158 F. Supp. 3d 473
M.D. La.2016Background
- Plaintiffs (three Louisiana abortion clinics and two named physicians, plus anonymous-doctor parties) challenged Act 620, La. R.S. § 40:1299.35.2, which requires physicians who perform abortions to have “active admitting privileges” at a hospital within 30 miles of the clinic.
- Act 620 took effect September 1, 2014; Plaintiffs obtained a TRO and sought a preliminary injunction against enforcement; consolidated related cases; evidentiary hearing occurred June 22–29, 2015.
- Five of six doctors who perform abortions in Louisiana lacked admitting privileges that met the statute’s definition; hospitals’ bylaws, credentialing practices, and lack of statutory non-discrimination protections produced de facto denials or only limited privileges.
- Evidence at trial showed legislative advocacy by anti‑abortion groups and public statements emphasizing pro‑life goals; parties also presented conflicting medical expert testimony about the statute’s health benefits.
- The court found Act 620: (1) passes rational‑basis review under Fifth Circuit precedent, but (2) when applied in Louisiana’s credentialing context would eliminate most in‑state abortion access and therefore imposes an undue burden; the court enjoined enforcement of the active admitting‑privileges requirement as to the named plaintiffs.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Validity under rational‑basis review | Act 620 is not medically reasonable and thus lacks a legitimate state purpose | Act 620 is rationally related to protecting women’s health and safety; Fifth Circuit precedent supports rationality | Court (following Fifth Circuit) held Act 620 passes rational‑basis review |
| Purpose prong of undue burden (improper purpose) | Legislature and drafters intended to restrict/close clinics; evidence of advocacy and statements shows improper purpose | Purpose evidence limited to statute text and legislative history; medical uncertainty precludes finding improper purpose | Court found plaintiffs did not meet the high Fifth Circuit standard to show sole improper purpose |
| Effect prong of undue burden (substantial obstacle) | Act 620 will shutter clinics / remove most providers, leaving large fraction of women without in‑state access | Any burdens are not caused by the statute but by independent factors (hospital policies, violence, poverty), so are irrelevant | Court held the statute, as applied with Louisiana hospital practices, would impose a substantial obstacle on a large fraction of women and enjoined enforcement for plaintiffs |
| Administrator interpretation (Secretary’s view of limited privileges) | Secretary’s concession that limited Tulane privileges suffice is unreliable and contrary to statute’s plain language requiring ability to provide diagnostic and surgical services | Secretary is the enforcing official; her interpretation should control and suffices for compliance | Court rejected deference to Secretary where interpretation contradicted unambiguous statutory text and found the Tulane‑style limitation did not meet Act 620’s definition |
Key Cases Cited
- Roe v. Wade, 410 U.S. 113 (1973) (establishes constitutional right to choose abortion)
- Planned Parenthood v. Casey, 505 U.S. 833 (1992) (undue‑burden standard: statute invalid if its purpose or effect is to place a substantial obstacle)
- Gonzales v. Carhart, 550 U.S. 124 (2007) (explains role of rational‑basis review for some abortion regulations)
- Planned Parenthood of Greater Tex. Surgical Health Servs. v. Abbott, 748 F.3d 583 (5th Cir. 2014) (Fifth Circuit rational‑basis and undue‑burden framework for admitting‑privileges laws)
- Jackson Women’s Health Org. v. Currier, 760 F.3d 448 (5th Cir. 2014) (application of undue‑burden analysis where a clinic closure left a state with no in‑state providers)
- Whole Woman’s Health v. Lakey, 769 F.3d 285 (5th Cir. 2014) (Fifth Circuit two‑step approach: rational‑basis then undue‑burden)
- Whole Woman’s Health v. Cole, 790 F.3d 563 (5th Cir. 2015) (clarifies burdens of proof on purpose and effect under Fifth Circuit precedent)
- Ex parte Young, 209 U.S. 123 (1908) (permits official‑capacity injunctive suits against state officers)
- Marbury v. Madison, 5 U.S. 137 (1803) (judicial duty to interpret law)