Amicus Curiae Brief — United States, Petitioner v. Texas, et al.

APP NO. 21A85

--------------------------IN THE SUPREME COURT OF THE UNITED STATES

--------------------------UNITED STATES OF AMERICA,

Applicant,

v.

STATE OF TEXAS,

Respondent.

--------------------------To the Honorable Samuel L. Alito,

Associate Justice of the United States Supreme Court

and Circuit Justice for the Fifth Circuit

--------------------------MOTION FOR LEAVE TO FILE AMICI BRIEF AND AMICI BRIEF OF HUMAN COALITION

AND NATIONAL INSTITUTE OF FAMILY AND LIFE ADVOCATES IN SUPPORT OF

NEITHER PARTY

JOHN BURSCH

Counsel of Record

KEVIN H. THERIOT

KENNETH J. CONNELLY

ALLIANCE DEFENDING FREEDOM

15100 N. 90th Street

Scottsdale, AZ 85260

(480) 444-0020

jbursch@ADFlegal.org

Counsel for Amici Curiae

To the Honorable Samuel A. Alito, as Circuit Justice for the United States

Court of Appeals for the Fifth Circuit:

Amici Curiae Human Coalition and National Institute of Family and Life

Advocates file this motion under Supreme Court Rules 21.1 and 21.2(c) and

respectfully request leave to file the attached amicus curiae brief in support of neither

party. In support of this motion, Amici Curiae state:

Amici Curiae were not able to comply with Rule 37.2(a)’s 10-day notice

requirement because of the expedited briefing schedule. The United States takes no

position on this motion. Texas and the Intervenors consented with the condition that

it be filed 48 hours before their briefs are due.

Amici Curiae have extensive experience serving over 80,000 Texas women

seeking abortion in the last three years. Drawing from this experience, their brief

supplies this Court with information about the lack of resources that traditionally

drives women to choose an abortion when most do not want it. Their brief also

presents the multitude of public and private Texas programs available to provide

those resources so women can make the choice they actually want—giving their child

the opportunity to live.

Amici Curiae seek leave to file this brief to equip this Court with the

information it needs to assess whether women are actually irreparably harmed by SB

8 and enjoining the law is in the public interest. Human Coalition’s and NIFLA’s

unique perspectives of serving women seeking abortion will help the Court make that

determination.

1

Respectfully submitted.

/s/ John Bursch

JOHN BURSCH

Counsel of Record

KEVIN H. THERIOT

KENNETH J. CONNELLY

ALLIANCE DEFENDING FREEDOM

15100 N. 90th Street

Scottsdale, AZ 85260

(480) 444-0020

ktheriot@ADFlegal.org

Counsel for Amici Curiae

2

TABLE OF CONTENTS

TABLE OF AUTHORITIES .......................................................................................... ii

INTEREST OF AMICI CURIAE ................................................................................... 1

SUMMARY OF ARGUMENT ....................................................................................... 3

ARGUMENT .................................................................................................................. 4

I.

Many women with unexpected pregnancies do not want abortions but

feel compelled to make that choice because of a lack of employment,

housing, material assistance, finances, or health services. .............................. 4

II.

Texas has a rich and wide-ranging set of resources available to women

who experience unexpected pregnancies............................................................ 5

A.

B.

III.

Texas has at least eight programs assisting women seeking

abortion. .................................................................................................... 5

1.

Alternatives to Abortion program ................................................. 5

2.

Healthy Texas Women Plus program ........................................... 7

3.

Other Texas programs supporting Texas women ........................ 7

Private organizations facilitate public assistance and provide

additional help to Texas women seeking abortion. ................................. 8

The abundance of services provided for women minimizes any need for

abortion after heartbeat detection. .................................................................. 10

CONCLUSION............................................................................................................. 13

i

TABLE OF AUTHORITIES

Cases

Planned Parenthood of Southeastern Pennsylvania v. Casey,

505 U.S. 833 (1992) ............................................................................................... 11

Roe v. Wade,

410 U.S. 113 (1973) ............................................................................................... 10

Other Authorities

Alternatives to Abortion, Texas Health and Human Services,

https://www.hhs.texas.gov/services/health/women-children/alternativesabortion .................................................................................................................... 6

Ashley Lopez, Gov. Abbott Signs Bill Extending Medicaid Coverage for New

Texas Mothers, Houston Public Media,

https://www.houstonpublicmedia.org/articles/news/politics/

2021/06/17/400901/gov-abbott-signs-bill-extending-medicaid-coverage-fornew-texas-mothers/ ................................................................................................. 8

Charlotte Lozier Institute, 1968-2018: A Half Century of Hope (2018),

https://s27589.pcdn.co/wp-content/uploads/2018/09/A-Half-Century-of-HopeA-Legacy-of-Life-and-Love-FULL.pdf .................................................................. 11

Charlotte Lozier Institute, A Legacy of Life and Love: Pregnancy Centers Stand

the Test of Time (2020), https://lozierinstitute.org/search/?x=0&y=0&search

=pregnancy+centers+stand+the+test+of+time .................................................... 11

Charlotte Lozier Institute, Pro-Life Pregnancy Centers Served 2 Million People

with Essential Medical, Education and Support Services in 2019,

https://lozierinstitute.org/pro-life-pregnancy-centers-served-2-millionpeople-with-essential-medical-education-and-support-services-in-2019/ ........... 12

Dawn Buckingham, Texas State Senator Dawn Buckingham Capitol Report

2021, https://senate.texas.gov/members/d24/nl/en/2021_SDB_NL.pdf ................. 6

HHSC’s Healthy Texas Women Program Launches Enhanced Postpartum Care

Services, Texas Health and Human Services,

https://www.hhs.texas.gov/about-hhs/communicationsevents/news/2020/08/hhscs-healthy-texas-women-program-launchesenhanced-postpartum-care-services ....................................................................... 7

HTW: Benefits, Healthy Texas Women, https://www.healthytexaswomen.org/

healthcare-programs/healthy-texas-women/htw-benefits ..................................... 7

ii

Infant Safe Haven Laws, Child Welfare Information Gateway,

https://www.childwelfare.gov/pubPDFs/safehaven.pdf ....................................... 12

Margaret H. Hartshorn, FOOT SOLDIERS ARMED WITH LOVE (2014) ......................... 10

Rachel K. Jones & Jenna Jerman, Abortion Incidence and Service Availability in

the United States, 49 PERSPECTIVES ON SEXUAL & REPRODUCTIVE HEALTH

(2017) ..................................................................................................................... 12

Ramiro Ferrando, While Abortion Clinics Diminish, Crisis Pregnancy Centers

Flourish, MIDWEST CENTER FOR INVESTIGATIVE REPORTING, Feb. 19, 2019 .. 11, 12

Women & Children, Texas Health and Human Services,

https://www.hhs.texas.gov/services/health/women-children ................................. 8

iii

INTEREST OF AMICI CURIAE1

Human Coalition, a Texas nonprofit 501(c)(3) corporation formed in 2009, is

committed to rescuing children, serving families, and ending abortion by offering

abortion-determined women a life-affirming message and tangible, individualized

services. Human Coalition works to build holistic, comprehensive care networks

across the United States to reach abortion-determined women and provide needed

support and care to empower them to choose life for their children. Human Coalition

operates its own specialized women’s care clinics and virtual clinics in major cities

across the country. In Texas, Human Coalition’s virtual clinic services 234 counties

or 99.84% of Texas geographically. Through its contact center, care clinics, outreach,

and continuum of care program, Human Coalition continually tests and optimizes its

practices so that it listens to and serves the abortion-determined community with

greater effectiveness and the utmost care.

The National Institute of Family and Life Advocates (“NIFLA”) is a 501(c)(3)

nonprofit membership organization which provides life-affirming pregnancy centers

with legal counsel, education, and training. NIFLA represents over 1,600 pro-lifepregnancy-center members across the country. One-hundred four of those members

provide women in Texas with pregnancy-related medical and non-medical

information and services without charge. NIFLA members’ medical services include

lab-quality

urine

pregnancy

tests,

limited

obstetrical

ultrasounds,

nurse

1 No counsel for a party authored this brief in whole or in part, and no person other

than amici and their counsel made any monetary contribution intended to fund the

preparation or submission of this brief.

1

consultations, proofs of pregnancy, and prenatal vitamins. NIFLA members in Texas

also provide pregnancy options counseling, adoption information and referrals,

support for fathers, post-abortion support, spiritual support, community referrals for

housing and employment, educational programs for pregnancy and parenting, and

material items such as baby clothes, formula, diapers, and other necessities.

Amici serve pregnant women with free comprehensive pregnancy and nonpregnancy related services, regardless of their birth outcome. They uniquely and

credibly advocate on behalf of women seeking abortion in Texas because they serve

tens of thousands of these women each year with holistic and individualized care.

Amici do not take a position regarding how the Court should rule on the Application

for stay filed by the United States and opposed by the State of Texas. But Amici

submit this brief to rebut the United States’ shocking claim that allowing SB 8 to

remain in place will “irreparably harm” women seeking abortion. In Amici’s

experience, many women seek abortion not because they are determined to take the

life of their child but because they are coerced into doing so by a spouse, partner,

boyfriend, human trafficker, or another third party. SB 8 is encouraging more women

to carry their children to term and to benefit from the extensive public and private

programs that provide pregnant mothers with the needed resources they need to be

successful and preserve the life of their child. Accordingly, the public interest does

not support enjoining SB 8.

2

SUMMARY OF ARGUMENT

Amici’s extensive experience shows that many abortion-seeking women accept

their pregnancies when provided with the tangible support they need. And Texas

women have access to unprecedented public and private programs offering that

support. Those programs include assistance with safe housing, education, securing

employment, health care, transportation, and material resources ranging from food

to diapers.

As a result, Texas women with unexpected pregnancies are not irreparably

harmed by laws like SB 8 that protect unborn children early in the pregnancy. Quite

the opposite, Amici’s centers report that SB 8—and the resources the centers

provide—are helping women combat abortion coercion from family members and

partners.

For example, a NIFLA center recently assisted a woman being coerced by her

boyfriend to abort. She was relieved to be able to tell him abortion is not an option

because the baby’s heart is already beating and that she has access to the resources

she needs to carry the child to term. Supp.App.2a (O’Connor Decl. ¶7). Another

woman served by Amici felt pressured to abort, only to learn she was too far along

under SB 8 and that upon disclosing her pregnancy to her mother, found she fully

supported having the baby. Id. (O’Connor Decl. ¶8).

These women and many others are now carrying their children to term and

benefitting from extensive public and private programs that provide them with the

3

resources they need to be successful. SB 8 is not irreparably harming women and the

public interest is not served by enjoining the law.

ARGUMENT

I.

Many women with unexpected pregnancies do not want abortions

but feel compelled to make that choice because of a lack of

employment, housing, material assistance, finances, or health

services.

Amici have a unique understanding of women seeking abortion because they

serve hundreds of thousands of women seeking abortion nationwide. Their records

show most women considering abortion do not want it, but feel they have no choice.

Supp.App.7a (Lane Decl. ¶3). And many pregnant women seeking abortion served by

Amici report they would prefer to keep their children if their life circumstances were

different. Supp.App.11a (Pagano Decl. ¶4). But these women need assistance because

socio-economic concerns are the primary driver of a woman’s decision to get an

abortion. Statistics show that women most often seek abortion because they lack

employment, affordable housing, material assistance, finances, and health services.

Supp.App.13a–14a (Pagano Decl. ¶12).

4

Some Texas women seeking abortion are unaware of the public or private

assistance available to meet these needs, or they do not know how to access it.

Supp.App.15a (Pagano Decl. ¶15). But many pregnant mothers served by Amici

decide to keep and parent their children when they are informed of, and equipped

with, needed resources. Supp.App.11a (Pagano Decl. ¶4). Human Coalition and

NIFLA represent and refer to hundreds of Texas organizations that assist and

support pregnant women so that they can safely bring their children to term. They

also provide these women with the resources they need after the child is born,

whether they choose to parent or place for adoption. Supp.App.15a (Pagano Decl.

¶16); Supp.App.1a–2a (O’Connor Decl. ¶4).

II.

Texas has a rich and wide-ranging set of resources available to

women who experience unexpected pregnancies.

Texas has unprecedented infrastructure to support women seeking abortion

and assist with their needs. The State spent decades building systems to empower

women and their children with real options and comprehensive care to alleviate

obstacles to parenting and reliance on abortion. The State also uniquely incorporates

public and private resources into a wide-ranging care system for pregnant women

seeking abortion.

A.

Texas has at least eight programs assisting women seeking

abortion.

1.

Alternatives to Abortion program

The Alternatives to Abortion (“A2A”) program, created in 2005, provides a

network of services that promotes childbirth and supports a woman and her family

through the early years of carrying, birthing, and raising a baby. The A2A program

5

(1) reduces abortions and improves pregnancy outcomes by helping women practice

sound, health-related behaviors and improve prenatal nutrition; (2) improves child

health and development by helping parents provide responsible and competent care

for their children; and (3) improves families’ economic self-sufficiency by helping

parents continue their education and find a job.2

Texas Health and Human Services

operates A2A, which provides:

(1) “Counseling, mentoring, educational information and classes on pregnancy,

parenting, adoption, life skills and employment readiness”; (2) “Material assistance,

such as car seats, clothing, diapers and formula”; (3) “Care coordination through

referrals to government assistance programs and other social services programs”;

(4) “Call center for information and appointment scheduling”; and (5) “Housing and

support services through maternity homes.”3

These services are available to biological parents of an unborn child or a child

up to three years old, as well as parents who experience a miscarriage for up to 90

days after the loss, adoptive parents for the first two years after the adoption is

finalized, and a minor parent’s parent/guardian/primary caregiver. Id. During the

last Legislative Session, Texas increased A2A funding for the next biennium from

$80 million to $100 million.4

See Alternatives to Abortion, Texas Health and Human Services,

https://www.hhs.texas.gov/services/health/women-children/alternatives-abortion.

2

3 Id.

4 Dawn Buckingham, Texas State Senator Dawn Buckingham Capitol Report 2021 at

4, https://senate.texas.gov/members/d24/nl/en/2021_SDB_NL.pdf.

6

2.

Healthy Texas Women Plus program

The Healthy Texas Women Plus program, also under Texas HHS, provides “an

enhanced postpartum services package” for women who “have been pregnant within

the last 12 months.” It focuses “on treating major health conditions that contribute to

maternal morbidity and mortality in Texas” and provides: (1) “individual, family and

group psychotherapy services and peer specialist services” to treat “[p]ostpartum

depression and other mental health conditions”; (2) “imaging studies; blood pressure

monitoring; and anticoagulant, antiplatelet and antihypertensive medications” to

treat “[c]ardiovascular and coronary conditions”; and (3) “screenings, brief

interventions, treatment referrals, outpatient substance use counseling, smoking

cessation services, medication-assisted treatment and peer specialist services” to

treat “[s]ubstance use disorders, including drug, alcohol and tobacco misuse[.]”5 The

Texas legislature recently strengthened this program.6

3.

Other Texas programs supporting Texas women

Texas HHS provides at least six other programs it describes as “aiding in

preventing unintended pregnancies, nurturing healthier pregnancies, addressing

domestic violence and taking care of children.” These services include: (1) “A Woman’s

Right to Know,” which “provides important information about the baby growing in

5 See HTW: Benefits, Healthy Texas Women, https://www.healthytexaswomen.org/

healthcare-programs/healthy-texas-women/htw-benefits.

6 See HHSC’s Healthy Texas Women Program Launches Enhanced Postpartum Care

Services, Texas Health and Human Services, https://www.hhs.texas.gov/abouthhs/communications-events/news/2020/08/hhscs-healthy-texas-women-programlaunches-enhanced-postpartum-care-services.

7

your womb and the resources available to you during and after your pregnancy”;

(2) “Family Violence Program,” which “promotes self-sufficiency, safety, and longterm independence of adult and child victims of family violence and victims of teen

dating violence”; (3) Medicaid7 and CHIP (Children’s Health Insurance Program),

which “help… cover medical expenses for children and people with disabilities who

meet income requirements”; (4) “So You’re Pregnant, Now What? (PDF),” which is “a

resource for pregnant women”; (5) “Texas Nurse-Family Partnership,” which “pairs

registered nurses with low-income, first-time mothers to improve prenatal care and

provide one-on-one education and counseling focusing on child development”; and (6)

“WIC (Women, Infants and Children Program),” which is “a health and nutrition

program that helps improve the diets of infants and children as well as pregnant,

postpartum and breastfeeding women.”8

B.

Private organizations facilitate public assistance and provide

additional help to Texas women seeking abortion.

Human Coalition assists expectant mothers both as an A2A contractor and

with its own private services. Supp.App.10a–11a (Pagano Decl. ¶3). Since June 2018,

it has served over 80,000 A2A clients and provided those services in 234 Texas

counties (which contain about 99.84% of Texas’ population). Id. (Pagano Decl. ¶5).

7 The Texas legislature recently expanded postpartum Medicaid coverage.

Ashley

Lopez, Gov. Abbott Signs Bill Extending Medicaid Coverage for New Texas Mothers,

Houston Public Media, https://www.houstonpublicmedia.org/articles/news/politics/

2021/06/17/400901/gov-abbott-signs-bill-extending-medicaid-coverage-for-newtexas-mothers/.

See Women & Children, Texas Health and

https://www.hhs.texas.gov/services/health/women-children.

8

8

Human

Services,

During the same period, NIFLA Texas members served over 85,000 clients with

private programs and through the A2A program. Supp.App.2a (O’Connor Decl. ¶5).

NIFLA and Human Coalition provide women seeking abortion with free

pregnancy tests, ultrasounds and OB/GYN referrals critical for prenatal care, along

with STI testing and referrals. They also receive material assistance, such as diapers,

wipes, car seats, formula, clothing, and breast pumps. Supp.App.8a (Lane Decl. ¶5–

7); Supp.App.1a–2a (O’Connor Decl. ¶4). Amici teach women how to care for

themselves during pregnancy and in the postpartum stage, including how to quit

smoking or drinking alcohol. As part of parenting classes, women can learn about

their child’s development, infant CPR, and infant care. Supp.App.8a–9a (Lane Decl.

¶9); Supp.App.11a–12a (Pagano Decl. ¶¶5–9); Supp.App.1a–2a (O’Connor Decl. ¶4).

Because pregnancy care is only one aspect of supporting and caring for women

who may be facing an unexpected pregnancy, Amici and the centers they represent

employ licensed professionals and social workers who develop individualized care

plans for women. These plans help women obtain long-term stability to promote

healthy pregnancies and positive life outcomes. Human Coalition, for example, helps

women enroll in or qualify for local, state, and federal programs like Medicaid, CHIP,

TANF (Temporary Assistance for Needy Families), SNAP (Supplemental Nutrition

Assistance Program), WIC, Healthy Texas Women, and Section 8 Housing. Amici also

assist women seeking abortion in finding safe housing, employment, education, and

transportation.

Supp.App.12a–13a

(Pagano

(O’Connor Decl. ¶4).

9

Decl.

¶¶11–12);

Supp.App.1a–2a

Texas women have personalized care, emotional support, and material

assistance (food banks, diaper banks, furniture, clothing), adoption, health services,

financial assistance, childcare, addiction resources, rental and utilities assistance,

and mental health services available to them upon request. Unsurprisingly, since

SB 8 went into effect, clients are adapting and seeking this assistance more quickly.

Supp.App.14a (Pagano Decl. ¶13). And over 95% of clients are satisfied with these

services, saying they would recommend them to friends and family. Supp.App.15a

(Pagano Decl. ¶14).

III.

The abundance of services provided for women minimizes any need

for abortion after heartbeat detection.

Today’s culture is far more supportive of women than in 1973, when this Court

was concerned about “the problem of bringing a child into a family already unable,

psychologically and otherwise, to care for it.” Roe v. Wade, 410 U.S. 113, 153 (1973).

Fifty years ago, women lacked access to the multitude of public programs that states

like Texas now provide. And while there were pregnancy centers like Amici when this

Court decided Casey in 1992, see Margaret H. Hartshorn, FOOT SOLDIERS ARMED

WITH LOVE 18–19 (2014), they were still taking shape and did not provide the same

breadth of services or depth of physical, medical, material, and emotional support as

do pregnancy centers today. Although there is “no reliable data about the total

number and location” of pregnancy centers in the 1990s, recent trends indicate there

were far fewer than the thousands that exist today. Ramiro Ferrando, While Abortion

Clinics

Diminish,

Crisis

Pregnancy

Centers

10

Flourish,

MIDWEST CENTER

FOR

INVESTIGATIVE REPORTING, Feb. 19, 20199 (centers grew from about 2,000 in 2010 to more

than 2,500 in 2018). And early pregnancy centers focused mainly on options counseling

and referrals to adoption agencies. Few pregnancy centers provided medical services

even at the time of Casey.10

Today, pregnancy centers like Amici are highly effective at helping women

through all stages of their pregnancy and beyond so they can “participate equally in

the economic and social life of the Nation.” Planned Parenthood of Se. Pa. v. Casey,

505 U.S. 833, 856 (1992). A significant majority of modern pregnancy centers provide

medical services—about 2,132 today, as compared to a handful at the time of Casey.11

These centers’ services include (depending on the center) medical-grade pregnancy

testing, ultrasounds to confirm a viable pregnancy and to rule out a dangerous ectopic

pregnancy, and sexually-transmitted-disease and infection testing. Charlotte Lozier

Report at 9, 34. In 2019, pregnancy centers provided nearly 1.85 million people with

the free services detailed in the previous sections, including more than 2 million babyclothing outfits, more than 1.2 million packs of diapers, more than 19,000 strollers,

and more than 30,000 new car seats. Id. at 16, 24, 61–62. In 2019, pregnancy centers

https://investigatemidwest.org/2019/02/19/while-abortion-clinics-diminish-crisispregnancy-centers-flourish/.

9

Charlotte Lozier Institute, 1968-2018: A Half Century of Hope at 5–7 (2018),

https://s27589.pcdn.co/wp-content/uploads/2018/09/A-Half-Century-of-Hope-ALegacy-of-Life-and-Love-FULL.pdf.

10

11 See Charlotte Lozier Institute, A Legacy of Life and Love: Pregnancy Centers Stand

the Test of Time at 6, 25 (2020), https://lozierinstitute.org/search/?x=0&y=0&search

=pregnancy+centers+stand+the+test+of+time (“Charlotte Lozier Report”).

11

like Amici outnumbered abortion clinics 3 to 112 and provided nearly $270 million in

assistance to 2 million people nationwide.13

In short, the pregnancy centers like Amici grew from a fledgling, loose

community when Roe and Casey were decided, to an established, vast, well-organized,

and professional network that spans the country. These centers now widely support

women throughout their pregnancies and afterwards—educating, equipping, and

empowering them to thrive after making life-affirming choices rather than be

pressured into making the difficult decision to take the life of their own child.

So it is no surprise that the 2018 abortion rate fell to its lowest level since

Roe.14 Abortion is less relied on now than in any time since it was legalized

nationwide. The services Texas and Amici provide give women scores of options if

they become pregnant. And Texas pioneered the trend of states providing mothers

who cannot care for their children with “designated locations” in which they can

“safely relinquish their babies” and “where the babies are protected and provided

with medical care until a permanent home is found.”15 Mothers who do not feel able

to parent have safe, legal alternatives to raising their children themselves.

12 See Ferrando, supra note 9.

13 Charlotte Lozier Institute, Pro-Life Pregnancy Centers Served 2 Million People with

Essential

Medical,

Education

and

Support

Services

in

2019,

https://lozierinstitute.org/pro-life-pregnancy-centers-served-2-million-people-withessential-medical-education-and-support-services-in-2019/.

14 Rachel K. Jones & Jenna Jerman, Abortion Incidence and Service Availability in

the United States, 49 PERSPECTIVES ON SEXUAL & REPRODUCTIVE HEALTH 17, 20

(2017) (“This is the lowest rate since abortion was legalized nationally in 1973.”).

See Infant Safe Haven Laws at 1, Child Welfare Information Gateway,

https://www.childwelfare.gov/pubPDFs/safehaven.pdf.

15

12

The family unable to care for a child—one of this Court’s primary concerns

when deciding Roe—now has an abundance of resources available so that both child

and family can not only survive but thrive. And that is exactly what many Texas

women seeking abortion want.

CONCLUSION

Amici take no position on whether this Court should grant or deny the United

States’ application for stay. But the Court should reject the shocking claim that

allowing SB 8 to remain in place will “irreparably harm” women seeking abortion.

And the Court should resoundingly decline the invitation to conclude that the public

interest favors a legal regime that results in more coercion and less choice for

pregnant mothers.

Respectfully submitted,

/s/ John Bursch

JOHN BURSCH

Counsel of Record

Kevin H. Theriot

Kenneth J. Connelly

ALLIANCE DEFENDING FREEDOM

15100 N. 90th Street

Scottsdale, AZ 85260

(480) 444-0020

jbursch@ADFlegal.org

Counsel for Amici Curiae

OCTOBER 2021

13

SUPPLEMENTAL APPENDIX

APP NO. 21A85

--------------------------IN THE SUPREME COURT OF THE UNITED STATES

--------------------------UNITED STATES OF AMERICA,

Applicant,

v.

STATE OF TEXAS,

Respondent.

Anne O’Connor declares the following:

1. I am over 18 years old and I have knowledge of the statements contained

herein.

2. I am the Vice President of Legal Affairs for National Institute of Family and

Life Advocates (NIFLA), a non-profit membership organization comprised of a

network of both medical and non-medical pregnancy care centers providing pro-life

services and information to women facing unplanned pregnancies.

3. NIFLA has 104 pregnancy centers and 1 maternity home in Texas. 91 of

NIFLA’s centers in Texas are medical facilities, and 13 are pregnancy resource

centers.

4. NIFLA’s centers provide a variety of services in Texas, including the following:

pregnancy testing, limited obstetric ultrasound, sexually transmitted infection

testing, prenatal vitamins, referrals for early prenatal care, OB-GYN referrals, onsite or referred professional counseling, mentoring, parenting classes, housing

Page 1 of 3

Supp.App.001a

assistance (help finding suitable housing if needed), employment assistance (help

finding employment/job training), financial assistance (including help applying for

assistance), and material assistance (baby and maternity clothes and items).

5. A preliminary survey conducted for this declaration on short notice, for which

32 of our 105 centers responded, reveals that since June 2018 until today those 32

centers alone had 85,836 client visits. Of these 32 centers only 7 are Alternatives to

Abortion recipients. Also, in September and October 15, 2021, our 32 centers

responding had 7,822 total client visits, and conducted 2,169 ultrasounds.

6. According to the Charlotte Lozier Institute and CareNet, the 185 pregnancy

centers in Texas provided an estimated $33 million in services to 178,724 clients in

2019 alone. This included 104,207 free pregnancy tests, 62,233 ultrasounds, and

14,637 STI tests. Additionally, those centers provided $11 million in family services

support and $2.2 million in material support. The Lozier Report is attached to this

declaration as Exhibit A.

7. There have been many women in Texas who have benefited from SB 8 and here

are just a couple of examples of the stories coming from our centers. A NIFLA center

recently assisted a woman being coerced by her boyfriend to abort. She was relieved

to be able to tell him she cannot abort because the baby’s heart is already beating and

that she has access to the resources she needs to carry the child to term.

8. Another woman served by one our centers felt pressured to abort, only to learn

she was too far along under SB 8. And when she disclosed her pregnancy to her

mother, she was fully supportive of continuing the pregnancy and having the baby.

Page 2 of 3

Supp.App.002a

I declare under penalty of perjury that the foregoing is true and correct.

Dated this 20th day of October, 2021.

s/ Anne O’Connor

Anne O’Connor

Page 3 of 3

Supp.App.003a

EXHIBIT A

Supp.App.004a

Pregnancy Center State Impact Report

TEXAS

helping communities flourish

In

2019, pregnancy centers provided services & materials valued at nearly

$33 million

to the state of Texas, serving

178,724 women, men, youth, & families.

$19,448,790 IN MEDICAL SERVICES

104,207 free pregnancy tests

62,233 free ultrasounds performed by registered nurses/medical

sonographers

14,637 total STD/STI tests performed by registered nurses (8,968

patients tested - 82% female, 18% male)

8 out of every 10 pregnancy center locations in the U.S. are medical

$10,889,759 IN FAMILY SERVICES

132,033 free consultations with new clients

46,691 students attended free sexual risk avoidance presentations

34,082 clients received free parenting education (85% female, 15% male)

3,230 clients received free after-abortion support & recovery (99% female, 1% male)

Supp.App.005a

$2,218,416 IN MATERIAL ITEMS

322,100

111,061 free packs of diapers

59,695 free packs of baby wipes

total free baby

146,440 free new & used baby clothing outfits

items given to

3,153 free new car seats

families in need

1,751 free new & used strollers

MADE POSSIBLE BY

1,258 total staff, 27% of whom were licensed medical professionals

5,329 total volunteers, 11% of whom were licensed medical professionals

Finding Hope in Austin, TX

Brittany was looking for an abortion. She shared, “I didn’t know of another option

besides abortion and possibly adoption at the time.” Brittany knew her family

wouldn’t approve of an abortion but she knew she couldn’t have another child.

Because of her drug use, she had lost custody of her older children who were

adopted by her mom. Emotionally, she felt like a failure.

She went to the Heart of Texas Pregnancy Resource Center where she had a positive

pregnancy test. There were a lot of tears when talking with her client advocate. She

remembered thinking, “Why am I telling a stranger all of this stuff? I’m not that kind

of person but I just felt so comfortable talking with the ladies there.”

After seeing her ultrasound, Brittany learned she was carrying twins and was able to

listen to their heartbeats. She credits Heart of Texas for encouraging and equipping

her to parent her babies and do it well. Brittany said, “I believed this was my second

chance: to clean up my act and to be a mom. And because of Heart of Texas, I’ve

been able to find ground. I wouldn’t have been able to do it without them. It’s good

to know there are people I can look to when I need help.” Brittany attended a

support group at the pregnancy center and was able to obtain maternity clothes as

well as parenting and prenatal education. She stayed sober and through an

invitation from her client advocate, became a member at a local church. She

continues to find support there as well as at Heart of Texas with her children Luke

and Lilly.

Brittany is an actual client and is pictured with her twins. Some quotes are edited for clarity purposes.

DATA NOTES:

This report is a collaborative project between Care Net and the Charlotte Lozier Institute

(CLI).

Value of services is based upon materials and services provided by 185 pregnancy

centers in the state of Texas. At least 22 of these centers received state or federal

funding in 2019.

Total savings are calculated based on cost estimates of services, classes and baby items

provided to clients. The sources for the cost estimates and valuation of items and

services can be found in the Methodology section, pgs 12-14, of the 2020 CLI national

pregnancy center report, "Pregnancy Centers Stand the Test of Time"

(www.lozierinstitute.org/pcr2020), except for the following state specific labor costs.

The Texas mean hourly wages referenced are as follows for: Social Workers in

local/state government is $30.56 per hour - BLS OES code 21-1029, Registered

Nurses is $36.92 per hour - OES code 29-1141, and Diagnostic Medical

Sonographers is $34.63 per hour - OES code 29-2032.

The estimated savings does not include housing and other monetary assistance

provided to some clients. We advocate for our clients by networking with hundreds

of county, state and non-profit social service organizations around the country. We

cannot quantify the value of emotional support given to the women we help

through phone calls and caring volunteers.

Published October 2021.

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DocuSign Envelope ID: E65B2E10-2C52-4BF7-AF9A-CA811FF2F2C6

U N I T E D S TAT E S D I S T R I C T C O U R T

FOR THE WESTERN DISTRICT OF TEXAS

AUSTIN DIVISION

United States of America,

Plaintiff,

v.

Case No. 1:21-cv-00796-RP

The State of Texas,

Defendant.

DECLARATION OF EVELYN RACHEL LANE

I, Evelyn Rachel Lane, declare the following pursuant to 28 U.S.C. § 1746:

1. I am a resident of Collin County, Texas, and I am over the age of eighteen.

2. I am the Vice President of Family Services for Human Coalition, a national pro-life

organization headquartered in Plano, Texas. Human Coalition works to build holistic, comprehensive care networks in major cities across the U.S. with the goal of reaching abortion-determined women and providing needed support and care to empower them to

choose life for their babies. Because of my role at Human Coalition, I am aware of the

services we provide for our clients.

3. Through our research and client interaction, we have found that a majority of abortion-determined women who participate in our continuum of care program prefer to carry

their baby to term. Through our continuum of care program, we aim to empower and

support women in changing their circumstances so they do not feel like the only choice

they have is abortion.

4. Our Contact Center, staffed by trained call agents, coordinates telephone and electronic contact with our clients. This includes initial intake, care coordination, and qualifying clients for care and state, federal, and private program eligibility.

Declaration of Evelyn Rachel Lane

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Page 1 of 3

DocuSign Envelope ID: E65B2E10-2C52-4BF7-AF9A-CA811FF2F2C6

5. Our telecare program is staffed by nurses who identify needs related to pregnancy,

parenting, and adoption, and offer referrals to client care resources, both internal and

external. Through the telecare program, we provide counseling, mentoring, and education

to pregnant women regarding such things as childbirth, and how to care for themselves

during pregnancy and in the postpartum stage. We also offer parenting counseling and

mentoring, educational materials, and parenting classes to all clients. As part of our parenting classes, we provide instruction for our clients on child development, infant nutrition and newborn care, and related topics. We also provide adoption counseling and mentoring, referrals, and classes. We provide similar support in educating clients on how to

obtain employment and other life skills.

6. We also offer other pregnancy-related services. These include pregnancy tests,

limited ultrasounds, OB/GYN referrals (and we follow up with patients to ensure that first

appointment has been made, which is critical for prenatal care) and STI testing and referrals.

7. Those services are also provided in our telecare or in-person clinics, where we additionally provide material assistance such as diapers, wipes, car seats, formula, baby

clothes, cribs, and breast pumps.

8. We strive to maintain continuing periodic contact to ensure that our clients feel

supported and can access the services they need. Our client care staff follows up with

clients on a weekly to monthly basis during pregnancy through delivery, and, if necessary,

post-delivery for such time as may be needed.

9. We also recognize that pregnancy care is only one aspect of supporting and caring

for women who may be facing an unplanned pregnancy, so we aim to provide a continuum

of care. Our continuum of care program is staffed with social workers and is designed to

develop individualized care plans for clients with the goal of providing near- and long-term

stability to promote healthy pregnancies and positive life outcomes. As part of that, our

social workers screen clients for eligibility for state programs and local resources, and help

Declaration of Evelyn Rachel Lane

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DocuSign Envelope ID: E65B2E10-2C52-4BF7-AF9A-CA811FF2F2C6

clients enroll in state and federal programs. Our social workers also help to support clients

in creating a plan to progress towards stable lives if needed, including finding safe housing,

employment, education, and transportation. Our staff also provides personalized care and

emotional support, and helps with material assistance (food banks, diaper banks, furniture, clothing), adoption, health services, financial assistance, childcare, addiction resources, rental and utilities assistance, and mental health services.

10. Based upon responses received to exit surveys provided to abortion-determined

clients of Human Coalition, over 90% stated that they would recommend our clinic to a

family member or friend.

I declare under penalty of perjury that the foregoing is true and correct.

30th day of September, 2021.

Dated this ____

_____________________________

Evelyn Rachel Lane

Declaration of Evelyn Rachel Lane

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Page 3 of 3

APP NO. 21A85

--------------------------IN THE SUPREME COURT OF THE UNITED STATES

--------------------------UNITED STATES OF AMERICA,

Applicant,

v.

STATE OF TEXAS,

Respondent.

I, Joseph Pagano, declare the following pursuant to 28 U.S.C. § 1746:

1. I am a resident of Collin County, Texas, and I am over the age of eighteen.

2. I am the National Director of Government Programs for Human Coalition, a national pro-life organization headquartered in Plano, Texas. Human

Coalition works to build holistic, comprehensive care networks in major cities

across the U.S. with the goal of reaching abortion-determined women and

providing needed support and care to empower them to choose life for their

babies. Because of my role at Human Coalition, I am aware of the government programs we participate in to provide services for our clients, as well as

the services we provide in those programs. I am also aware that we do provide services outside of those programs.

3. Human Coalition is one of the contractors providing services under

Texas’s Alternatives to Abortion program (“A2A”). The A2A program was created in 2005 and provides a network of services that promote childbirth and

supports a woman and her family through the early years of raising a baby.

A2A is designed to (1) reduce abortions and improve pregnancy outcomes by

Declaration of Joseph Pagano

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helping women practice sound health-related behaviors and improve prenatal

nutrition; (2) improve child health and development by helping parents provide responsible and competent care for their children; and (3) improve families’ economic self-sufficiency by helping parents continue their education and

find a job. It is my understanding that during the last legislative session, the

Texas Legislature increased the A2A program overall budget for the next biennium from $80 million to $100 million.

4. Through our research and client interaction, we found that a majority

of abortion-determined women who participate in our continuum of care program in Texas, which we also utilize in the A2A program, prefer to carry their

baby to term. Through our continuum of care program, we aim to empower

and support women in changing their circumstances, so they do not feel like

the only choice they have is abortion. The majority of women equipped with

our continuum of care resources decide to parent.

5. We have assisted A2A eligible clients from 234 counties in Texas, and

together, those counties make up 99.84% of Texas’ population. Under A2A, eligible clients must be Texas residents and include biological parents of an unborn child or a child up to three years old. Since June 2018, we have served

over 80,000 eligible clients through A2A. We also serve non-eligible clients

outside of the A2A program. A majority of abortion-determined clients that

come to us through the A2A program contact us within the first six weeks of

pregnancy.

6. Our Contact Center, which we also utilize in the A2A program and is

staffed by trained call agents, coordinates telephone and electronic contact

with our clients. This includes initial intake, care coordination, and qualifying clients for care and program eligibility.

Declaration of Joseph Pagano

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7. Our telecare program, which we also utilize in the A2A program, is

staffed by nurses who identify needs related to pregnancy, parenting, and

adoption, and offer referrals to client care resources, both internal and external. Through the telecare program, we provide counseling, mentoring, and

education to pregnant women regarding such things as childbirth, how to

care for themselves during pregnancy and in the postpartum stage, and how

to quit smoking or drinking alcohol. We also offer parenting counseling and

mentoring, educational materials, and parenting classes to all clients. As part

of our parenting classes, we provide instruction for our clients on child development, infant CPR (A2A only), infant nutrition and newborn care, daycare

(A2A only), and related topics. We also provide adoption counseling and mentoring, referrals, and classes. We provide similar support in educating clients

on how to obtain employment and other life skills.

8. We also offer pregnancy-related services outside the A2A program.

These include pregnancy tests, limited ultrasounds, OB/GYN referrals (and

we follow up with patients to ensure that first appointment has been made,

which is critical for prenatal care) and referrals for STI testing.

9. Those services are also provided in our telecare or in-person clinics,

where we additionally provide material assistance such as diapers, wipes, car

seats, formula, baby clothes, cribs, and breast pumps.

10. We strive to maintain continuing periodic contact to ensure that our

clients feel supported and can access the services they need. Our client care

staff follows up with clients on a weekly to monthly basis during pregnancy

through delivery, and, if necessary, post-delivery for such time as may be

needed.

11. We also recognize that pregnancy care is only one aspect of supporting and caring for women who may be facing an unplanned pregnancy, so we

Declaration of Joseph Pagano

Supp.App.012a

Page 3 of 6

aim to provide a continuum of care, which we also utilize in the A2A program.

Our continuum of care program includes social workers and is designed to

develop individualized care plans for clients with the goal of providing nearand long-term stability to promote healthy pregnancies and positive life outcomes. As part of that, our social workers screen clients for eligibility for state

programs and local resources, and help clients enroll in state and federal programs like Medicaid, CHIP (Children’s Health Insurance Program), TANF

(Temporary Assistance for Needy Families), SNAP (Supplemental Nutrition

Assistance Program), WIC (Women Infants and Children Program), Healthy

Texas Women, and Section 8 Housing vouchers.

12. Our social workers also help to support clients in creating a plan to

progress towards stable lives if needed, including finding safe housing, employment, education, and transportation. Our staff also provides personalized

care and emotional support, and helps with material assistance (food banks,

diaper banks, furniture, clothing), adoption, health services, financial assistance, childcare, addiction resources, rental and utilities assistance, and

mental health services. The types of services women seeking abortion request

and their approximated frequency are reflected in the categories below:

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13. Since September 1, 2021, clinics report clients are acting more quickly when they become pregnant. Women considering abortion seek out sonogram services from our clinics earlier to confirm pregnancy and engage abortion services. Specifically, many clients pre-schedule their abortions in Oklahoma prior to contacting Human Coalition for services. Pregnant women in

Texas continue to steadily identify and use numerable alternatives to abortion, including seeking adoption placements. Truly abortion determined clients continue to access abortion in three primary ways: before their child’s

heartbeat being detected, by traveling to neighboring states to obtain an

abortion, or by ordering abortion pills online.

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14. Based upon responses received to exit surveys provided to abortiondetermined clients of Human Coalition in the State of Texas, over 95% stated

that they would recommend our clinic to a family member or friend.

15. Many Human Coalition clients are unaware that any public or private assistance for the needs in paragraph 12, and/or do not know how to access it.

16. Human Coalition works with and refers to hundreds of Texas organizations that assist and support pregnant women so that they can raise their

children.

I declare under penalty of perjury that the foregoing is true and correct.

Dated this 20th day of October, 2021.

s/ Joseph Pagano

Joseph Pagano

Declaration of Joseph Pagano

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