Comprehensive Health of Planned Parenthood Great Plains v. Hawley
Opinion
Invoking the Constitution to enjoin the laws of a state requires more than "slight implication and vague conjecture."
Fletcher v. Peck
, 10 U.S. (6 Cranch) 87, 128,
I.
The roots of this case can be traced to 2007. That year, the Missouri legislature amended the statutory definition of "ambulatory surgery center" ("ASC") to include most facilities that performed abortions.
1
A number of consequences followed, two of which are at issue here. The first flows from statutory language. By law, all doctors who perform abortions at ASCs must be "privileged to perform surgical procedures in at least one licensed hospital in the community."
The second consequence at issue flows from enacting regulations. The Missouri Department of Health and Senior Services ("DHSS") has delegated authority to enact health and safety regulations for abortion facilities.
A.
This is not the first time these laws have been challenged. Prior to the current suit, Appellee Comprehensive Health of Planned Parenthood Great Plains ("Comprehensive Health") brought facial and as-applied challenges to the statutory classification of abortion facilities as ASCs almost immediately after the provision went into effect in 2007. 3 Comprehensive Health succeeded in its as-applied challenge only. The district court enjoined the ASC statutory classification (and attendant requirements) for two facilities Comprehensive Health operated: one in Kansas City and one in Columbia.
Comprehensive Health and the State of Missouri settled the lawsuit in 2010 ("2010 Settlement"). The parties agreed to modifications of the requirements of the Physical Plant Regulations for the Columbia facility and a complete waiver of the requirements for the Kansas City facility. And Comprehensive Health agreed to release any claims "whether or not now known or contemplated" that are "based on or arising out of the allegations in Lawsuits relating to licensure of the Columbia and [Kansas City] Centers."
B.
The 2010 Settlement was not the last word, however. After the Supreme Court's decision in
Whole Woman's Health v. Hellerstedt
, --- U.S. ----,
Unlike its initial suit, Comprehensive Health is joined here by Reproductive Health Services of Planned Parenthood of the St. Louis Region ("RHS"), and Dr. Ronald Yeomans-a gynecologist who wishes to provide abortions at Comprehensive Health facilities in Missouri. Together, Comprehensive Health and RHS represent every facility that provides or is seeking to provide abortions in Missouri: Comprehensive Health operates facilities in Kansas City and Columbia, and RHS operates a facility in St. Louis and has plans to operate in Springfield and Joplin. The complaint here sought declaratory and injunctive relief to roll back the 2007 amendment which classified (most) abortion facilities as ASCs. It also sought specific relief from the Hospital Relationship Requirement. Both the ASC classification and the Hospital Relationship Requirement were challenged on substantive due process and equal protection grounds. 4
After evidentiary submissions and a brief hearing, the district court issued a slightly narrower preliminary injunction. It preliminarily enjoined enforcement of the Hospital Relationship Requirement-as well as certain associated criminal penalties for doctors who violate it-and the Physical Plant Regulations solely on substantive due process grounds. In doing so, it found that
Hellerstedt
"controls [its] ruling." Because of that, it refused to weigh any evidence of benefits of the provisions, likening Missouri's advocacy on this front to an "attempt[ ] to undermine
Brown v. Board of Education
,
Missouri now seeks to vacate the preliminary injunction.
II.
Our review of a preliminary injunction is layered: fact findings are reviewed for clear error, legal conclusions are reviewed de novo, and the "ultimate decision to grant the injunction" is reviewed for abuse of discretion.
McKinney ex rel. NLRB v. S. Bakeries, LLC
,
With this framework in mind, we proceed to review the district court's injunction with regards to the Physical Plant Regulations and Hospital Relationship Requirement separately.
A.
Missouri first argues that the Physical Plant Regulations were improperly enjoined because the Appellees had not "ripened" their claims. Drawing on administrative law jurisprudence, they argue "[w]here a regulatory regime provides for variances, a constitutional challenge to those restrictions is not ripe until the challenger has sought-and been denied-a variance." So because none of the facilities run by Appellees had utilized the Waiver Provision, the district court's injunction of the Physical Plant Regulations was improper.
The main case they cite in support of this argument-
Suitum v. Tahoe Regional Planning Agency
,
In fact, it would make little sense to find an exception here. The constitutional question in this case turns on the law's "effect ... on women seeking abortions."
Hellerstedt
,
This is not to say, however, that a facial challenge to the Physical Plant Regulations on substantive due process grounds is justiciable at the present moment. To be clear, while we have said that individual organizations or facilities need not apply for waivers to "ripen" a facial claim, that does not mean we can decide a facial challenge to the Physical Plant Regulations without information about the Waiver Provision. Here, there is scant evidence as to how the Waiver Provision actually operates. As noted above, the record contains only one instance of a request for a minor waiver in normal course. In that case, it was granted with a single page letter from DHSS. In cases like this, the "[r]ules of justiciability" counsel against a decision "based upon [an] amorphous and ill-defined factual record."
Renne v. Geary
,
Refraining from "premature" decisions on facial challenges is a proper exercise of judicial restraint.
See, e.g.
,
Wash. State Grange v. Wash. State Republican Party
,
Hellerstedt
made clear that the undue burden standard "requires that courts consider the burdens a law imposes on abortion access together with the benefits those laws confer."
Appellees underscore just how "cloudy,"
Wash. State Republican Party
,
The district court nevertheless made such a judgment, and we conclude that in doing so it committed an error of law. "It would take a very hardy [DHSS] Director," according to the district court, "to agree voluntarily to establishment of abortion clinics ... out of compliance with ASC standards." And so it enjoined the regulations on the presumption that a DHSS Director would act less than scrupulously on any waiver application.
6
Our starting point, though, is the polar opposite: " '[t]he good faith of [state] officers and the validity of their actions are presumed.' "
Robbins v. Becker
,
In sum, we believe a substantive due process challenge to the Physical Plant Regulations-governed by the "cost-benefit analysis" required by the undue burden standard-is not currently fit for judicial resolution given the paucity of evidence on how DHSS will grant waivers. Again, we emphasize this is distinct from the position Missouri has advocated. We are not holding that a facial claim must be "ripened." We simply hold that we lack sufficient information to make a constitutional determination on the Physical Plant Regulations. Any ruling now would mean "our disposition ... would lack the clarity and force which ought to inform the exercise of judicial authority."
Geary
,
On remand, the district court should not consider a facial challenge on substantive due process grounds to the Physical Plant Regulations. That does not end the matter, though. The Appellees asked for broader injunctive relief from the statutory ASC classification,
B.
We now shift to the Hospital Relationship Requirement. Unlike the Physical Plant Regulations, the Hospital Relationship Requirement operates by statute, is unwaivable, and is enforced by criminal penalty. The district court erred in enjoining it (and related criminal provisions) because the district court did not apply the plain language of Hellerstedt . 7
As noted in our prior discussion,
Hellerstedt
's rendition of the undue burden standard is fairly straightforward: it "requires that courts consider the burdens a law imposes on abortion access together with the benefits those laws confer."
In light of
Hellerstedt
the district court erred in so ruling. On remand, the district court should, at the very least, weigh the state's "asserted benefits." Despite the district court's assertions to the contrary,
Hellerstedt
's analysis of the purported benefits of the law at issue were, of course, related to what the law in that case regulated: abortion in Texas. And so the Supreme Court recognized that "before the act's passage, abortion in
Texas
was extremely safe."
No such determination about abortion in Missouri was made here. Perhaps there was a unique problem Missouri was responding to under its inherent "police power."
See
Barnes v. Glen Theatre, Inc.
,
III.
As a final note, we address the 2010 Settlement Agreement. To re-emphasize, only one current plaintiff, Comprehensive Health, was a party to that agreement. Whether Comprehensive Health stays in the suit or not does not affect the disposition of this case. RHS may properly maintain any of the remaining justiciable facial claims on its own.
10
The district court explicitly did not decide the issue. While we note the broad language in the release, we "decline to decide" in the first instance "whether the release language bars [Comprehensive Health's] claims."
Lynch v. Nat'l Prescription Adm'rs, Inc.
,
IV.
For the foregoing reasons, we vacate the preliminary injunction entered on May 2, 2017 in its entirety and remand for proceedings consistent with this opinion.
The definition of ASC included "any establishment operated for the purpose of performing or inducing any second or third-trimester abortions or five or more first-trimester abortions per month."
The regulations were changed during the pendency of these proceedings to exempt facilities that only provided medicinal abortions.
Comprehensive Health was formerly known as Planned Parenthood of Kansas and Mid-Missouri, Inc.
The suit was brought against various Missouri officials in their official capacities. For ease, we refer to the state appellants collectively as "Missouri."
Appellees also concede that only one of the two remaining facilities is seeking to provide surgical abortions and thus only that facility will be subject to the Physical Plant Regulations. Appellee Br. 4 n.1 (noting that only Springfield facility is seeking to provide surgical abortion).
The district court also suggested in a footnote that the law at issue in
Hellerstedt
contained a waiver provision for abortion facilities.
Hellerstedt
, however, noted that the law before it "neither grandfathers nor provides waivers for any of the facilities that perform abortions."
Missouri argues that Appellees lack standing to pursue a challenge to the Hospital Relationship Requirement if, as we have decided, the Physical Plant Regulations are non-justiciable. They argue that any challenge is not redressable because the Physical Plant Regulations act as an independent barrier to operating abortion facilities. Factually, that is not accurate given the limited scope of the Physical Plant Regulations which apply only to facilities providing surgical abortions. More importantly, as we emphasized earlier, this is a third-party facial challenge. The concern on facial review is whether "in a large fraction of the cases in which [the Hospital Relationship Requirement] is relevant, it will operate as a substantial obstacle to a woman's choice to undergo an abortion."
Planned Parenthood of Se. Pa. v. Casey
,
The district court observed that "
Hellerstedt
's factual conclusions were not confined to Texas" because the "majority relied on Wisconsin and Alabama case law and amicus briefs and materials unrelated to Texas."
Hellerstedt
cited other cases to show that its "answer is consistent with the findings of the other Federal District Courts."
The district court made an attempt at some findings along these lines, but then suggested "[t]he record is not clear enough ... to make findings."
The same attorneys represent Comprehensive Health, RHS, and Yeomans in this action. Missouri does not press any argument on appeal that RHS is covered by the 2010 Settlement.
Reference
- Full Case Name
- COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS, on Behalf of Itself, Its Patients, Physicians and Staff; Reproductive Health Services of Planned Parenthood of the St. Louis, on Behalf of Itself, Its Patients, Physicians, and Staff; Ronald Yeomans, on His Own Behalf and on Behalf of His Patients, Plaintiffs - Appellees, v. Josh HAWLEY, in His Official Capacity as Attorney General of the State of Missouri; Dr. Randall Williams, in His Official Capacity as Director of Department of Health and Senior Services, Defendants - Appellants, Daniel Knight, in His Official Capacity as Boone County Prosecutor ; Jean Peters Baker, in Her Official Capacity as Jackson County Prosecutor ; Dan Patterson, in His Official Capacity as Green County Prosecutor; Theresa Kenney, in Her Official Capacity as Jasper County Prosecutor Defendants. Foundation for Moral Law, Amicus on Behalf of Appellant(s). National Abortion Federation, Amicus on Behalf of Appellee(s). Eagle Forum Education and Legal Defense Fund, Amicus on Behalf of Appellant(s).
- Cited By
- 14 cases
- Status
- Published