64 F. Supp. 3d 1235
S.D. Ind.2014Background
- PPINK operates Indiana clinics; the Lafayette clinic provides only medication abortions (no surgical procedures) and lacks certain surgical physical-plant features (e.g., recovery room, scrub facilities).
- Indiana amended the definition of "abortion clinic" to include any freestanding entity that "provides an abortion inducing drug," while excepting an undefined "physician’s office" if such drugs are not primarily dispensed there (I.C. §16-18-2-1.5(a)(2)).
- Separately, the legislature barred the Indiana Department of Health (IDOH) from exempting abortion clinics from physical-plant requirements by waivers (I.C. §16-21-2-2.5(b)); other facility types may still seek waivers under I.C. §16-21-1-9.
- IDOH denied PPINK’s Lafayette licensing waiver; PPINK sued challenging both statutes as unconstitutional (Fourteenth Amendment right to choose, substantive due process, and equal protection).
- The parties filed cross-motions for summary judgment; the court previously granted a preliminary injunction on the equal protection claim as to the Lafayette clinic.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether applying the amended “abortion clinic” definition to the Lafayette clinic unduly burdens patients’ Fourteenth Amendment right to choose abortion | The surgical physical-plant requirements are unrelated to medication-abortion safety and impose an undue burden on access | The law furthers legitimate health and continuity-of-care interests; no evidence PPINK proved a substantial burden | Summary judgment denied to both sides — disputed material facts (competing expert evidence) preclude resolution on summary judgment |
| Whether the amendment defining abortion clinic violates PPINK’s substantive due process rights (rational-basis review) | Imposing surgical standards on a non-surgical clinic is arbitrary and irrational | The classification is rationally related to protecting patient health | Summary judgment denied to both sides — factual disputes about medical necessity preclude resolution |
| Whether the statute’s distinction between “abortion clinics” and undefined “physician’s offices” violates equal protection as applied to Lafayette | The statute arbitrarily treats providers of the same procedure differently; no rational basis for singling out clinics while excluding physician offices | Legislature rationally targeted facilities that openly offer abortions; physician offices rarely perform such abortions | Court grants summary judgment for PPINK — statute violates equal protection as applied to Lafayette due to ambiguity and lack of rational basis |
| Whether the ban on IDOH waivers for abortion clinics (I.C. §16-21-2-2.5(b)) violates equal protection for PPINK’s Lafayette, Indianapolis, Bloomington, Merrillville clinics | The waiver ban treats abortion clinics worse than hospitals/ambulatory surgical centers that still may obtain waivers, with no rational justification; existing waiver standard already protects patient safety | State argues it may require abortion clinics be minimally prepared to treat complications and may treat abortion providers differently | Court grants summary judgment for PPINK — waiver prohibition violates equal protection because it singles out abortion clinics without a rational basis |
Key Cases Cited
- Planned Parenthood of Wisconsin, Inc. v. Van Hollen, 738 F.3d 786 (7th Cir. 2013) (preliminary-injunction and evidentiary guidance on medical-justification and undue-burden analysis; recommends neutral expert at trial)
- Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992) (undue-burden standard for abortion regulations)
- Stenberg v. Carhart, 530 U.S. 914 (2000) (invalidating abortion regulations lacking health justification)
- Planned Parenthood of Cent. Missouri v. Danforth, 428 U.S. 52 (1976) (states may regulate abortion providers differently than other medical providers, but not irrationally)
- LaBella Winnetka, Inc. v. Village of Winnetka, 628 F.3d 937 (7th Cir. 2010) (equal protection principle: similarly situated persons must be treated alike unless a rational basis exists)