The Supreme Court dealt a blow to states’ ability to investigate anti-abortion pregnancy centers on April 29, 2026, with its ruling in favor of so-called “crisis pregnancy centers.”
Anti-choice pregnancy centers are ideologically-based facilities masquerading as health clinics. In recent years, their conservative anti-choice backers have pushed a national strategy to exempt these centers from basic privacy and accountability regulations, like the Health Insurance Portability and Accountability Act (HIPAA), that health-care facilities must obey.
In First Choice Women’s Resource Centers v. Platkin, the justices were asked to rule on a narrow question: Should a federal or state court determine whether New Jersey may investigate “crisis pregnancy centers” for potentially misleading donors and engaging in unlicensed practices?
New Jersey said its investigation into a statewide chain of “crisis pregnancy centers” called First Choice Women’s Resource Centers stems from concerns that the organization is misleading donors, offering unlicensed practices, violating patient privacy, and making false medical claims. First Choice has refused to comply with the state’s subpoena into its donor information.
The organization and its lawyers appealed the state’s subpoena power to two federal courts, which dismissed the case. So they took it to the Supreme Court. Now, the justices have unanimously agreed that the “crisis pregnancy center” should have the chance to make its case in a federal court.
The decision could weaken one of the last safeguards states can use to regulate “crisis pregnancy centers”—obtaining records to facilitate fraud investigations—by creating a new First Amendment objection to state subpoenas in those probes.
Anti-abortion centers exploit regulatory loopholes
As a reproductive rights attorney and as a Texan who grew up driving past these centers daily while attending religious schools that supported their mission, I have been watching a trend for years: Anti-abortion centers are gaining more exceptions to state regulation.
In Texas, anti-abortion centers are embedded in communities, often positioned near or next to legitimate clinics and frequently affiliated with churches. There are more than 200 across the state.
Anti-abortion “crisis pregnancy centers” are designed to appear as legitimate, trustworthy places for pregnant people to seek care. In practice, however, most are not medical facilities; the privacy and transparency standards that govern actual licensed providers do not apply to anti-abortion counseling centers without medical licensing.
Unlike licensed clinics, for example, most “crisis pregnancy centers” are not subject to credentialing requirements, HIPAA privacy protections, or other accountability regulations.
Without these safeguards, these centers can give pregnant patients inaccurate or misleading information about their options without facing professional discipline or legal liability.
They tend to target their misinformation at vulnerable populations.
Disproportionately located in low-income communities and communities of color, anti-abortion centers frequently advertise “free” pregnancy testing and ultrasounds to attract newly pregnant patients seeking affordable medical care and advice.
Employees rely on a pattern of medical cosplay to make patients think they are receiving actual health care, research has found. Staff may wear white coats—despite lacking medical credentials—and rooms are often designed to look like doctors’ offices.
Yet ultrasounds are used only to confirm a pregnancy—not to provide comprehensive, diagnostic care.
For example, in March 2026, Dallas News reported that when a pregnant woman got a sonogram at Abundant Life Pregnancy Resource Center in Athens, Texas, unlicensed staff members said both she and her fetus were fine. Three days later, she had to have emergency surgery to treat an ectopic pregnancy. The pregnancy was never viable, and it could have been life-threatening.
This is not an isolated incident. Studies have found that roughly 80 percent of anti-abortion centers provide false or misleading information. They may misstate gestational age to delay time-sensitive abortion care, for example, or promote unscientific medical practices like “abortion pill reversal.”
Anti-abortion advocates target federal regulations
“Crisis pregnancy centers” have been effective at attracting patients because they exploit gaps in access to care. And they have significant financial backing for their operations.
While licensed reproductive health clinics struggle for funding, anti-abortion counseling centers are bankrolled by a network of private donors and even taxpayer funds. Other reporting has found that these donors include wealthy conservative philanthropies, large religious organizations, everyday grassroots supporters often motivated by religious and political opposition to abortion, and even the Department of Health and Human Services.
A 2022 analysis from the National Committee for Responsive Philanthropy found that anti-abortion centers outspend abortion funds and clinics by a 5-to-1 ratio.
In 2021, The Alliance, a group of state advocates for women’s rights and gender equality, reported that 29 states direct millions in funding to these centers, and at least ten states divert federal anti-poverty funds away from traditional recipients like cash-assistance programs and child-care programs to support them. This increase in funding has not come with additional scrutiny, allowing religious organizations to spend public money with little monitoring or evaluation.
This whole setup hinges on weak regulation. So proponents of anti-abortion centers are actively working at both the state and nation level to squelch government oversight of their work through law, policy, and litigation.
In 2025, the anti-choice legal organization Alliance Defending Freedom (ADF) developed the Center Autonomy and Rights of Expression (CARE) Act. The objective of this model legislation is to exempt anti-abortion pregnancy centers from the transparency and accountability standards applied to licensed health-care providers.
In states where this legislation gets enacted, regulation is framed as a violation of free speech or religious liberty. That makes it more difficult for states to require accuracy, disclosure, and basic consumer protections.
The ADF is the legal powerhouse behind several landmark anti-rights court decisions. Its lawyers assisted in drafting the abortion restrictions at issue in Dobbs v. Jackson Women’s Health Organization—the Supreme Court decision that ended federal abortion protections—and served on the legal team that argued the case. In 303 Creative LLC v. Elenis, the group helped a conservative Christian graphic designer win the right to refuse her services to gay couples.
In crafting the CARE Act to shield anti-abortion centers from oversight, the organization has relied on First Amendment and religious liberty arguments similar to those it has used to win these cases. The underlying arguments are that government mandates requesting disclosure of service violate the First Amendment as compelled speech and that laws burdening religious practice must yield to “conscience” protections.
The Supreme Court has previously sided with this framing. In addition to 303 Creative, the justices in National Institute of Family and Life Advocates v. Becerra struck down a California law requiring anti-abortion centers to disclose information about state-funded reproductive services.
Kansas’ legislation, enacted in March 2026, mirrors this model to effectively legalize this kind of deception in reproductive care. Other states, including Montana, Oklahoma, Wyoming, and New Hampshire, have pursued similar measures to expand protections and funding while limiting oversight for “crisis pregnancy centers.”
And now, the Supreme Court has weighed in, potentially bolstering the powers of these anti-abortion counseling centers nationwide.
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How SCOTUS shook things up
The Court’s ruling in favor of First Choice could make it harder for states to investigate “crisis pregnancy centers” or impose disclosure requirements, indirectly expanding protections of these anti-abortion organizations.
If this dual strategy—legislation and litigation—continues to succeed, the consequences for U.S. pregnancy care will be profound.
Medical deception is a serious matter. “Crisis pregnancy centers” force people to navigate pregnancy based on incomplete information and outright lies at a medically fragile time when expert health care and honest counsel is pivotal.
Pregnant patients would have little recourse when they realize they’ve visited an unlicensed facility and suffered the health consequences of delayed care, misinformation, and coercion.
States have the tools to regulate fake medical providers. States routinely use consumer protection tools to shut down other dangerous actors, such as unlicensed black-market providers offering discounted medical procedures in unsafe settings.
Carving out an exception for anti-abortion centers creates a double standard that prioritizes an organization’s ideology over the very public safety laws designed to prevent medical deception.
Editor’s note: This is an updated version of a story originally published on April 28, 2026. It was updated to reflect the Supreme Court’s decision in First Choice Women’s Resource Centers v. Platkin.
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