Sen. Susan Collins, R-Maine, listens during a Senate Health, Education, Labor, and Pensions Committee hearing, Tuesday, July 20, 2021, on Capitol Hill in Washington. Credit: Stefani Reynolds / The New York Times via AP, Pool

U.S. Sen. Susan Collins called a new Texas law severely restricting abortion “extreme” and criticized the U.S. Supreme Court’s decision to leave it in place amid outcry from abortion-rights activists who decried the senator’s 2018 vote to confirm a conservative justice.

In a 5-4 ruling late Wednesday night, the high court declined to block the implementation of a Texas law that bans abortions after six weeks of pregnancy, even in cases of rape or incest, and allows for civil lawsuits against anyone who helps facilitate an abortion after that point.

It is likely not the final word on the Texas law, but the ruling has thrust Collins, a rare pro-abortion rights Republican, back into the center of a national conversation. She defended her vote for Justice Brett Kavanaugh by arguing that he would respect precedent and not roll back Roe v. Wade, the 1973 landmark decision enshrining abortion rights.

The Texas law outlaws abortions after six weeks of pregnancy, which typically refers to about four weeks after conception and within a week or two of a woman finding out she is pregnant. It will affect the majority of women seeking an abortion in the state, as national estimates suggest about 63 percent of abortions are performed after six weeks of pregnancy.

Rather than criminal penalties, the Texas law allows citizens to sue anyone — such as a doctor, friend or taxi driver — who assists a woman in receiving an abortion after six weeks and recoup a $10,000 award if successful. The court did not address the constitutionality of the law, but said it could not immediately block it because it relies on the civil court system.

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Justices Clarence Thomas, Samuel Alito, Neil Gorsuch and Amy Coney Barrett were in the majority, along with Kavanaugh. That ruling did not address Roe v. Wade, which shields abortion rights in the first two trimesters of pregnancy, but it rendered it irrelevant for the moment in Texas, as clinics no longer offer abortions to women more than six weeks pregnant. Constitutional questions are still being litigated and may return to the high court.

In a Thursday statement, Collins noted the court had questions about the Texas law’s constitutionality and said she disagreed with the decision to leave it in effect while those procedural and constitutional questions are resolved. She noted she had voted to confirm three conservative justices in the majority and three liberal ones in the minority.

“The Texas law is extreme and harmful,” she said.

But the court’s Wednesday decision angered abortion rights activists who protested Collins’ vote to confirm Kavanaugh in 2018, a move that kicked off a heavily nationalized race between the incumbent and former Maine House Speaker Sara Gideon, who lost to Collins in 2020.

Collins “made it clear that she believed that [Kavanaugh] was going to respect precedent, including Roe v. Wade,” said Nicole Clegg, the senior vice president of public affairs at Planned Parenthood of Northern New England.

“Congress has to act, and [Collins] needs to lead and protect the rights that she says are so important to her,” Clegg said.

Congress could pass a law codifying the Roe decision, something Sen. Angus King, an independent who caucuses with Democrats, called for on Thursday. But action is unlikely in the evenly divided Senate.

The ruling has no immediate effect in Maine, which has among the strongest legal protections for abortion rights in the U.S. The Maine Legislature passed several laws expanding access to abortion in 2019, including allowing Medicaid to cover the procedure and allowing nurse practioners and physician assistants to perform abortions early in pregnancy.

Gov. Janet Mills, a Democrat, called the Supreme Court ruling a “a dog whistle to extremists” in a Thursday statement, adding that she would work to ensure similar Maine efforts are defeated.

Under Democratic control of Augusta, a similar law is unlikely to pass in Maine in the next few years, said Carroll Conley, executive director of the evangelical Christian Civic League of Maine, but he said he was encouraged by the Texas ruling.

For now, his group is focused on incremental steps, such as requiring minors to get parental consent for abortions and banning the use of state Medicaid funds to cover the procedure. Those are uphill battles unless Republicans pick up additional legislative seats and take back the governor’s mansion in 2022 or beyond.

“We recognize the political realities,” Conley said.