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The current case, June Medical Services v Russo (formerly v Gee),1 pits a Louisiana abortion clinic and two doctors against the state’s health secretary over Bill 620, which requires doctors providing abortion services in the state to have hospital admitting privileges. An almost identical law, passed by Texas, was struck down by the Supreme Court in 2016, when conservatives were still in the minority.2 Demanding hospital admitting privileges, the court ruled then, would force about 20 of 40 clinics to close in Texas, imposing an “undue burden” on women’s access to abortion services, something deemed unconstitutional by the court in 1992. The same outcome seems far from guaranteed in the Louisiana case. Since 2016 one judge who ruled against the Texas law has left and two anti-abortion conservatives have come in.