June Med. Servs. LLC v. Kliebert
| Decision Date | 26 April 2017 |
| Docket Number | CIVIL ACTION NO. 14-CV-00525-JWD-RLB. |
| Parties | JUNE MEDICAL SERVICES LLC d/b/a Hope Medical Group for Women, on behalf of its patients, physicians, and staff; Bossier City Medical Suite, on behalf of its patients, physicians, and staff; Choice, Inc., of Texas, d/b/a Causeway Medical Clinic, on behalf of its patients, physicians, and staff, John Doe 1, M.D., and John Doe 2, M.D. v. Kathy KLIEBERT, in her official capacity as Secretary of the Louisiana Department of Health and Hospitals and Mark Henry Dawson, M.D., in his official capacity as President of the Louisiana State Board of Medical Examiners |
| Court | U.S. District Court — Middle District of Louisiana |
250 F.Supp.3d 27
JUNE MEDICAL SERVICES LLC d/b/a Hope Medical Group for Women, on behalf of its patients, physicians, and staff; Bossier City Medical Suite, on behalf of its patients, physicians, and staff; Choice, Inc., of Texas, d/b/a Causeway Medical Clinic, on behalf of its patients, physicians, and staff, John Doe 1, M.D., and John Doe 2, M.D.
v.
Kathy KLIEBERT, in her official capacity as Secretary of the Louisiana Department of Health and Hospitals and Mark Henry Dawson, M.D., in his official capacity as President of the Louisiana State Board of Medical Examiners
CIVIL ACTION NO. 14-CV-00525-JWD-RLB.
United States District Court, M.D. Louisiana.
Signed April 26, 2017
William E. Rittenberg, Charles M. Samuel, III, Rittenberg & Samuel, LLC, New Orleans, LA, David Brown, Ilene Jaroslaw, Janet Crepps, Zoe Levine, New York, NY, Dimitra Doufekias, Morrison & Foerster LLP, Washington, DC, for June Medical Services LLC d/b/a Hope Medical Group for Women, on behalf of its patients, physicians, and staff; Bossier City Medical Suite, on behalf of its patients, physicians, and staff; Choice, Inc., of Texas, d/b/a Causeway Medical Clinic, on behalf of its patients, physicians, and staff, John Doe 1, M.D., and John Doe 2, M.D.
S. Kyle Duncan, Schaerr Duncan LLP, Steven H. Aden, Washington, DC, Charlotte Y. Bergeron, Baton Rouge, LA, J. Michael Johnson, Kitchens Law Firm, Bossier City, LA, Natalie Decker, Greenwood Village, CO, for Kathy Kliebert, in her official capacity as Secretary of the Louisiana Department of Health and Hospitals and Mark Henry Dawson, M.D., in his official capacity as President of the Louisiana State Board of Medical Examiners.
FINDINGS OF FACTS AND CONCLUSIONS OF LAW
JUDGE JOHN W. deGRAVELLES
TABLE OF CONTENTS
OVERVIEW... 31
I. Introduction... 31
FINDINGS OF FACT... 35
II. Background and Procedural History... 35
III. Contentions of the Parties... 38
IV. The Factual Issues... 39
V. Abortion in Louisiana... 39
A. Generally ... 39
B. The Clinics ... 40
(1) Hope ... 40
(2) Bossier ... 40
(3) Causeway ... 41
(4) Women's Health ... 41
(5) Delta ... 41
C. The Doctors ... 41
(1) Doe 1 ... 41
(2) Doe 2 ... 42
(3) Doe 3 ... 42
(4) Doe 4 ... 43
(5) Doe 5 ... 43
(6) Doe 6 ... 43
D. Admitting Privileges in Louisiana ... 44
E. The Climate ... 51
VI. Act 620... 53
A. Text of Act 620 and Related Provisions ... 53
B. Louisiana's Policy and Past Legislation Regarding Abortion ... 54
C. Drafting of Act 620 ... 55
D. Official Legislative History of Act 620 ... 55
VII. The Purpose and Medical Reasonableness of Act 620... 58
A. Expert Testimony ... 59
B. Abortion Safety ... 61
C. Requiring Abortion Practitioners to Obtain Admitting Privileges Confers No Medical Benefit ... 64
VIII. Efforts of Doctors to Comply With Act 620 and the Results of Those Efforts... 66
A. Doe 1 ... 66
B. Doe 2 ... 68
C. Doe 3 ... 74
D. Doe 4 ... 75
E. Doe 5 ... 75
F. Doe 6 ... 76
G. Post–Trial Updates ... 77
IX. Effects of Act 620... 77
A. The Effect of Act 620 on Doe 1–6 ... 77
B. The Effect of Act 620 on the Clinics and Women of Louisiana ... 80
C. The Real–World Effect of Act 620 on Louisiana Women ... 82
CONCLUSIONS OF LAW... 84
X. Summary of Legal Arguments... 84
XI. Test for Determining the Constitutionality of Act 620... 84
XII. Analysis... 86
A. Act 620 Does Not Protect Women's Health ... 86
B. The Burdens Imposed by Act 620 ... 87
C. The Burdens Imposed by Act 620 Vastly Outweigh its Benefits ... 88
XIII. Conclusion... 88
OVERVIEW
I. Introduction
Since this Court issued a preliminary injunction in this matter, the Supreme Court has held that the Fifth Circuit's interpretation of the undue burden test was incorrect. Whole Woman's Health v. Hellerstedt , ––– U.S. ––––, 136 S.Ct. 2292, 2309, 195 L.Ed.2d 665 (2016) (hereinafter " WWH ") ("The Court of Appeals' articulation of the relevant standard is incorrect."). In its ruling, this Court's conclusions of law applied the Fifth Circuit's legal standard, which WWH reversed. Specifically, this Court initially concluded, in line with Fifth Circuit precedent, that it could not consider evidence regarding whether the Act would actually serve its purported purpose to advance women's health and safety in practice, and could not weigh the Act's burdens against its benefits. (Doc. 216 ¶¶ 178, 333–35, 346, 351–52, 364–67, 372) (citing, inter alia, Whole Woman's Health v. Cole , 790 F.3d 563, 587 n.33 (5th Cir. 2015) ). Accordingly, this Court ruled it could not resolve the parties' dispute over whether the Act is medically reasonable. (Id. ¶ 178(C) & n.41.)
In addition, this Court held the undue burden test, as applied in the Fifth Circuit, precluded consideration of evidence related
to the challenges women would face in obtaining abortions under the Act in their "real-world" context. (Id. ¶¶ 340–43) (citing, inter alia, Cole , 790 F.3d at 589 ). This Court therefore did not consider evidence regarding how the Act, when considered in the real-world context of abortion patients' poverty and transportation challenges, providers' fear of anti-abortion violence, pre-existing regulations, and other obstacles to abortion access, would impose unique burdens on Louisiana women. (Id. ¶ 344.) The Supreme Court has now clarified that these facts should be considered when evaluating whether an abortion restriction is constitutional. See WWH , 136 S.Ct. at 2302, 2312–13.
The Supreme Court held in WWH that restrictions on access to abortion before viability must be subject to meaningful judicial scrutiny: rational basis review is simply not enough when "regulation of a constitutionally protected personal liberty" is at issue. WWH , 136 S.Ct. at 2309. Rather, under the undue burden analysis, a restriction must be shown to actually "further" its purported interest, and it is constitutional only if its benefits outweigh its burdens. See id. at 2309–10. Additionally, in evaluating a restriction's benefits and burdens, courts must not simply defer to a State's assertions about any purported benefits or burdens, but must consider actual evidence. See id. at 2310–12. The Court explained its reasons for rejecting the Fifth Circuit's analysis:
The rule announced in [ Planned Parenthood of Southeast ern Pennsylvania v. Casey , 505 U.S. 833, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992) ] ... requires that courts consider the burdens a law imposes on abortion access together with the benefits those laws confer. And the [Court of Appeals was] wrong to equate the judicial review applicable to the regulation of a constitutionally protected personal liberty with the less strict review applicable where, for example, economic legislation is at issue. The Court of Appeals' approach simply does not match the standard that this Court laid out in Casey , which asks courts to consider whether any burden imposed on abortion access is "undue."
Id. at 2309–10 (citations omitted). Thus, WWH makes clear that courts have a "constitutional duty" to look beyond a State's assertions...
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