Four states—Connecticut, Colorado, Illinois and Vermont—expressly prohibit anti-abortion clinics from deception or fraud. “If the medical provider does not lie,” Rep. Margaret Croke said, “they have nothing to worry about.”
On Thursday, July 27, Illinois Governor J.B. Pritzker (D) signed “The Deceptive Practices of Limited Services Pregnancy Centers Act” (SB 1909) into law, prohibiting anti-abortion “crisis pregnancy centers” (CPCs) from using deception or fraud to interfere with a person seeking access to abortion or other reproductive health services. The law became effective as of signing.
“Women need access to comprehensive, fact-based healthcare when making critical decision about their own health—not manipulation or misinformation from politically motivated, non-medical actors,” said Pritzker. “By empowering the attorney general’s office to battle deceptive practices, we’re ensuring Illinoisans can make their own decisions about their bodies using accurate and safe information.”
“Misinformation is a form of injustice, particularly when it is used in an attempt to control women’s healthcare decisions,” added Lt. Governor Juliana Stratton. “In Illinois, we refuse to accept anything less than bodily autonomy for all, and that includes the right to accessible and accurate medical information. We are committed to protecting Illinoisans from these manipulative tactics and ensuring all have the power to choose what is best for their futures.”
Illinois is the fourth state, following Connecticut, Colorado and Vermont, to enact a law reigning in the deceptive practices of CPCs, also known as limited service pregnancy centers (LSPCs), which often masquerade as reproductive health clinics to lure vulnerable women, and use lies and disinformation about abortion to pressure them to carry pregnancies to term.
SB 1909 amends the Illinois Consumer Fraud and Deceptive Business Practices Act to prohibit LSPCs from engaging in “deceptive, fraudulent, and misleading advertising and practices that interfere with an individual’s ability to make autonomous, informed, and evidence-based decisions” about their reproductive healthcare and access “quality reproductive health care that adheres to accepted standards of medical practice or care.”
Under the law, LSPCs may not engage in “deception, fraud, false pretense, false promise, or misrepresentation, or the concealment, suppression, or omission of any material fact…in conducting, providing, or performing pregnancy-related services.” The law empowers the Illinois attorney general to investigate any LSPC accused of deceptive practices, and empowers individuals to make a formal complaint about any LSPC using deceptive, misleading or fraudulent practices. Any center found in violation will be assessed a civil penalty up to $50,000.
In applying to both deceptive advertising and fraudulent practices, the Illinois law goes far beyond the Connecticut, Colorado and Vermont laws, which address advertising and, in Colorado and Vermont, specific standards of practice. (Colorado’s law bans “abortion pill reversal” and Vermont’s law establishes basic medical standards for LSPCs.)
Public Officials, Providers and Advocates Called for CPC Accountability in Illinois
The Illinois House passed SB 1909 on a 70-40 vote in April, following a state Senate vote of 36-19 in favor in March.
During House debate, state Representative Dagmara Avelar recounted her experience at a CPC.
“Back in 2010, I walked into one of these fake clinics. I asked for my options. Abortion was out of the question. When I’m demanding for my options to be laid out in a way where I know that I could make an educated decision, that clinic failed. So I am here 13 years later, saying that this is the right thing to do,” said Avelar. “As a Latina, as somebody who has seen these fake clinics prey on our community, preying on people who lack the understanding of how the healthcare system works here in the U.S., people who have limited English proficiency, I’ve seen it happen.”
Illinois Attorney General Kwame Raoul described witnessing deceptive CPC tactics firsthand on a visit to a Planned Parenthood clinic.
“People who appeared as though they might work at the health center were outside with a sign that said to check in, and they were attempting to redirect us away from the health center,” Raoul said in a statement supporting SB 1909. “Patients report being misled into going to crisis pregnancy centers—sometimes even receiving exams and ultrasounds—thinking they were visiting another clinic that offers the full range of reproductive care. As a result, patients may disclose personal medical information, unaware the center may not keep that information private and confidential.
“By signing this law at a time when reproductive health access faces continued attacks in other states,” he continued, “Governor Pritzker is helping to protect patients who seek care in Illinois from these extreme violations of trust and privacy.”
As a Latina, as somebody who has seen these fake clinics prey on our community, preying on people who lack the understanding of how the healthcare system works here in the U.S., people who have limited English proficiency, I’ve seen it happen.
Rep. Dagmara Avelar
The chief medical officer at Planned Parenthood of Illinois, Dr. Amy Whitaker, also attested to ways CPCs harm patients in Illinois.
Whitaker recounted a recent case at her clinic in which a patient brought ultrasound images from her visit to a CPC that did not resemble medical ultrasound images, and the clinic staff realized that “the patient had been misinformed and had not actually received anything close to the standard of care for pregnancy diagnosis and assessment.” Planned Parenthood performed an ultrasound and discovered she had a rare complication—a nonviable “molar pregnancy,” which can cause cancer if left untreated.
“It is an outrage that the patient had been led to believe that she had received legitimate healthcare for her pregnancy, when really she was given the wrong information that could have caused severe health issues,” said Whitaker. “[SB 1909] is not intended to close down any organization; rather, it holds accountable those that systematically employ deception, fraud and false pretense in order to sway a patient’s healthcare decisions.”
In 2019, Illinois enacted the Reproductive Health Act, which established abortion a fundamental right. After the U.S. Supreme Court overturned the federal right to abortion in Dobbs v. Whole Women’s Health Organization, many states in the South and Midwest banned abortion and a flood of patients are now traveling to states like Illinois that protect abortion access. Planned Parenthood of Illinois reports 25 percent of their patients now come from other states—up from 7 percent before Dobbs.
At their Waukegan clinic, out-of-state patients outnumber Illinois patients—57 percent of Waukegan Planned Parenthood patients have traveled from one of 34 other states for care.
In response, the anti-abortion movement is expanding its network of crisis pregnancy centers to intercept women seeking abortion, stepping up use of deceptive advertising; disinformation about abortion, contraception and pregnancy; and non-medical ultrasounds to persuade women to carry to term and falsely signal medical legitimacy—all while collecting their personal and health information, with no privacy protections.
If the medical provider does not lie, they have nothing to worry about.
Rep. Margaret Croke
In Illinois, anti-abortion CPCs outnumber abortion clinics by almost three to one – there are currently 97 CPCs in the state compared with 35 abortion clinics and nine virtual providers. And a new report finds, since Dobbs, CPCs are spending twice as much on deceptive Google ads in states where abortion is legal than in states with bans.
“The state of Illinois has seen an unprecedented influx of abortion-seeking patients from other states since the Dobbs decision,” said Lisa Battisfore, founder and president of Reproductive Transparency Now (RTN), which led the effort to pass SB 1909.
“Abortion seekers from out-of-state, and from areas in Illinois that lack adequate abortion access, must overcome large logistical and financial hurdles to access basic healthcare. CPCs and the people who support them know this and use it as an opportunity to create additional barriers and rob people of their bodily autonomy.”
According to Battisfore, the director of the ‘Hope Life Center’ CPC in Illinois told lawmakers at a House hearing on SB 1909 that many anti-abortion abortion activists will do ‘whatever it takes’ to achieve their mission.
“’Whatever it takes,’” said Battisfore. “That is a frightening statement when you’re talking about intentionally robbing people of making a fully-informed decision that affects the entire trajectory of their health, family and future.”
At the final hearing on the bill, a pregnant lawmaker spoke to the importance of its passage.
“The fact that we have laws in place that could protect me from buying a bad car, but not receiving information that could potentially threaten my life is completely ridiculous,” said state Rep. Margaret Croke. “If the medical provider does not lie, they have nothing to worry about.”
Local government officials are pledging to enforce the new law. “It has always been against state law to mislead or deceive consumers in Illinois,” said Lucy Prather, an attorney at the with the Chicago Department of Law. “With the Deceptive Practices of Limited Services Pregnancy Centers Act, the Illinois legislature reaffirmed its commitment to protecting pregnant people from misinformation and deception. The city of Chicago is aligned with the state in our shared goal of ensuring that pregnant people get the information and care they need to make the best choices for themselves.”
Growing Trend of States Holding CPCs Accountable for How They Advertise and Operate
In July 2021, Connecticut became the first state to pass a law prohibiting deceptive advertising about pregnancy-related services. Public Act No. 21-17 prohibits deceptive advertising “in any newspaper or other publication, through any advertising device, or in any other manner, including, but not limited to, through use of the Internet,” and charges the state attorney general to take legal action against any limited service pregnancy center violating the law and to seek injunctive relief such as corrective advertising, civil penalties up to $500, and attorneys’ fees.
In April 2023, Colorado became the second state to prohibit deceptive LSPC practices, when Gov. Jared Polis (D) signed “The Deceptive Trade Practice Pregnancy-Related Service Act” (SB 23-190), making it a deceptive trade practice in Colorado “for a person to make or disseminate to the public any advertisement that indicates, directly or indirectly, that the person provides abortions, emergency contraceptives, or referrals for abortions or emergency contraceptives when the person knows or reasonably should have known that the person does not provide those specific services.”
The Colorado law is also the first in the country to identify provision of “abortion pill reversal” (APR) as “unprofessional conduct” unless all three state medical boards determine it is an acceptable standard of practice by October 2023. APR is an unproven high-dose progesterone intervention the anti-abortion movement claims can stop a medication abortion. The American College of Obstetricians and Gynecologists strongly disavows APR as “unethical” and “not based on science.”
And in May 2023, Vermont Gov. Phil Scott (R) signed S 37/ACT 15, an omnibus reproductive rights law that includes an “Unfair and Deceptive Act” that makes LSPCs subject to the state’s consumer protection laws prohibiting false and deceptive advertising in commerce, and grants authority to the Attorney General to investigate and bring civil suits against centers in violation.
The Vermont law also establishes basic medical standards for LSPCs, the first state law to do so, by requiring that licensed providers “who are employed by, contracted to provide services for or on behalf of, or volunteer to provide services at a limited-services pregnancy center shall be responsible for conducting and providing health care services, information, and counseling at the center,” and and that their failure to do so “in accordance with State law and professional standards of practice may constitute unprofessional conduct under State law.”
Concurrently, lawmakers in at least five other states have introduced bills to prohibit deceptive advertising by LSCPs this year: California, Massachusetts, Maine, Missouri and New Jersey.
And attorneys general and health agencies in California, Massachusetts, Minnesota and New Jersey have issued consumer advisories about deceptive CPC practices and created new avenues for consumer complaints since Dobbs. States are also developing policy approaches to address specific CPC practices.
California and Washington state enacted new laws to protect the privacy of reproductive healthcare data, and bills were introduced in Arizona, California, Kentucky, Massachusetts, Minnesota, New Jersey, Pennsylvania, South Carolina, and Texas address data privacy, ultrasound provision, public funding and a need for public education about CPCs.
Right-Wing Legal Groups Challenge CPC Accountability Measures Around the U.S.
Anti-abortion groups claim any accountability measure violates the free speech and religious rights of crisis pregnancy centers, and a well-resourced ecosystem of conservative Christian advocacy groups with a sweeping agenda to limit the rights of women and LGBTQ+ people is backing CPC legal challenges to state actions across the country.
Connecticut
In October 2021, the Arizona-based “Alliance Defending Freedom” (ADF) brought a constitutional challenge to the Connecticut law prohibiting deceptive CPC advertising on behalf of Care Net, an evangelical Christian network of CPCs headquartered in Virginia. ADF identifies as “the world’s largest legal organization committed to protecting religious freedom, free speech, the sanctity of life, parental rights, and God’s design for marriage and family.”
Two recent Guardian exposes identify ADF as a “hate group” driving legislation and lawsuits to overturn same-sex marriage, strip trans people of new rights, and enact a total ban on abortion. Recent high-profile ADF clients include anti-abortion plaintiffs challenging FDA approval of the abortion pill, mifepristone, and the Colorado website designer who won the June 2023 U.S. Supreme Court ruling that it is her First Amendment right to refuse services to same-sex couples.
On Jan. 12, 2023, ADF and Care Net voluntarily withdrew their lawsuit, leaving the Connecticut law in full effect. On June 21, 2023, Connecticut Attorney General William Tong appointed two new special counsels for reproductive rights, charged with developing a reproductive rights litigation and policy agenda for the state.
Colorado
In Colorado, Washington, D.C.-based “Becket Fund” has brought a court challenge to the S190 provision prohibiting “abortion pill reversal.” Becket Fund, which calls itself the “premier religious liberty law firm in the U.S.,” claims the Colorado law violates a Denver-based Catholic CPC’s First Amendment right to religious freedom.
Becket Fund is best known for representing the owners of the Hobby Lobby company in their successful U.S. Supreme Court challenge to the Affordable Care Act’s contraceptive coverage mandate. In Burwell v. Hobby Lobby, Becket Fund’s clients won a conservative majority ruling that a for-profit company can deny contraception coverage to its employees based on the religious beliefs of its owners.
On April 17, a Trump-appointed federal judge in Colorado issued a temporary restraining order halting enforcement of S190’s APR ban against the Denver CPC.
On April 28 the judge lifted the order when state officials declared they will not enforce the provision until the medical boards determine whether APR is an acceptable practice. The Colorado ban on deceptive CPC advertising is in full effect.
Massachusetts
In Massachusetts, Texas-based “First Liberty Institute” is representing a coalition of CPCs to demand withdrawal of the attorney general’s consumer advisory on crisis pregnancy centers, and to threaten local officials considering CPC accountability measures.
First Liberty also represented the global CPC network, Heartbeat International (HBI), in refusing Sen. Elizabeth Warren’s (D-Mass.) formal requests for information about how HBI gathers, protects and shares the personal data of pregnant people. First Liberty Institute brings lawsuits around the country on behalf of anti-abortion and anti-LGBTQ rights activists.
Trump-appointed Texas judge Matthew Kacsmaryk, who ruled in favor of anti-abortion plaintiffs challenging FDA approval of the abortion drug mifepristone in April, served as First Liberty’s deputy general counsel from 2014-2019.
New Jersey
In New Jersey, Virginia-based “National Institute of Family and Life Advocates” (NIFLA) is backing CPCs challenging the consumer alert issued by Attorney General Matthew J. Platkin. NIFLA is an evangelical Christian law firm founded to provide legal support to the CPC movement. Since the 1990s, the group has led CPC efforts nationwide to use ultrasound “to introduce mothers to their unborn children.”
In 2015, NIFLA represented California CPCs in a constitutional challenge to the California FACT Act requiring CPCs to post information about state programs providing low-cost or free contraception and abortion. In 2018, the conservative majority of the U.S. Supreme Court ruled in NIFLA v. Becerra to invalidate the California law under the First Amendment.
On February 27, 2023, a NIFLA-backed New Jersey consortium of CPCs filed a lawsuit against the state of New Jersey for consumer alert-related documents. On July 25, 2023, NIFLA and Alliance Defending Freedom filed a case challenging Vermont’s ACT 15 as unconstitutional.
Illinois
And now, in Illinois, NIFLA has filed a federal lawsuit to block enforcement of SB 1909.
The Illinois case is backed by Thomas More Society, a national Catholic group that brings lawsuits opposing abortion, gay marriage, transgender rights and vaccine mandates. Thomas More Society, which recently represented the Texas man who sued his ex-wife’s friends for wrongful death because they helped her access abortion pills, also plays a central legal role in the election denialism movement, “sowing doubts about election integrity as part of its long-term strategy to battle abortion rights,” according to a recent ProPublica expose.
This network of right wing legal groups claim all state CPC accountability measures are unconstitutional under the NIFLA v Becerra ruling, despite the fact that none of the state laws passed or consumer advisories issued include any information posting provisions ruled unconstitutional in that case.
“Anti-abortion crisis pregnancy centers and the massive organizations that support them have managed to largely fly under the radar for decades,” said Battisfore. “The Supreme Court ruling in NIFLA v. Becerra brought CPCs to the forefront of the conversation, but created a landscape where politicians and elected officials were apprehensive about taking a stand against them for fear of time- and resource-consuming lawsuits.The deceptive advertising law in Connecticut set a new standard for abortion ‘safe states’ and paved the way for SB 1909, a crucial first step in holding CPCs accountable for intentionally deceiving abortion seekers in Illinois.”
But Battisfore cautions that accountability will depend on members of the public knowing how to identify when they have been deceived by a CPC and how to report violations of the new law.
“Every person who supports bodily autonomy and abortion access has the power to make a difference,” said Battisfore. “Identify the CPCs in your community, educate your neighbors about CPCs’ anti-abortion agenda and tactics, and support organizations that provide material support and resources to pregnant people and needy families with no strings attached.”
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