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This decision overrules a 2018 ruling by U.S. District Judge Greg Stivers, which had said that the regulations on abortion clinics placed too large of a barrier between women and abortion access. EMW Women’s Surgical Center in Louisville and Planned Parenthood of Indiana and Kentucky both sued the state to challenge the law after it closed an abortion clinic that was operating without a license.
The Appeals Court majority opinion writes, “In 1998, the Kentucky General Assembly imposed new licensing requirements on abortion providers in response to concerns about the appalling, unsanitary conditions in some Kentucky abortion facilities.” Live Action News says that the reason the law wasn't challenged for so long is that it was never actually enforced until 2016.