National Institute of Family & Life Advocates v. Harris, 839 F.3d 823

California enacted the FACT Act requiring: (1) licensed pregnancy-related clinics to post a notice informing patients of publicly funded family-planning services (Licensed Notice); and (2) unlicensed pregnancy-related clinics to disclose they are not state-licensed (Unlicensed Notice). Violations carry civil penalties.
Appellants are religiously affiliated pregnancy centers (licensed and unlicensed) that oppose abortion and refuse to comply; they sued state officials claiming the Act violates the First Amendment (free speech and free exercise). They sought a preliminary injunction; the district court denied relief.
The Ninth Circuit reviewed justiciability (ripeness and prudential ripeness) and found the pre-enforcement challenge fit for decision and ripe, so it addressed the merits.
The panel treated the Licensed Notice as regulating ‘‘professional speech’’ (speech within the clinician–patient/clinic–client relationship) and applied intermediate scrutiny; it treated the Unlicensed Notice as survivable under any level of scrutiny (including strict).
On free exercise, the court held the Act is a neutral, generally applicable law subject only to rational basis review and therefore survived that review.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether claims are justiciable (ripeness/prudential ripeness)	FACT challenge ripe because plaintiffs will not comply and face penalties	State argued lack of enforcement history and prudential reasons to decline	Claims are constitutionally and prudentially ripe; court exercised jurisdiction
Whether the Licensed Notice compels speech and what scrutiny applies	Strict scrutiny needed because content-based and aimed at anti-abortion speakers; viewpoint discrimination	Content-based but viewpoint neutral; the notice regulates professional speech—intermediate scrutiny applies	Licensed Notice is professional speech; intermediate scrutiny applies and is satisfied
Whether the Unlicensed Notice violates free speech	Compelled ideological speech; therefore unconstitutional	Disclosure is factual, neutral, and serves compelling safety/accuracy interests; survives any scrutiny	Unlicensed Notice survives any level of review (including strict scrutiny)
Whether the Act violates free exercise of religion	Act targets religious objections and burdens religious practice	Act is neutral and generally applicable; exceptions are limited and secular	Act is a neutral law of general applicability; survives rational basis review

Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7 (2008) (preliminary-injunction standard)
Reed v. Town of Gilbert, 135 S. Ct. 2218 (2015) (content- and viewpoint-discrimination framework)
Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992) (state regulation of physician speech in abortion context)
Gonzales v. Carhart, 550 U.S. 124 (2007) (state role in regulating medical profession)
Sorrell v. IMS Health Inc., 564 U.S. 552 (2011) (disfavored-speaker analysis under content/viewpoint discrimination)
Pickup v. Brown, 740 F.3d 1208 (9th Cir. 2014) (professional-speech continuum)
Stuart v. Camnitz, 774 F.3d 238 (4th Cir. 2014) (intermediate scrutiny for compelled abortion-related speech)
Conant v. Walters, 309 F.3d 629 (9th Cir. 2002) (First Amendment and medical advice context)
Zauderer v. Office of Disciplinary Counsel, 471 U.S. 626 (1985) (compelled commercial disclosures)
Employment Div., Dep't of Human Res. of Or. v. Smith, 494 U.S. 872 (1990) (free exercise: neutral, generally applicable laws get rational basis review)
Stormans, Inc. v. Wiesman, 794 F.3d 1064 (9th Cir. 2015) (free exercise neutrality/generality analysis)