On March 2, the Supreme Court will hear oral arguments on its biggest abortion rights case in decades, Whole Woman's Health v. Hellerstedt.
The stakes are massive. Abortion access for millions of American women could hang in the balance. So could the power of pro-life lawmakers to restrict abortion when Roe v. Wade is still the law of the land.
And according to a new Vox poll, almost nobody knows that the case is happening. Very few Americans know anything about the anti-abortion laws that have closed about half of Texas abortion clinics and that the Court now has to decide whether to uphold.
But once they hear more information, most of those polled don't support these laws and think they place an "undue burden" on women seeking an abortion. This is significant. It's likely the entire case will turn on those two words — "undue burden" — and on how the justices react to the real stories of women who have been affected by the laws.
Most Americans know almost nothing about the Supreme Court case or the issues at stake
According to the poll, which surveyed 1,060 registered voters and was conducted by the communications firm Perry/Undem, only 15 percent of respondents said they had heard of a new Supreme Court case about abortion. Twenty percent weren't sure, and the other 65 percent said they hadn't heard of it.
It's true that many Americans generally aren't well-informed about the Supreme Court, and they don't always pay close attention to high-profile cases. Shortly before the ruling came out in last year's King v. Burwell case that could have gutted the Affordable Care Act, seven in 10 Americans had heard little or nothing about it.
It's also likely that as we get closer to the ruling expected this summer, and especially after the ruling comes down, more people will become aware of the case. But right now, most people are in the dark.
The American public is also in the dark about the laws at stake in the case — and abortion laws in general.
In our poll, 83 percent of respondents said they don't know or aren't sure about which laws are in place around abortion. That's just "laws" in general, not any specific state or national laws.
Asking more detailed questions about real abortion laws confirmed this. The poll listed eight major abortion laws and asked people whether they think those laws are actually in place either in some states or nationally. Almost half of respondents knew that parents sometimes have to be notified if their under-18 child has an abortion. But fewer than 25 percent knew that the other seven laws are real.
That includes the two laws at issue in Whole Woman's Health v. Hellerstedt, which have already forced about half of Texas abortion clinics to close. If the Court lets them go into full effect, even more clinics will shut down.
One law requires doctors to get admitting privileges, or permission to admit their patients, at a nearby hospital. The other law requires abortion clinics to undergo expensive renovations to become hospital-like ambulatory surgical centers.
Once people learn what the laws do, they oppose them
The Texas laws force clinics to close because they are very difficult, and sometimes impossible, for abortion providers to follow. Supporters of the laws say they protect women's health and safety and sensibly regulate abortion, but most doctors and major medical associations say they have absolutely no medical benefit.
But most people don't know that. How could they, if they haven't even heard of the laws to begin with?
And even if they do hear of the laws — say, through a poll — dry-sounding regulations about "admitting privileges" and "ambulatory surgical centers" seem pretty innocuous. Who would make the connection that changing building codes, or requiring doctors to sign an agreement with a hospital, would become the thing that decimates an entire state's abortion access?
That's why Tresa Undem and Mike Perry designed the Vox poll to inform voters about the laws' effects before asking their opinion. Once informed, more people opposed the laws than supported them. And two-thirds said states that pass these kinds of laws are moving in the "wrong direction."
The poll explained that admitting privileges are difficult for abortion providers to get because hospitals often require doctors to admit a minimum number of patients per year to retain their hospital privileges. But abortion is so safe — safer than wisdom teeth removal — that doctors can't meet that minimum because hospital-level emergencies just don't happen often. And clinics that can't find a doctor with hospital privileges must shut down.
The poll also explained that rebuilding a clinic into an ambulatory surgical center can cost $1 million, that most abortions don't actually require surgery or cutting, and that other outpatient clinics that perform surgical procedures aren't required to convert into ambulatory surgical centers like abortion clinics are.
After reading this information, more respondents opposed the Texas laws than favored them.
Our poll also found that most Americans think abortion is less safe, more rare, more complicated, and less well-regulated than it actually is. So it would make sense if some people think it's a good idea to pass new regulations on abortion — and indeed, people who thought abortion was less safe were also more inclined to support the laws.
That's exactly what the pro-life advocates who designed the Texas laws tell people the laws are — commonsense regulation of a dangerous procedure to protect women's health.
But most people think otherwise once they learn how safe abortion actually is, and why the laws can be a Catch-22 for abortion providers in practice.
It's worth noting that when they first read about the Texas laws and were asked whether they support them, a lot of people said they weren't sure. On admitting privileges, for instance, 27 percent favored them and 42 percent were opposed, but 30 percent weren't sure.
But a later question asked respondents whether they support or oppose several different abortion laws, including laws requiring admitting privileges and ambulatory surgical centers. By the time that question was asked, and once people only had two options, a solid majority said they oppose both laws. They opposed ambulatory surgical centers 58 to 39 percent, and opposed admitting privileges 54 to 42 percent.
"When something's counterintuitive, it takes time and it takes information to think through that," Undem said.
For example, some people had never even heard of admitting privileges before this survey, and their first exposure was a few paragraphs of information.
But it's also not surprising, Undem said, that most people opposed the laws after learning about them. She said she's never seen anything like the "profound" reactions when she ran focus groups on abortion and showed people a simple timeline of anti-abortion laws Texas has passed in the past few decades.
People were shocked and angry. They said they wanted to tell all their friends and call their representatives. They felt ashamed of themselves for not having heard of the laws — but then realized that they pay pretty good attention and that the information just isn't well-distributed.
Our poll also found that 67 percent of Americans think the news media spends more time talking about the politics of abortion than the facts. And given what our other results say about the facts, those 67 percent of Americans are probably right.
Why this Supreme Court case, and the idea of an "undue burden," is important
Whole Woman's Health v. Hellerstedt will rule on the constitutionality of the two Texas laws, which were passed in 2013 as part of an omnibus anti-abortion bill called HB2.
Texas had 44 open abortion providers five years ago. Now it has 19. If the Supreme Court allows the new laws to go into effect, that number will be down to nine.
The central constitutional question is: Do these new laws place an "undue burden" on women who are seeking an abortion, or not? If they do, precedent dictates that the court should strike down the laws. States can regulate abortion in order to protect a woman's health, or to try to persuade her to give birth instead — but they can't put a "substantial obstacle" in her way.
Abortion rights supporters say the laws definitely impose an undue burden. Having so few clinics means longer wait times for a very time-sensitive procedure. It means that many women have to travel long distances and spend a lot of money on things like gas, child care, hotels, or taking unpaid time off work. It could mean that more women will try to take matters into their own hands and self-induce an abortion.
"These clinic shutdowns are creating higher costs, they're creating delays — in some communities up to 20 days," said Amy Hagstrom Miller, CEO of Whole Woman's Health, the abortion provider that is the lead plaintiff in the case. "You can't make the argument that you have women's health and safety in mind when you close 75 percent of licensed abortion facilities with board-certified physicians."
If the Court overturns the Texas laws, it could help open up abortion access nationwide. If not, abortion access may never recover in states like Texas and Louisiana, where courts have allowed the laws to go forward.
The death of Justice Antonin Scalia makes the final outcome more complicated. Before he died, a 5-4 ruling in favor of the Texas laws was a possibility. That could have set a precedent that would unleash the floodgates nationwide for even more anti-abortion lawmaking and even more clinic closures.
Now the best outcome for the pro-life side is probably a 4-4 split that upholds the lower court ruling but sets no precedent because it's a tie. It wouldn't affect the rest of the country, but abortion providers in Texas would still be out of luck.
The Court isn't going to rule based on public opinion. But public opinion can matter more than we think when it comes to the Supreme Court. Either way, it's noteworthy that after our poll told voters what the laws do, about two-thirds of them agreed that the laws place an undue burden on women.
Abortion polling has a lot of problems. Our poll tried to fix some of them.
It's possible that the explanations in the poll could bias respondents. But, Undem said, the alternative is collecting data that tells you nothing meaningful about public attitudes toward abortion.
Take this Ipsos/Reuters poll, which tried to measure public opinion on the Texas laws and found the public divided. Thirty-three percent said the Supreme Court should strike the laws down, 32 percent said the laws should be upheld, and 36 percent said they didn't know.
Looking at how the poll describes the laws, though, it's easy to see how people would be confused or ambivalent.
Should abortion clinics follow the same building standards as "facilities that perform outpatient medical procedures," or hospitals that perform "more invasive" procedures? If you don't know that abortion is typically an outpatient procedure — or if you think it's dangerous and more rigorous standards probably couldn't hurt — you might pick "hospitals."
Or you might just be confused, because what do building standards actually have to do with medicine? And what does any of this have to do with the Constitution?
"How do you measure public opinion on admitting privileges laws when people have no idea how safe abortion is?" Undem said. "How do you measure views on ambulatory surgical center laws when the public has no idea whether abortion is a surgery or whether current health centers are regulated?"
The answer, she said, is that you can't. To get a meaningful sense of what people think of these laws and their effect on abortion, a well-designed poll must explain to voters what the laws actually do.
Conventional wisdom holds that public opinion on abortion is polarized: America is, always has been, and always will be divided in half between "pro-choice" and "pro-life."
As our poll last year showed, this isn't really true. More people have mixed feelings about abortion than strictly identify as pro-choice or pro-life. But one reason people believe abortion is so polarized is that most polls ask poorly designed questions about it — and don't take into account what people actually know about it, or how complicated their feelings can be.
That's why both this year and last, our poll also asks Americans not just about laws or restrictions, but about the experience of the woman having the procedure.
Large majorities want a woman to be supported and respected if she decides to get an abortion, and want her to be able to get an abortion in her community. Seventy percent don't want Roe v. Wade to be overturned.
And if Americans understand that a new law conflicts with those basic values, they are more likely to oppose it.
PerryUndem Research/Communication conducted the survey among n = 1,060 registered voters 18 and older nationwide, January 20 through 27, 2016. The survey was administered among a nationally representative sample of voters, using GfK's KnowledgePanel. The margin of error is +/- 3.7 percentage points. Some results do not add to 100 percent as a result of rounding. Topline results are available here.