June Med. Servs. L. L. C. v. Russo

Decision Date29 June 2020
Docket Number No. 18-1460,No. 18-1323,18-1323
Parties JUNE MEDICAL SERVICES L. L. C. et al., Petitioners v. Stephen RUSSO, Interim Secretary, Louisiana Department of Health and Hospitals; Stephen Russo, Interim Secretary, Louisiana Department of Health and Hospitals, Petitioner v. June Medical Services LLC., et al.
CourtU.S. Supreme Court

Gene C. Schaerr, Erik S. Jaffe, Stephen S. Schwartz, Kathryn E. Tarbert, Schaerr | Jaffe LLP, Washington, DC, William S. Consovoy, Jeffrey M. Harris, Consovoy McCarthy PLLC, Arlington, VA, Jeff Landry, Attorney General, Elizabeth B. Murrill, Solicitor General, Joseph Scott St. John, Deputy Solicitor General, Louisiana Department of Justice, Baton Rouge, LA, for the Respondent/Cross-Petitioner

Jeffrey L. Fisher, O'Melveny & Myers LLP, Menlo Park, CA, Bradley N. Garcia, Samantha M. Goldstein, Kendall Turner, Jeremy Girton, O'Melveny & Myers LLP, Washington, DC, Julie Rikelman, Travis J. Tu, Jessica Sklarsky, Center for Reproductive Rights, New York, NY, Anton Metlitsky, Yaira Dubin, O'Melveny & Myers LLP, New York, NY, for Petitioners.

Justice BREYER announced the judgment of the Court and delivered an opinion, in which Justice GINSBURG, Justice SOTOMAYOR, and Justice KAGAN join.

In Whole Woman's Health v. Hellerstedt , 579 U. S. ––––, 136 S.Ct. 2292, 195 L.Ed.2d 665 (2016), we held that " [u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right’ " and are therefore "constitutionally invalid." Id., at ––––, 136 S.Ct., at 2300 (quoting Planned Parenthood of Southeastern Pa. v. Casey , 505 U.S. 833, 878, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992) (plurality opinion); alteration in original). We explained that this standard requires courts independently to review the legislative findings upon which an abortion-related statute rests and to weigh the law's "asserted benefits against the burdens" it imposes on abortion access. 579 U. S., at ––––, 136 S.Ct., at 2310 (citing Gonzales v. Carhart , 550 U.S. 124, 165, 127 S.Ct. 1610, 167 L.Ed.2d 480 (2007) ).

The Texas statute at issue in Whole Woman's Health required abortion providers to hold " ‘active admitting privileges at a hospital’ " within 30 miles of the place where they perform abortions. 579 U. S., at ––––, 136 S.Ct., at 2300 (quoting Tex. Health & Safety Ann. Code § 171.0031(a) (West Cum. Supp. 2015)). Reviewing the record for ourselves, we found ample evidence to support the District Court's finding that the statute did not further the State's asserted interest in protecting women's health. The evidence showed, moreover, that conditions on admitting privileges that served no "relevant credentialing function," 579 U. S., at ––––, 136 S.Ct., at 2313, "help[ed] to explain" the closure of half of Texas’ abortion clinics, id., at ––––, 136 S.Ct., at 2312. Those closures placed a substantial obstacle in the path of Texas women seeking an abortion. Ibid. And that obstacle, "when viewed in light of the virtual absence of any health benefit," imposed an "undue burden" on abortion access in violation of the Federal Constitution. Id., at ––––, 136 S.Ct., at 2313 ; see Casey , 505 U.S. at 878, 112 S.Ct. 2791 (plurality opinion).

In this case, we consider the constitutionality of a Louisiana statute, Act 620, that is almost word-for-word identical to Texas’ admitting-privileges law. See La. Rev. Stat. Ann. § 40:1061.10(A)(2)(a) (West 2020). As in Whole Woman's Health, the District Court found that the statute offers no significant health benefit. It found that conditions on admitting privileges common to hospitals throughout the State have made and will continue to make it impossible for abortion providers to obtain conforming privileges for reasons that have nothing to do with the State's asserted interests in promoting women's health and safety. And it found that this inability places a substantial obstacle in the path of women seeking an abortion. As in Whole Woman's Health , the substantial obstacle the Act imposes, and the absence of any health-related benefit, led the District Court to conclude that the law imposes an undue burden and is therefore unconstitutional. See U. S. Const., Amdt. 14, § 1.

The Court of Appeals agreed with the District Court's interpretation of the standards we have said apply to regulations on abortion. It thought, however, that the District Court was mistaken on the facts. We disagree. We have examined the extensive record carefully and conclude that it supports the District Court's findings of fact. Those findings mirror those made in Whole Woman's Health in every relevant respect and require the same result. We consequently hold that the Louisiana statute is unconstitutional.



In March 2014, five months after Texas’ admitting-privileges requirement forced the closure of half of that State's abortion clinics, Louisiana's Legislature began to hold hearings to consider a substantially identical proposal. Compare Whole Woman's Health , 579 U. S., at –––– – ––––, 136 S.Ct., at 2299–2300, with June Medical Services LLC v. Kliebert , 250 F.Supp.3d 27, 53 (MD La. 2017) ; Record 11220. The proposal became law in mid-June 2014. 2014 La. Acts p. 2330.

As was true in Texas, Louisiana law already required abortion providers either to possess local hospital admitting privileges or to have a patient "transfer" arrangement with a physician who had such privileges. Compare Whole Woman's Health , 579 U. S., at ––––, 136 S.Ct., at 2300 (citing Tex. Admin. Code, tit. 25, § 139.56 (2009) ), with former La. Admin. Code, tit. 48, pt. I, § 4407(A)(3) (2003), 29 La. Reg. 706–707 (2003). The new law eliminated that flexibility. Act 620 requires any doctor who performs abortions to hold "active admitting privileges at a hospital that is located not further than thirty miles from the location at which the abortion is performed or induced and that provides obstetrical or gynecological health care services." La. Rev. Stat. Ann. § 40:1061.10(A)(2)(a).

The statute defines "active admitting privileges" to mean that the doctor must be "a member in good standing" of the hospital's "medical staff ... with the ability to admit a patient and to provide diagnostic and surgical services to such patient." Ibid. ; La. Admin. Code, tit. 48, pt. I, § 4401. Failure to comply may lead to fines of up to $4,000 per violation, license revocation, and civil liability. See ibid. ; La. Rev. Stat. Ann. § 40:1061.29.


A few weeks before Act 620 was to take effect in September 2014, three abortion clinics and two abortion providers filed a lawsuit in Federal District Court. They alleged that Act 620 was unconstitutional because (among other things) it imposed an undue burden on the right of their patients to obtain an abortion. App. 24. The court later consolidated their lawsuit with a similar, separate action brought by two other clinics and two other abortion providers. (Like the courts below, we shall refer to the two doctors in the first case as Doe 1 and Doe 2; we shall refer to the two doctors in the second case as Doe 5 and Doe 6; and we shall refer to two other doctors then practicing in Louisiana as Doe 3 and Doe 4.)

The plaintiffs immediately asked the District Court to issue a temporary restraining order (TRO), followed by a preliminary injunction that would prevent the law from taking effect. June Medical Services LLC v. Caldwell , No. 14–cv–00525, 2014 WL 12923494 (MD La., Aug. 22, 2014), Doc. No. 5.

The State of Louisiana, appearing for the defendant Secretary of the Department of Health and Hospitals, filed a response that opposed the plaintiffsTRO request. App. 32–39. But the State went on to say that, if the court granted the TRO or if the parties reached an agreement that would allow the plaintiffs time to obtain privileges without a TRO, the court should hold a hearing on the preliminary injunction request as soon as possible. Id. , at 43. The State argued that there was no reason to delay a ruling on the merits of the plaintiffs’ undue-burden claims. Id ., at 43–44. It asserted that there was "no question that the physicians had standing to contest the law." Id. , at 44. And, in light of the State's "overriding interest in vindicating the constitutionality of its admitting-privileges law," the plaintiffs’ suit was "the proper vehicle" to "remov[e] any cloud upon" Act 620's "validity." Id ., at 45.

The District Court declined to stay the Act's effective date. Instead, it provisionally forbade the State to enforce the Act's penalties, while directing the plaintiff doctors to continue to seek conforming privileges and to keep the court apprised of their progress. See TRO in No. 14–cv–00525, Doc. No. 31, pp. 2–3; see, e.g., App. 48–55, 64–82. These updates continued through the date of the District Court's decision. 250 F.Supp.3d at 77.


In June 2015, the District Court held a 6-day bench trial on the plaintiffsrequest for a preliminary injunction. It heard live testimony from a dozen witnesses, including three Louisiana abortion providers, June Medical's administrator, the Secretary (along with a senior official) of the State's Department of Health and Hygiene, and three experts each for the plaintiffs and the State. Id., at 33–34. It also heard from several other witnesses via deposition. Ibid. Based on this evidentiary record, the court issued a decision in January 2016 declaring Act 620 unconstitutional on its face and preliminarily enjoining its enforcement. June Medical Services LLC v. Kliebert , 158 F.Supp.3d 473 (MD La.).

The State immediately asked the Court of Appeals for the Fifth Circuit to stay the District Court's injunction. The Court of Appeals granted that stay. But we then issued our own stay at the plaintiffs’ request, thereby leaving the District Court's preliminary injunction (at least temporarily) in effect. See June Medical Services, L. L. C. v. Gee , 814 F.3d 319 (CA5...

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