National Institute of Family and Life Advocates v. Becerra, 138 S. Ct. 2361

Background

California enacted the Reproductive FACT Act requiring two government-drafted notices for clinics that primarily serve pregnant women: a licensed-clinic notice (informing patients of state programs including abortion and a phone number) and an unlicensed-clinic notice (stating the facility is not state-licensed and must be posted and included in advertising).
Petitioners were two crisis pregnancy centers (one licensed, one unlicensed) and an association of such centers; they sued claiming both notices violate the First Amendment.
The District Court denied a preliminary injunction; the Ninth Circuit affirmed, applying a lower standard to "professional speech" for the licensed notice and upholding the unlicensed notice under its review.
The Supreme Court granted certiorari and reversed: it held the licensed notice is a content-based regulation subject to strict scrutiny (and likely unconstitutional), rejected a free-standing "professional speech" category, and found the unlicensed notice unjustified and unduly burdensome even under Zauderer.
The Court remanded; there were concurrences stressing viewpoint concerns and a dissent arguing the notices are permissible disclosures tied to medical regulation and to Casey.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Licensed-clinic notice: does it violate the First Amendment?	The notice compels speech conveying a government message (including abortion referral) contrary to petitioners' beliefs.	The notice is a content-neutral regulation of professional activity or permissible disclosure to inform low-income women about state services.	The notice is content-based; Court rejects a broad "professional speech" exception and finds the notice likely unconstitutional because it fails intermediate scrutiny (underinclusive; less-restrictive alternatives available).
Existence of a distinct "professional speech" category that warrants relaxed review	Professionals have reduced First Amendment protection for speech within professional-client relationships; lower courts may apply intermediate review.	First Amendment protections do not disappear because the speaker is a professional; existing precedents are limited to Zauderer (commercial disclosures) and regulation of conduct that incidentally burdens speech.	The Court refuses to recognize a free-standing "professional speech" doctrine; protections generally apply and content-based professional speech can trigger strict scrutiny.
Unlicensed-clinic notice: is it permissible? (including whether Zauderer applies)	The notice is factual: it informs patients the facility is unlicensed and is therefore permissible under Zauderer or, at minimum, justified to prevent confusion about medical care.	The notice is narrowly tailored to inform pregnant women when they are receiving care from licensed professionals; state interest is substantial.	Even assuming Zauderer, California failed to show a non-hypothetical harm; the disclosure is speaker-based, unduly burdensome, and not reasonably tailored, so it is unjustified and likely unconstitutional.
Remedy at preliminary-injunction stage	Petitioners sought an injunction based on likelihood of success on the merits.	State defended statute and argued petitioners could not show likelihood of success.	Court found petitioners likely to succeed on both claims, reversed Ninth Circuit, and remanded.

Key Cases Cited

Reed v. Town of Gilbert, 576 U.S. 155 (2015) (content-based speech regulations are presumptively unconstitutional)
Riley v. Nat’l Fed’n of the Blind of N.C., 487 U.S. 781 (1988) (compelled speech alters speaker’s message)
Zauderer v. Office of Disciplinary Counsel of Supreme Court of Ohio, 471 U.S. 626 (1985) (factual, uncontroversial commercial disclosures may be upheld if not unjustified or unduly burdensome)
Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) (state may impose certain informed-consent disclosures in medical context without violating First Amendment)
Sorrell v. IMS Health Inc., 564 U.S. 552 (2011) (speaker- or content-based regulations can reflect viewpoint or impermissible discrimination)
Turner Broad. Sys., Inc. v. FCC, 512 U.S. 622 (1994) (risk of suppression of unpopular ideas is central concern in content-based regulation)
McCullen v. Coakley, 573 U.S. 464 (2014) (speaker-based exemptions can indicate viewpoint discrimination)
Holder v. Humanitarian Law Project, 561 U.S. 1 (2010) (strict scrutiny applied to content-based regulations of noncommercial speech)
In re R. M. J., 455 U.S. 191 (1982) (disclosures must be no broader than reasonably necessary)
Ibanez v. Florida Dept. of Business & Prof. Regulation, 512 U.S. 136 (1994) (disclosure requirements must address a potentially real harm)
Entertainment Merchants Assn. v. Schwarzenegger, 564 U.S. 786 (2011) (underinclusiveness casts doubt on asserted governmental purpose)
Miami Herald Publ’g Co. v. Tornillo, 418 U.S. 241 (1974) (compelled speech doctrine)