought their asapplied challenge in el paso and did not prevail. And the killeen clinic did not seek asapplied relief. Indeed, if there are any future concerns, asapplied challenges can be raised. For instance, the wide swath of area in west texas that does not have an Abortion Clinic today, there was no asapplied relief sought in this case. And if there were if it would turn out that there were going to be an issue in that area, a future asapplied challenge could address that concern. Justice ginsburg well, thats the problem. Once a clinic closes you said mccallen reopened, but that was very swift. Once a clinic closes, equipment are gone, the doctors are gone, you cant reinstate it tomorrow. It wont be there. There will be no remedy for that woman who succeeds in the asapplied challenge. Mr. Keller mr. Chief justice, my time has expired, if may address it. Chief Justice Roberts sure. Mr. Keller except even there, the clinic was not just closed for a single day. It was closed for a longer period of time. And there was an el paso clinic that actually reopened also months later. So an as applied challenge could allow a clinic, if an undue burden, if a substantial obstacle were shown because of driving distances or capacity in the future, in that discrete instance, but were in this facial challenge posture, petitioners bear the heavy burden to show at least a large Justice Sotomayor why isnt selfevident in that area Justice Kennedy sonia is off. Justice sotomayor this area of western texas, its as big as california. No . Bigger . Mr. Keller im not sure about california, but it certainly is a large size. Justice sotomayor huge area. Mr. Keller absolutely. Justice sotomayor why isnt it selfevident if you have a law that says you can only be an asc provider, and whos going to come in and say, i cant be an asc provider, but its an undue burden on me, or its an undue burden thats selfevident on the women in that area . Mr. Keller well, the right is possessed by the women. The clinics and doctors can bring challenges. Justice sotomayor exactly. So why dont we take this lawsuit as those women saying just that . Mr. Keller because there was Justice Sotomayor you cant have a law that has marginal, if any, medical benefit be applied to this procedure anywhere where theres an undue burden on people on women. Mr. Keller planned parenthood had four clinics in west texas. They all closed before any part of hb2 was actually put into effect. They could have brought an asapplied challenge. They didnt. Planned parenthood did not join this lawsuit. They were part of the first lawsuit. And indeed, the facial challenges here are barred by res judicata and there are significant record gaps. Justice ginsburg may i ask you one question . You earlier in your argument, you were quoting how many women are within a reasonable range of the clinic. But dont we know from casey that the focus must be on the ones who are burdened and not the ones who arent burdened . There there is and the District Court said, you know, this is not a problem for women who have means to travel, that those women will have access to abortion, anyway. So in texas or out of texas. So casey was quite precise in this, when its talking about husbands and notification. You dont look to all the women who are getting abortions. You look only to the to the the women for whom this is a problem. And so the only women we would be looking at is not all of the women who are who live in austin or in dallas, but the women who have the problem, who dont live near a clinic. Isnt that the clear message of casey and the husband notification mr. Keller when a law is regulating women, as it would in the spousal notification provision, that might be different. But when were talking about doctor and clinic regulations, when the law is going to have a relevant effect, is going to be for every doctor and every clinic, which is precisely why the fifth circuit noted that that was the proper denominator, all women of texas reproductive age. And petitioners have not challenged that denominator holding in their opening brief. Justice ginsburg but this is about what its about is that a woman has a fundamental right to make this choice for herself. Thats what we sought as the starting premise. And then this is certainly about casey casey made that plain, that it the focus is on the woman, and it has to be on the segment of women who are affected. Mr. Keller yes. And and the right held by women to make that ultimate decision is not burdened in, at a minimum, a large fraction of cases in texas, when each metropolitan area will still have a clinic, even after the law goes into effect, and future asapplied challenges could address any possible concerns about west texas or otherwise. Chief Justice Roberts thank you, counsel. Mr. Keller thank you, mr. Chief justice. Chief Justice Roberts ms. Toti, you have five minutes remaining. Ms. Toti thank you. A few brief points. First, the record cites from earlier, evidence that hb two caused clinics to close in texas. The plaintiffs testified that hb two caused clinics in killeen, austin, beaumont, mcallen, and el paso to close, and that testimony is that ja 339, 715, 722, and 731. Respondents stipulated at ja and ja 183 and 184, that the asc requirement would cause any licensed Abortion Facility still operating on the day it took effect to close. Plaintiffs exhibit 28 at page two, which is not in the joint appendix but was admitted in the record at 2808 and 09, demonstrates that for the five years prior to the enactment of and finally, there is a testimony. Shows 11a response clinics closed on the day the admitting privileges required. The last evidence was from dr. Grossman . Yes. He said, i am not here offering any opinion on the cause of the decline in the number of abortion facilities. Is correct. Dr. Grossman did not offer an opinion, but his testimony supplies the fact from which of the District Court drew the inference that 11 clinics closed on that day. The District Court inferred from that fact that enforcement was the cause of the closure. There was no alternative explanation offered as to why they would be such a precipitous drop in the number of clinics. Would you tell me why planned parenthood left the west would area . Admitting privileges have nothing to do with the closures in the western area. Eo the two clinics in el pas that would be forced to close are not operated by planned parenthood. Planned parenthood does not have any clinics in texas. The plaintiff in this case, is another independent provider, which operates those clinics. The direct evidence show whether the cause was the admitting privileges requirement, or the acs requirement, or both . With respect, it does specify. Some specify the acs requirement and some specify both. Respect to whether abortion can be regulated differently than other medical procedures, abortion can certainly be treated differently if there is a reason to treat it differently. But it does not need to have unnecessary medical regulations that burden womens access to abortion. The court found that the regulations of second trimester procedures were consistent with prevailing medical standards at the time. That was critical to the courts decision. That is not the case here. There is extensive testimony that these requirements are not medically justified. They are not consistent with prevailing medical standards. There are briefs from leading medical institutions confirming that. You think that the Federal District judges, for this court, is wellqualified to determine whether there is a different risk with respect to abortion, as compared to other procedures that may or may not have to be required, may or may not have to be performed in an asc . Your honor, District Courts are quite competent to determine the credibility and reliability of expert testimony. That is some think that is within the courts competence of the trial court. In this case, the trial court determined there was no credible evidence backing up texas contentions. Texas truly believed that these laws provided some kind of important benefit for outpatient surgery, it would have made them generally applicable. All outpatient providers would have to have admitting messages, but that is not the case. Texas law expressly authorizes other surgical procedures, including those performed under general anesthesia, which early abortion is not, to be performed within the physicians office. And even other physicians that operate at an acs are not required to have admitting privileges. The facility merely must have a transfer agreement. These regulations target one of the safest procedures that a patient can have in an outpatient setting. Thank you council. The case is submitted. Coming up on cspan, british Prime Minister David Cameron taking questions on the u. K. Vote to leave the European Union. Then, the Supreme Court oral argument in which the court overturned the conviction of former virginia governor, robert mcdonald. After that, a discussion on the future of nato. Delivers a speech on trade and the economy tuesday in pennsylvania. We have that live at 2 30 eastern here on cspan. Cspans washington journal, live every day with news and policy issues that impact you. On tuesday court morning, National Journal correspondent sam baker talks about this most significant ruling on abortion and all must two in almost two decades. Also, the courts ruling and other key rulings this term. And henry olson, the author of the book the four phases of the republican party. Cspanso watch the washington journal, beginning live at 7 00 a. M. Eastern on tuesday morning. Join the discussion. British Prime Minister David Cameron told members at the house of commons that the decision for the u. K. To leave the European Union was not the best outcome for the country, but must be accepted. Following his remarks, he answered questions from members on the future of scotland, immigration, and new relations with the European Union member states. This is just over two hours. [inaudible conversation] order, statement of the Prime Minister. Here here. Thank you mr. Speaker. With permission i would like to make a statement on the results of the referendum. Last week saw one of the biggest mechanic exercises in our history with over 33 Million People from england, scotland, wales, Northern Ireland all having their say. We should be proud of our parliamentary democracy. It is right when we consider questions of this magnitude and we dont just leave it to politicians but rather listen directly to the people. That is why members from across this house voted for a referendum margin of almost 60 met one. When i talk about this house let me talk about the new member choosing to take her place. [laughter] and i thought i was having a bad day. What this means, that steps were taken immediately to stabilize the uk economy, the work on negotiation to leave the eu, our plans of involving both administrations and the next step toward the European Council it was the british peoples vote to leave the union. It was not the result i wanted or what i think was best for the country that i love but there is no doubt about the result. I dont take about back what i said about the respirator will be difficult. Weve seen there will be adjustments within our economy. Complex institutional issues and challenging new negotiations under take with europe. I am clear on the reason this morning morning that the decision must be accepted in the process of implementing the decision in the best possible way must now begin. At the same time mr. Spiegel we have a fundamental responsibility to bring our country together. In the past few days we have seen despicable graffiti on the polish community center. We have seen verbal abuse because they are members of ethnic minorities. These people have come here and made a wonderful contribution to our country. We will not stand for a crimes are these kind of attacks. They must be stamped out. Mr. Speaker, we can reassure citizens living here and brits living in European Countries that there will be no immediate changes in their circumstances. Neither will there be any initial change in the way our people can travel, the way our goods can move or the way our services can be sold. We negotiate that the European Council will be discarded in a new negotiation to leave the eu will begin under a new Prime Minister. Turning to our economy its clear that markets are volatile. Some companies are considering their investments and we know this will be far from easy. We should take confidence from the fact that we are ready to confront what the future holds for us from a position of strength. As a result of a longterm plan, we have one of the strongest major advanced economies in the world. We are well played to face the challenges ahead. We have stable inflation, the employment rate remains the highest its ever been. And its forecast bully below 3 this year. The Financial System is more resilient and was 66 years ago. With Capital Requirements for the largest banks, there are ten times higher than before the banking crisis. The markets may not have been expecting the referendum result but as the chance chancellor said this morning, the treasury and bank of england and other authorities have spent the last few months putting in place robust continuously plans. As the governor of the bank of england said, the Bank Stress Test has shown that the uk institutions have enough capital and liquidity reserves to withstand a scenario more sincere severe than the country currently faces. The banks can make it available 250 billion additional funds of it needs to support banks and market. In the coming days the treasury come the bank of england and the Financial Authority will continue to be in close contact. They have contingency plans in place to maintain financial ability and they will not hesitate to take further measures if required. Turning to preparations for our negotiations from the exit of eu the cabinet met this morning that will bring together officials and policy expertise from across the cabinet office, treasury, Foreign Office and business departments. Clearly this clearly this will be the most complex and most important task that the british Double Service has undertaken in decades. The new unit will set at the heart of government and be led and stopped by the best and brightest from across our civil service. It will report to the cabinet on delivering the outcome of the referendum, advising on transitional issues and exploring objective options from outside the eu. It will be responsible for ensuring the new Prime Minister has the best possible advice from the moment of their arrival. Mr. Speaker i know colleagues on all sides of the house will want to contribute to how we prepare and execute the new negotiation to leave the eu. The dutch of lancaster will listen to all comments and make sure they are put into this plan turning to the administration we must ensure that the interest of all parts of the United Kingdom are protected in advance. As we prepare for new negotiation with the eu, we willfully involve the scottish, welsh and Northern Ireland governments. We also consult gibraltar and the territories and Regional Centers including the lump london assembly. I spoke with scotland and wales as well as the first minister in Northern Ireland and our officials will be working together over the coming weeks to bring our administrations into the process for determining the decisions that need to be taken. While all the key decisions will have to await the new Prime Minister, there is a lot of work that can be started now. For instance the british and irish governments meet this week to work through the challenges relating to the common border area. Mr. Speaker, tomorrow i will attend the year pin counsel. In the last few days ive spoken to chancellor merkel and a number of other european leaders. Weve discussed the need to prepare for negotiations and the fact that the British Government will not be triggering a local 50 at this stage. Before we do that we need to determine the kind of relationship we want for the eu. Theres really something for the next Prime Minister and their cabinet to decide. Ive also made this point to the president of the European Council and the European Commission and ill make this again at the European Council tomorrow. Mr. Speaker this is our sovereign decision and it will be for britain and britain away alone to take. Tomorrow is also an opportunity to make this point. Britain is leaving the eu that we must not turn our back on europe or the rest of the world. Care. The nature of the relationship we secure with the eu will be determined by the next government. I think everyone agrees we want the strongest economic links with our european neighbors as well as our friends in north america and the commonwealth and all its partners like india and china. Im also sure that whatever the nature of our future relationship, we want to continue with a great deal of our extensive Security Corporation and to do all we can to influence decisions that will affect the prosperity and safety of our people here at home. Mr. Speaker this negotiation will require strong and committed leadership. As i said i think the country requires a new administering cabinet to take it in this direction for this is not a decision ive taken likely but im actually convinced it is in the National Interest. Mr. Speaker although leaving the eu is not the path i recommended, i am the the first to praise our incredible strength of the country. As we proceed with implementing this decision in facing the challenges that it will bring, i believe we should hold fast to the vision of britain that wants to be respected abroad, tolerant at home and engaged in the world and working with our International Partners to advance the prosperity and security of our nation for generations to come. I have fought with these things every day of my political life and i will continue to do so and i commend the statement of the house. Your hair. Thank you, thank you mr. Speaker. First of all i would like to thank the british people for turning out to vote in such high numbers. The vote was a reflection of the significance of the issue. It was a close vote. On the back of the campaign that was too often divided and negative. These put forward a positive step to remain part of the European Union and required two thirds of our own supporters but majority of people have voted to leave. We have accepted what they said. Many people feel disenfranchised and powerless, especially in parts of the country that have been left behind for far too long. Communities that have been let down, not by the European Union but by government. Those communities dont trust politicians because for too long they havent. So, instead of more extreme cuts to local services, which have hit the areas the hardest, this government needs to invest in those communities. Many of those areas are deeply concerned about the security of pledged eu funding. Can the Prime Minister give us any guarantees on those issues as that money is desperately needed. Secondly, the issue of trust in the tenor in the Referendum Campaign was disheartening. Untruths were told. Many key figures spent the weekend distancing themselves from to claim that the vote to leave would hand nhs an extra 350 Million Pounds per week. It is quite shameful that politicians made claim they need to be false and promises they knew could not be delivered. Thirdly, real concern exists about immigration but too much of a discussion in the Referendum Campaign was divided. In the days following the referendum results, it appears we have seen the rise in greatest incidents such as the attack on hammersmith which the Prime Minister referred to and sadly many other subjects all over this country. I hope the time minister can address the attacks on the streets of this country. As political leaders we have a duty to calm our language and our tone, especially after shocking events of ten days ago. Our country is divided and the country. [inaudible] mr. Speaker we have serious work in this house and in the country. I want to accommodate as many as possible of those colleagues who wish to question the Prime Minister. Matters are slowed up a people make a lot of noise. Thank you mr. Speaker. It does appear that neither wing of the government has an exit plan which is why we are insisting that the labour party be fully engaged in the negotiation that lie ahead. We need the freedoms to shape our economy for the future and protect social and Employment Rights while building new policies on trade, on migration, Environmental Protection and on dash investment. I fully understand the Prime Minister is standing down in three months time but we cannot be in a stage of paralysis until then. The Prime Minister is making the European Council tomorrow. I hope you will say that the negotiations will begin so we know whats going on rather than being delayed until october. We as a house have a duty to act in the National Interest and ensure we get the best agreements for our constituents. Will the Prime Minister today confirmed that in the light of the economic turmoil the chancellor will announced a suspension and determination of the now even more accountable productive physical rule. What the economy needs now is a clear plan for investment. Particularly in those communities that have been so damaged by this government and sent such a strong message to all of us last week. Will he specifically rule out tax or further cuts to Public Services that were threatened in the free referendum. I welcome his assurances on the uncertainty felt by many eu nationals, currently working in our economy, including the 52000 who work so well and help our National Health service to provide the service we all need. It is welcome that the Prime Minister consulted with the leaders and administration i hope with the mayor of london two, city for which the implications are huge. We must act in Public Interest and support measures to reduce volatility. I welcome protections but what about protections for peoples jobs, their wages and their pensions. Can the Prime Minister make clear what plans are in place. The chancellor spoke this morning to reassure the stock markets though they clearly remain very uncertain. We understand that some measures cannot be discussed in the house so just an assurance that they will provide private briefings on this matter. Finally mr. Speaker, on a personal note, may i say i have many fundamental disagreements with the Prime Minister and his government. Another the left as he announces the end of his leadership its right to say that he was right to do so. I want to thank you two in response to the inquiry and the reaction to tragic murder of jo cox. Im sure we will enjoy many more debates and disagreements while he continues as time minister. Thank you mr. Speaker. Let me agree with the leader of the opposition that was positive turnout was high and i also agree with him we need to reach out to the people who havent benefited from Economic Growth and make sure they feel their Economic Security is important to us as well but i dont agree with him that its right to start to try and refight the campaign all over again. All i know for my part is i feel i put everything i could into the campaign that i believed in, head heart and soul and i left nothing out. I think that was the right thing to do. Answering his questions on money of different areas of the country, until we leave the eu, none of those arrangements change so what has been set out in the budget budget and the payments, all of those continue. As the negotiation begin for leaving, obviously the next government will want to set out what arrangements it will put in place for farmers or local authorities for regions of our country. On intolerance and fighting intolerance, i absolutely agree, we have to take all action we can to stamp this out. He asked about the chancellors physical rule and also future plans. What i would say is we have not worked so hard to get the budget deficit from 11 down to below 3 to see that go to waste. We must continue to make sure that we have a sound and strong economic plan in our country for the coming months that is my responsibility and in time it will be the responsibly of new government and they have to decide how to react if there are economic difficulties along the way. He asked if there could be private briefings for members of the process with the chancellor and as always, in these arrangements, if shadow cabinet members want these briefings they can have them. Can i finally thanked him for his kind remarks and the fact that he hopes we will be debating with each other and some weeks and months to come. Mr. Speaker, when we acquire a new government that assigns what it means by leaving and rolled up some detailed policy instructions, a great deal of detailed legislation will be uncovering a whole variety of fields will start being submitted to this parliament. Does my friend agree that we still have a parliamentary democracy and it will be the duty of each member of parliament to judge each measure and the like of which each man and woman regards as the National Interest and not to take broad guidance from what has produced a small majority on a question with an illinformed event. Would he agree that if we face months of uncertainty, if were not careful. Certs really not acceptable for people to make that amount of noise. The gentleman will be heard in every member of this house will be heard. Lets accord the gentleman the respect of which is entitled. Thank you mr. Speaker. As a risk of uncertainty for a few months causing very considerable difficulty, we consider the first step of joining the European Economic area which was designed in the first place for countries like norway and iceland were the great bulk of politicians wish to join the European Union but could not get past the ridiculous hurdle of a referendum in order to get there that could be negotiated, modifications, changes if anybody can decide what they want after we get there. Or do we give some reassuring order and stability to our economy and might begin to attract a little investment in future prospect for our country. Thank you for our honorable friend for his remarks. Might be a symbol that this house shouldnt block the will of the british people to leave the European Union but of course we now have a look at all the detailed arrangements in parliament will rarely have a role in that, in making sure that we find the best way forward. That will be the job for the next government, but i do believe in parliamentary sovereignty and the sovereignty of this group. It must be for a future government. Thank you very much mr. Speakman. Scotland voted overwhelmingly to remain. 62 of voters cast their votes to remain in the eu, every single local government area and the country voted to remain in the eu and in scotland we voted to remain because it really matters that we are in a single European Market because we value the Free Movement of people of goods and services because our eu Citizenship Rights matter as to our legal safeguards for what goes for women and others. In scotland, mr. Speaker, we voted to remain because we are a european nation and it really, really matters to us that we live in an hour looking country, not a diminished little britain. In scotland we are now being told from westminster that despite the majority against leave, we are going to have to do as were told, we have to be taken out of europe against our will. Mr. Speaker, let me tell this house and our friends across europe, we have no intention whatsoever of seeing scotland taken out of the eu. That would be totally democratically unacceptable. We are a european country and we will stay a european country. If that means we have to have an independence referendum to protect the island then so be it thank goodness mr. Speaker we have a Scottish Parliament in a minister prepared to lead and protect scotlands place and it is very, very welcome that this approach is being supported by oppositions across the Scottish Parliament. Projects here have turned to project sparse. Apparently those who propose we should leave europe has no plan. There is no plan, believe campaign went on to say number ten should have had a plan. Meanwhile, share prices are so volatile that some docs have temporarily been suspended and sterling has hit a 31 year low. Mr. Speaker, on one thing i hope we are all agreed and that is that we take very serious note of the very disturbing series of races incidents directed against our fellow citizens who happen to come from other European Countries. Ive hope that we all, on all sides totally repudiate these despicable acts and encourage the police and prosecuting authorities to do all that they can. Mr. Speaker, given the economic damage and uncertainty that is currently being caused, may ask the Prime Minister the following questions. We welcome the actions of the governor of the bank of england to help provide certainty in difficult times. Can the Prime Minister confirmed that the governor has no plans presently to change his Forward Guidance on interest rates. The essence he will continue to prevent measures to deliver stability in the uk economy at this time, however, we want to be explicitly clear that this will not be used to further deepen the program of prosperity. In conclusion, the lack of leadership from over the past few days has been unprecedented. We recognize that any further threats or vacuum exacerbate uncertainty. We know the Prime Minister is planning to leave and we wish him well, but can we have an absolute assurance that his government will finally start to take a firm grip of the situation we all sadly find ourselves in. First about what i say is that our focus should be to get the very best deal for the United Kingdom outside the European Union and that should mean the very best deal for scotland as well. I actually agree with the despicable acts of racism that have taken place in many reassure him we will take every step that we can. Yes question specifically about interest rate. That is for the Monetary Policy committee then they are out their views in advance of the referendum