Utah’s Republican Gov. Spencer Cox signed legislation Wednesday that will by next year ban clinics from providing abortions, setting off a rush of confusion among clinics, hospitals and prospective patients in the deeply Republican state.

Administrators from hospitals and clinics have not publicly detailed their plans to adapt to the new law, adding a layer of uncertainty on top of fear that, if clinics close, patients may not be able to access care at hospitals because of a variety of staffing and cost concerns.

With the law set to start taking effect as early as May 3, both the Planned Parenthood Association of Utah and the Utah Hospital Association declined to detail how the increasingly fraught legal landscape for providers in Utah will affect abortion access.

The turmoil mirrors developments in Republican strongholds throughout the United States that have taken shape since the U.S. Supreme Court overturned the Roe v. Wade decision, transformed the legal landscape and prompted a raft of lawsuits in at least 21 states.

The Utah lawmakers have previously said the law would protect “the innocent” and “the unborn,” adding that they don’t think the state needs abortion clinics after the high court overturned the constitutional right to abortion.

Though Planned Parenthood previously warned the law could dramatically hamper its ability to provide abortions, Jason Stevenson, the association’s lobbyist, said Wednesday it would now further examine the wording of other provisions of the law that could allow clinics to apply for new licenses to perform hospital-equivalent services.

Based on Planned Parenthood’s interpretation, he said in an interview, clinics will no longer be able to provide abortions with their current licenses. They plan to continue, however, to provide the majority of their services such as STI and pregnancy testing and cancer screenings. Stevenson said they were “looking closely” at the licensing options in the law, but would not say whether the clinics would apply at this point.

Jill Vicory, a spokesperson for the Utah Hospital Association, said in an email that it was “too early to comment” on whether hospitals could soon be the only abortion providers in Utah, noting each ”will need to make a determination on how they choose to proceed.”

If clinics stop providing abortions, experts are concerned hospitals’ comparatively higher cost of care and staffing shortages will make it harder to get a legal abortion in Utah, even though the law isn’t explicitly a restriction on those seeking them in the state, where they remain legal up to 18 weeks.

Dr. Carole Joffe, a University of California, San Francisco professor who has written about the societal effects of reproductive health care, said stripping clinics of licenses would upend how abortions have been provided for decades. Historically, patients with low-complication pregnancies have mostly received abortions at outpatient clinics, which on average are able to provide them at a lower cost.

“Everything in a hospital is more expensive than in a clinic. Doing an abortion in a hospital, you need more personnel,” she said, noting hospitals, with teams of anesthesiologists, physicians and surgeons have historically provided them in emergency scenarios.

Another challenge facing already overburdened hospitals is staffing, Joffe said, both in terms of recruitment and getting personnel to provide abortions. Especially in states where anti-abortion sentiment runs strong, many physicians or nurses at hospitals may not want to provide them, she added.

“You have to draw from a pool that may or may not be sympathetic to abortion, unlike in a clinic where you don’t go to work at unless you’re committed to abortion being part of health care,” Joffe said.