As Texas abortion providers head to court to challenge parts of the state’s new omnibus anti-choice law, representatives of a new reproductive health group, which has applied for nonprofit status, say they will open abortion-providing ambulatory surgical centers (ASCs) with the aim of addressing the impending problem of access to legal abortion in Texas.
Charles Cohen, founder of the new Texas Women’s Reproductive Health Initiative (TWRHI), told RH Reality Check that while most “specialty surgery centers don’t want to get into the emotional and political whirlwind” that comes with providing abortion, he is up to the challenge.
“When HB 2 reared its head, we were looking at, ‘What are we going to do? What are we going to do to capacity in the state as it relates to an abortion facility?'” explained Cohen, who lives in Houston and founded TWRHI with his long-time friend, a Las Vegas OB-GYN named Richard Chudacoff.
Three of HB 2’s restrictions are set to take effect this month, including those that severely restrict medication abortions, ban abortion after 20 weeks, and require abortion-providing doctors to secure admitting privileges at hospitals within 30 miles of where they perform abortions. The last restriction, which requires all abortion facilities to meet the standards of ambulatory surgical centers, does not take effect until September 2014. Only six abortion providers in Texas currently operate as ambulatory surgical centers, and critics say they will be the only ones left open after HB 2’s ASC requirements go into effect. Those providers are currently located in Dallas, Houston, San Antonio, and Austin, which could leave much of Texas without access to an abortion provider after September 2014.
By then, said Cohen, his group will have secured its nonprofit status and, he hopes, raised enough funds, to take over an existing ambulatory surgical center, or to build a new one. Because of the extremely high cost of building an ambulatory surgical center—including extensive physical plant requirements for HVAC systems and wide, gurney-accommodating hallways, among other costly demands—most existing abortion providers do not have the funds to make the ambulatory surgical center modifications or build new facilities from the ground up.
Cohen is confident that TWRHI can increase access to abortion care in Texas, but Cohen’s background in the medical industry has not been without its challenges. As CEO of a company called Deployed Medical Solutions, he was sued—Cohen says wrongfully so—for breach of contract in 2008 and forced to file bankruptcy rather than fight the suit. His company imported a Food and Drug Administration-approved tumor-targeting MRI technology called Xablate from Israel, but was ultimately unable to get its treatment facilities off the ground.
Cohen said that despite this, Texans can trust his stewardship of the TWRHI, because ambulatory surgical centers are his “wheelhouse,” as part of his company, SurgiCare Consulting. Cohen also owns a number of other business ventures, including a not-yet launched doctor’s appointment scheduling website (co-founded with Chudacoff), a medical asset recovery firm, and an aviation asset recovery firm, which he describes as an extension of his “passion” as a pilot. His bankruptcy records also affiliate him with a gold buying business.
Cohen told RH Reality Check that his initial TWRHI facility will be in a major urban area, one that most likely will already have an open and operating abortion-providing ambulatory surgical center, which means TWRHI will not initially do much to increase access to abortion for Texans living in farther-flung parts of the state like El Paso or the Rio Grande Valley. But he said the volume of abortions that his facility can provide in a place like Houston or Dallas can generate the funds needed to support an abortion-providing ASC along the border, or in rural West Texas.
“With support of facilities in major metropolitan areas, that’s a sustainable business model,” said Cohen.
But the launch of the TWRHI has given supporters of HB 2 reason to claim that the law will not be as devastating to abortion access in the state as abortion providers and supporters of reproductive rights have claimed. During Monday’s hearing in Planned Parenthood, et al v. Texas, which challenges the parts of HB 2 that require hospital admitting privileges and restrict the prescription of medication abortion, state attorneys cited the TWRHI as evidence that abortion access would not decrease with the implementation of the law.
To that, Cohen responded, “Shame on them.”
“The people who will support TWRHI will not support TWRHI if they feel that it’s helping the state,” he continued. “They’re enhancing the problem.” For the State of Texas to claim that TWRHI would solve the problem of abortion access caused by HB 2, said Cohen, “it’s like saying we need $13 million, and we’ve got $12,999,999 to go, so we’re right on the cusp of making a dent.”
He also says his abortion-providing ambulatory surgical centers are not a capitulation to the argument that ASC’s necessarily provide a higher standard of care, or that they’re necessary for providing abortions.
“We don’t feel like all abortions need to be performed in an ambulatory surgical center,” said Cohen. “Medically and clinically, it’s probably an overkill.” But if it is what the law requires, said Cohen, and if the ambulatory surgical center requirement won’t be challenged in court, or if challengers won’t succeed in an attempt, it will be the law.
Cohen said that despite political opposition to abortion, he believes that there is enough “grassroots” support for his project.
“If people make a small donation, $50 or $10, we’ll get it done.”