June Medical Services L. L. C. v. Russo
140 S.Ct. 2103, 207 L. Ed. 2d 566 (2020)
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Rule of Law:
A state law requiring physicians who perform abortions to have active admitting privileges at a nearby hospital is unconstitutional if it places a substantial obstacle in the path of women seeking an abortion and offers no significant health-related benefits. This holding is compelled by the doctrine of stare decisis and the precedent set in Whole Woman's Health v. Hellerstedt, which invalidated a nearly identical Texas law.
Facts:
- In June 2014, Louisiana enacted Act 620, which was modeled on a similar Texas law.
- Act 620 required any physician performing an abortion to hold active admitting privileges at a hospital located within 30 miles of the abortion facility.
- Prior to Act 620, Louisiana law permitted abortion providers to either have admitting privileges or a patient transfer agreement with a physician who did.
- At the time of the lawsuit, Louisiana had approximately five doctors providing abortions to roughly 10,000 women annually.
- The physicians who performed abortions in Louisiana made efforts to obtain admitting privileges after Act 620 was passed.
- Most of these physicians were unable to secure admitting privileges for reasons unrelated to their competence, such as hospital opposition to abortion or requirements that doctors admit a minimum number of patients annually, which abortion providers rarely do.
Procedural Posture:
- Several abortion clinics and physicians sued the Louisiana Secretary of Health in the U.S. District Court for the Middle District of Louisiana, seeking to enjoin Act 620.
- After a bench trial, the District Court found Act 620 unconstitutional on its face and issued a permanent injunction preventing its enforcement.
- The State of Louisiana (appellant) appealed the District Court's decision to the U.S. Court of Appeals for the Fifth Circuit.
- A divided panel of the Fifth Circuit reversed the District Court's judgment, finding that Act 620 was constitutional.
- The abortion clinics and physicians (petitioners) sought a writ of certiorari from the U.S. Supreme Court, which was granted.
- The State of Louisiana (respondent) filed a cross-petition for certiorari challenging the petitioners' standing to sue, which was also granted.
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Issue:
Does a state law that requires physicians who perform abortions to have active admitting privileges at a nearby hospital impose an unconstitutional undue burden on a woman's right to an abortion if the law offers no significant health benefits and would drastically reduce the number of available abortion providers in the state?
Opinions:
Plurality - Justice Breyer
Yes. A law that imposes a substantial obstacle to a woman's choice to have an abortion cannot be considered a permissible means of serving legitimate state ends. Applying the balancing test from Whole Woman's Health, the burdens imposed by Act 620 far outweigh its nonexistent health benefits. The District Court's factual findings—that the law would offer no significant health benefits while drastically reducing the number of abortion clinics and providers to as few as one in the entire state—were not clearly erroneous. Given that the Louisiana law and its effects are nearly identical to the Texas law struck down in Whole Woman's Health, the law imposes an unconstitutional undue burden.
Concurring in the judgment - Chief Justice Roberts
Yes. The legal doctrine of stare decisis requires the Court to treat like cases alike, and this law is unconstitutional under the precedent of Whole Woman's Health. The Louisiana law imposes a burden on abortion access that is just as severe as the Texas law struck down in that case, based on factual findings that are not clearly erroneous. While Whole Woman's Health was wrongly decided and its cost-benefit balancing test is inconsistent with the 'substantial obstacle' standard from Casey, the result in that case is a binding precedent that controls the outcome here.
Dissenting - Justice Thomas
No. The Court lacks jurisdiction to hear this case, and even if it did, the Constitution does not protect a right to abortion. The plaintiff abortion providers lack Article III standing to assert the constitutional rights of their patients, and this jurisdictional defect cannot be waived. Fundamentally, the Court's entire abortion jurisprudence, starting with Roe v. Wade, is egregiously wrong as it is based on a constitutional right created from 'whole cloth' with no basis in the Constitution's text. Therefore, these precedents should be overruled, and Louisiana's legitimate state law should be upheld.
Dissenting - Justice Alito
No. The Louisiana law does not impose an unconstitutional undue burden, and the case should be remanded for further proceedings. The majority misapplies stare decisis, as the factual record in this pre-enforcement challenge is different from the post-enforcement record in Whole Woman's Health. The District Court's finding that the law would cause a drastic reduction in providers was based on a flawed 'good faith' legal standard and an inadequate factual inquiry, ignoring the doctors' incentives to fail in obtaining privileges. Furthermore, the law provides legitimate health benefits by ensuring physician competency, and the plaintiffs have a clear conflict of interest in challenging a law designed to protect the very patients whose rights they claim to assert.
Analysis:
This fractured decision reaffirmed the outcome of Whole Woman's Health but weakened its legal foundation, creating uncertainty for future abortion cases. While a majority agreed to strike down the Louisiana law, there was no majority agreement on the legal test. The plurality applied the Whole Woman's Health cost-benefit analysis, but Chief Justice Roberts's controlling concurrence explicitly rejected that test, relying instead on stare decisis and a narrower 'substantial obstacle' standard from Casey. This signals a potential shift in abortion jurisprudence, inviting states to pass new regulations that might survive scrutiny under the narrower Casey standard, even if they would have failed the Whole Woman's Health balancing test.
