903 F.3d 750
8th Cir.2018Background
- In 2007 Missouri reclassified most abortion providers as ambulatory surgery centers (ASCs), triggering (1) a statutory Hospital Relationship Requirement: abortion-performing doctors must have hospital privileges at a licensed hospital "in the community" (regulation defines this as 15 minutes away), and (2) detailed Physical Plant Regulations for surgical-abortion facilities, but those physical requirements are waivable by DHSS upon written request.
- Comprehensive Health (Planned Parenthood) previously challenged the ASC classification and settled in 2010 with Missouri; that settlement produced waivers/modified requirements for two facilities and included a broad release by Comprehensive Health as to claims relating to those centers.
- After the Supreme Court decided Whole Woman’s Health v. Hellerstedt, Comprehensive Health (joined by RHS and Dr. Yeomans) sued, seeking declaratory and injunctive relief against the ASC classification and the Hospital Relationship Requirement on substantive due process and equal protection grounds.
- The district court preliminarily enjoined enforcement of the Hospital Relationship Requirement (and some criminal penalties) and preliminarily enjoined the Physical Plant Regulations on substantive due process grounds, relying on Hellerstedt and declining to weigh the State’s evidence of benefits.
- The Eighth Circuit vacated that preliminary injunction and remanded: it held the district court lacked sufficient factual record to adjudicate a facial substantive-due-process challenge to the Physical Plant Regulations (given the opaque waiver process) and erred by refusing to weigh the State’s asserted benefits regarding the Hospital Relationship Requirement.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Justiciability of facial substantive-due-process challenge to the Physical Plant Regulations | Clinics can bring facial challenge without seeking waivers; regulations are unconstitutional under undue-burden analysis | Missouri: challenge is unripe because facilities did not pursue waivers under the DHSS Waiver Provision | Court: Facial challenge need not be ripened by waiver application, but the record lacks sufficient facts about waiver process; district court should not decide facial substantive-due-process claim on current scant record (vacated and remanded) |
| Standard of review and evidentiary approach for Physical Plant Regulations | Hellerstedt supports enjoining similar physical requirements without detailed waiver evidence | Missouri: factual record matters and DHSS waiver use could avoid burdens; presumptively good-faith administration | Court: Because undue-burden review is fact-intensive (a cost-benefit inquiry), the district court erred by deciding on an inadequate factual record and by presuming DHSS would deny waivers; remand for further factfinding |
| Whether district court properly enjoined Hospital Relationship Requirement without weighing benefits | Plaintiffs: Hellerstedt requires striking similar requirements; benefits are negligible and burdens severe | Missouri: district court must weigh asserted benefits against burdens per Hellerstedt; statute is unwaivable and criminally enforceable | Court: District court erred by refusing to consider the State’s asserted benefits; remand for district court to weigh benefits and burdens under Hellerstedt (vacated injunction) |
| Effect of 2010 settlement/release on Comprehensive Health's claims | Plaintiffs: suit may proceed; RHS can maintain claims independently | Missouri: release may bar Comprehensive Health's claims arising from earlier litigation | Court: Declined to decide release issue in the first instance; noted RHS can pursue justiciable claims independent of Comprehensive Health |
Key Cases Cited
- Fletcher v. Peck, 10 U.S. 87 (1810) (preliminary invocation of constitutional relief requires adequate information)
- Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292 (2016) (undue-burden analysis requires weighing burdens on abortion access against asserted health benefits)
- Singleton v. Wulff, 428 U.S. 106 (1976) (third-party standing for physicians to litigate patients' abortion rights)
- Wash. State Grange v. Wash. State Republican Party, 552 U.S. 442 (2008) (courts should exercise restraint to avoid premature constitutional adjudication)
- Suitum v. Tahoe Reg’l Planning Agency, 520 U.S. 725 (1997) (facial challenges to regulations are generally ripe on enactment)
- Renne v. Geary, 501 U.S. 312 (1991) (avoid decisions based on an amorphous record)
- Planned Parenthood Minn., N.D., S.D. v. Rounds, 530 F.3d 724 (8th Cir. 2008) (preliminary injunction requires likelihood of success on merits)
- Robbins v. Becker, 794 F.3d 988 (8th Cir. 2015) (presumption of good faith for state officers' actions)
- McKinney ex rel. NLRB v. S. Bakeries, LLC, 786 F.3d 1119 (8th Cir. 2015) (standards of review for preliminary injunctions)
- Roe v. Wade, 410 U.S. 113 (1973) (state interest in regulating abortion to protect health and safety)
- Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992) (undue burden test and discussion of obstacles to abortion choice)