Planned Parenthood of Arkansas & Eastern Oklahoma v. Jegley, 2017 U.S. App. LEXIS 13747

Background

Arkansas enacted the Abortion‑Inducing Drugs Safety Act, which among other things required medication‑abortion prescribers to have a signed contract with a physician who has hospital admitting and gynecological/surgical privileges and to provide patients the contract physician’s contact and hospital information.
Planned Parenthood of Arkansas & Eastern Oklahoma (PPAEO) and a PPAEO physician sued to enjoin enforcement, arguing the contract‑physician requirement imposes an undue burden on patients seeking medication abortions.
The district court preliminarily enjoined the provision, finding Planned Parenthood likely to succeed on the merits, that the requirement provided few tangible benefits over Planned Parenthood’s existing continuity‑of‑care protocols, and that closure of PPAEO clinics would force some patients (particularly in the Fayetteville area) to travel great distances, delay care, or forgo abortions.
The district court relied in part on evidence that medication abortions comprised a minority of Arkansas abortions and that Planned Parenthood could not secure a contract physician, concluding the law would effectively eliminate medication abortion access outside Little Rock.
On appeal, the State argued the district court erred in granting a facial preliminary injunction; the Eighth Circuit vacated and remanded because the district court failed to make factual findings estimating how many women seeking medication abortions would be unduly burdened (i.e., whether a “large fraction” would be affected).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the contract‑physician requirement imposes an undue burden on a large fraction of women seeking medication abortions in Arkansas	The requirement will close PPAEO clinics, increase travel and delays, causing some women to postpone or forgo abortions; benefits are minimal vs. current protocols	The law advances health and safety by ensuring continuity of care via physicians with admitting privileges; enforcement is presumptively valid	Vacated preliminary injunction and remanded because district court failed to quantify how many women would be unduly burdened and thus did not determine whether a “large fraction” is affected; factual findings required on remand
Standard for a facial challenge to an abortion regulation	Facial relief appropriate because statute operates as a substantial obstacle for a large fraction of affected women	Facial challenges disfavored; plaintiff must meet the "large fraction" showing for the relevant denominator (women seeking medication abortion)	Court reiterated that facial challenge requires showing that statute is an undue burden for a large fraction of the relevant group and district court must make findings estimating that fraction
Weight of benefits vs. burdens under Whole Woman’s Health framework	The regulation’s benefits are low relative to burdens; existing Planned Parenthood protocols provide comparable care	State has deference where medical uncertainty exists and may justify regulation for safety	Declined to resolve benefits issue; remanded because the required factual predicate (size of burdened population) was not found; noted district court should assess benefits but did not decide them here
Appropriateness of preliminary injunction without numeric findings	Plaintiff argued conceptual showings and anecdotal evidence suffice for issuance	State argued preliminary injunction requires concrete factual findings about scope of burden, especially in facial challenges	Court held district court abused discretion by failing to make specific factual findings estimating number/proportion of women who would forgo or delay abortions and whether that constitutes a large fraction

Key Cases Cited

Planned Parenthood Minn., N.D., S.D. v. Rounds, 530 F.3d 724 (8th Cir. 2008) (higher showing required to enjoin state statute; interlocutory review standard)
Dataphase Sys., Inc. v. C L Sys., Inc., 640 F.2d 109 (8th Cir. 1981) (four‑factor preliminary injunction test)
Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992) (undue burden standard; "substantial obstacle" formulation)
Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292 (2016) (must balance benefits and burdens; closures, wait times, crowding relevant)
Gonzales v. Carhart, 550 U.S. 124 (2007) (legislatures have deference where medical uncertainty exists)
United States v. Salerno, 481 U.S. 739 (1987) (standard for facial challenges generally)
Wash. State Grange v. Wash. State Republican Party, 552 U.S. 442 (2008) (facial challenges are disfavored)
Cincinnati Women’s Servs., Inc. v. Taft, 468 F.3d 361 (6th Cir. 2006) (discussion of what may constitute a "large fraction")
Phelps‑Roper v. Troutman, 712 F.3d 412 (8th Cir. 2013) (remanding for district court factual findings when lower court omitted necessary findings)