Foothill Church v. Watanabe

• Decision Date: 02 February 2023
• Docket Number: 2:15-cv-02165 KJM EFB
• Parties: Foothill Church, et al., Plaintiffs, v. Mary Watanabe, in her official capacity, as Director of California Department of Managed Healthcare, Defendant.
• Court: U.S. District Court — Eastern District of California

Foothill Church, et al., Plaintiffs, v. Mary Watanabe, in her official capacity, as Director of California Department of Managed Healthcare, Defendant.

No. 2:15-cv-02165 KJM EFB

United States District Court, E.D. California

February 2, 2023

ORDER

The court has summarized the background of this litigation in its previous order granting summary judgment for the plaintiff churches on their Free Exercise Clause claim and granting defendant's motion for summary judgment on plaintiffs' Equal Protection Clause claim. See Prev. Order (Aug 24, 2022) at 1-15, ECF No 129.^[1] Only a brief summary is necessary here.

In July 2018, counsel for plaintiffs Foothill Church, Calvary Chapel Chino Hills and Shepherd of the Hills Church (the Churches) sent a letter to California's Department of Managed Health Care (DMHC) requesting an exemption from the DMHC's abortion care coverage requirement. Riess Decl Ex. Y (Letter from plaintiffs' counsel to DMHC) at 2, ECF No. 110 28. Defendant Mary Watanabe is the DMHC's Director. The Churches did “not object to providing coverage for abortions when absolutely necessary to save the life of the mother, but their religious beliefs prohibit them from covering elective abortions under any other circumstance . .” Id. at 3.^[2] California's Attorney General responded, arguing the DMHC could only consider granting exemptions to health plans, not employers or other plan customers. Riess Decl., Ex. Z (Letter from DMHC's counsel to plaintiffs' counsel) at 2-3, ECF No. 110-29.

In August 2022, as noted, the court granted summary judgment for the Churches on their Free Exercise Clause claim, finding the state's Knox-Keene Act provides a “system of individual exemptions,” see Fulton v. City of Philadelphia, Pennsylvania, 141 S.Ct. 1868, 1881 (2021) (quoting Church of Lukumi Babalu Aye, Inc. v. City of Hialeah, 508 U.S. 520, 546 (1993)), and the DMHC's policy of not considering exemption requests from employers was not narrowly tailored to serve a compelling interest, Prev. Order (Aug. 24, 2022) at 17-20. The court directed the parties to file supplemental briefing on remedies and the scope of injunctive relief. Id. at 22. The parties have submitted supplemental briefs and responses. See Pls.' Suppl. Br., ECF No. 132; Def.'s Suppl. Br., ECF No. 135; Pls.' Resp. to Def.'s Suppl. Br. (Pls.' Resp.), ECF No. 136; Def's Resp. to Pls.' Suppl. Br. (Def.'s Resp.), ECF No. 137. The Churches seek a permanent injunction for themselves and all religious employers with sincere religious objections to providing abortion care coverage. Defendant Director Watanabe argues any injunction should apply only to the Churches and include coverage for abortion care services where the life or health of the pregnant person is at risk.

For the following reasons, the court grants a permanent injunction as described below.

I. DISCUSSION

A. Legal Standard for Permanent Injunction

“According to well-established principles of equity, a plaintiff seeking a permanent injunction must satisfy a four-factor test before a court may grant such relief. A plaintiff must demonstrate: (1) that it has suffered an irreparable injury; (2) that remedies available at law, such as monetary damages, are inadequate to compensate for that injury; (3) that, considering the balance of hardships between the plaintiff and defendant, a remedy in equity is warranted; and (4) that the public interest would not be disserved by a permanent injunction.” eBay Inc. v. MercExchange, L.L.C., 547 U.S. 388, 391 (2006). The court considers the totality of the circumstances when determining if a permanent injunction is appropriate. La Quinta Worldwide, LLC v. Q.R.T.M., S.A. de C.V., 762 F.3d 867, 880 (9th Cir. 2014). For elements (3) and (4), “[w]hen the government is a party, the balance of equities and public interest factors merge.” Nat'lAss'n of Wheat Growers v. Becerra, 468 F.Supp.3d 1247, 1265 (E.D. Cal. 2020).

In deciding on a remedy, “[a] district court has considerable discretion in fashioning suitable relief and defining the terms of an injunction.” Lamb-Weston, Inc. v. McCain Foods, Ltd., 941 F.2d 970, 974 (9th Cir. 1991). However, such relief must be “no more burdensome to the defendant[] than necessary to provide complete relief to the plaintiffs.” Califano v. Yamasaki, 442 U.S. 682, 702 (1979). This is especially true when a court is directing a state agency to act in a certain manner. Melendres v. Maricopa Cnty., 897 F.3d 1217, 1221 (9th Cir. 2018) (“Federalism principles make tailoring particularly important where . . . plaintiffs seek injunctive relief against a state or local government.”). Likewise, “[a]n injunction must be narrowly tailored to remedy the specific harm shown.” Aviation Consumer Action Project v. Washburn, 535 F.2d 101, 108 (D.C. Cir. 1976); see also Lamb-Weston, Inc., 941 F.2d at 974 (relief “must be tailored to remedy the specific harm alleged”)); Bresgal v. Brock, 843 F.2d 1163, 1170 (9th Cir. 1987) (if relief can be “structured on an individual basis, it must be narrowly tailored to remedy the specific harm shown”). Indeed, an “overbroad injunction is an abuse of discretion.” Lamb-Weston, Inc., 941 F.2d at 974 (citations omitted).

A court must also “state the reasons why [the injunction] issued; state its terms specifically; and describe in reasonable detail . . . the act or acts restrained or required.” Fed.R.Civ.P. 65(d). The court is obligated to craft an understandable and thus enforceable injunction, i.e., it cannot be “impermissibly vague.” Portland Feminist Women's Health Ctr. v. Advocates for Life, Inc., 859 F.2d 681, 685 (9th Cir. 1988); see also Schmidt v. Lessard, 414 U.S. 473, 476 (1974) (“[Rule 65(d)] was designed to prevent uncertainty and confusion on the part of those faced with injunctive orders, and to avoid the possible founding of a contempt citation on a decree too vague to be understood”); United States v. Holtzman, 762 F.2d 720, 726 (9th Cir. 1985) (interpreting Schmidt to mean “the language of injunctions . . . [must] be reasonably clear so that ordinary persons will know precisely what action is proscribed”).

B. Analysis

1. Permanent Injunction

The Churches succeeded on the merits of their motion for summary judgment on their Free Exercise Clause claim and therefore satisfy the four-factor test entitling them to permanent injunctive relief on this claim. See Prev. Order (Aug. 24, 2022).

First, the Churches have established irreparable injury by showing the State violated their rights guaranteed by the Free Exercise Clause by refusing to consider their exemption request. See id. at 16-20; see also Valle Del Sol Inc. v. Whiting, 709 F.3d 808, 828 (9th Cir. 2013) (“[t]he loss of First Amendment freedoms, for even minimal periods of time, unquestionably constitutes irreparable injury” (quoting Elrodv. Burns, 427 U.S. 347, 373 (1976))). Second, the only relief plaintiffs request that is available and appropriate for this First Amendment violation is injunctive relief. See Second Am. Compl. at 31, ECF No. 71; Pls.' Suppl. Br. at 6. Third, the balance of hardships between the Churches and DMHC warrants injunctive relief. The right to Free Exercise is a core constitutional right. Furthermore, the Director of the DMHC may for “good cause” exempt a plan or plan contract from the statute's “basic health care services” requirement, see Cal. Health & Safety Code § 1367(i), and the Director may “waive any requirement of any rule or form where in [her] discretion that requirement is not necessary,” see id. § 1344(a). There is no competing interest to balance. As this court previously observed, nothing in the Knox-Keene Act “appears to preclude the Director from fielding requests from religious claimants,” or from “directing the religious claimant's plan to submit a revised evidence of coverage document comporting with the religious claimant's belief to the DMHC for approval.” Prev. Order (Aug. 24, 2022). Finally, regarding the fourth factor, the public interest as described in the DMHC's motion for summary judgment would not be disserved by a permanent injunction. See Def.'s Mot. for Summ. J. (Def.'s MSJ) at 18-25, ECF No. 110. As noted above, this element merges with the third when the government is a party. Wheat Growers, 468 F.Supp.3d at 1265. But on its own, “it is always in the public interest to prevent the violation of a party's constitutional rights.” Am. Beverage Ass'n v. City & Cnty. of San Francisco, 916 F.3d 749, 758 (9th Cir. 2019) (quoting Melendres v. Arpaio, 695 F.3d 990, 1002 (9th Cir. 2012)).

2. Scope of Injunction

Finding a permanent injunction appropriate, the court considers the parties' competing arguments regarding the scope and contours of such an injunction.

The court first briefly reviews what its summary judgment order did and did not address. This litigation began in 2015 see Compl., ECF No. 1, when the Churches challenged the DMHC's decision to issue a letter to seven health plans directing the plans to remove any limitations or exclusions of abortion services from the health care coverage they offered, see Riess Decl., Ex. U (Aug. 22, 2014 letters from DMHC to seven plans), ECF No. 110-24. In mid-2018, after this court had submitted the State's third and final motion to dismiss for decision, the Churches asked the DMHC for a religious exemption. Riess Decl., Ex. Y (Letter from plaintiffs' counsel to DMHC) at 2. A few months later, the DMHC responded it could not consider requests from employers. Riess Decl., Ex. Z (Letter from DMHC's counsel to plaintiffs' counsel) at 2-3. After this court granted the DMHC's third motion to dismiss in 2019, see Church v. Rouillard, 371 F.Supp.3d 742 (E.D. Cal. 2019), the Churches appealed. In 2021, the Ninth Circuit remanded for this court to...