984 F. Supp. 2d 912
S.D. Ind.2013Background
- PPINK operates a Lafayette clinic that provides medication (non-surgical) abortions but performs no surgical procedures; the clinic sought an abortion-clinic license and waiver of surgical physical-plant rules.
- Indiana amended its definition of "abortion clinic" to include freestanding entities that "provide an abortion inducing drug," effective Jan. 1, 2014, while excluding undefined "physician’s offices" so long as abortion drugs are not primarily dispensed there.
- Administrative rules impose surgical-facility physical plant requirements (e.g., 120 sq ft procedure rooms, scrub facilities, recovery area, emergency call system) on entities defined as abortion clinics.
- A statutory amendment (I.C. § 16-21-2-2.5(b)) bars IDOH from exempting abortion clinics from those requirements after Dec. 31, 2013; IDOH interpreted this to require the Lafayette clinic to comply or be denied licensure.
- PPINK sued state officials seeking a preliminary injunction enjoining enforcement of (a) the expanded "abortion clinic" definition (I.C. § 16-18-2-1.5(a)(2)) as applied to Lafayette and (b) the waiver prohibition (I.C. § 16-21-2-2.5(b)); the court heard cross‑briefs and evidence about medical risks and the clinic’s operations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the amended definition of "abortion clinic" (I.C. § 16-18-2-1.5(a)(2)) violates Equal Protection by treating medication-abortion providers differently (abortion clinics vs. physician’s offices) | The statutory split irrationally treats providers performing the same procedure differently; no rational basis supports imposing surgical physical-plant requirements on some medication-abortion providers but not others, especially given statutory ambiguity about "physician’s office" | The legislature may regulate abortion providers differently for health/safety reasons and may do so "one step at a time"; physician offices can be treated differently and are overseen by medical licensing | Granted in part: Court found PPINK likely to succeed on Equal Protection as applied to Lafayette clinic — no rational basis shown for the differential treatment and statutory terms are ambiguous; enjoined enforcement against Lafayette clinic |
| Whether the waiver prohibition (I.C. § 16-21-2-2.5(b)) violates Equal Protection by barring IDOH from exempting abortion clinics from physical-plant rules | The ban forbids waivers that would not harm patient safety and targets abortion clinics unfairly | Legislature permissibly may allow waivers for some facilities (e.g., birthing centers) but prohibit them for abortion clinics to protect women's health | Denied: Court found PPINK did not show a likelihood of success on this claim; birthing centers and abortion clinics are different and can be regulated differently |
| Whether the statutes violate Substantive Due Process (novel right to dispense medication or irrational regulation) | Imposing surgical requirements on non-surgical providers is arbitrary and irrational given medication-abortion complications occur after patients leave the clinic | PPINK failed to identify a clear substantive-due-process interest; state has leeway to regulate medicine and to promote continuity of care | Denied: PPINK did not adequately define the protected interest and so did not show likelihood of success |
| Whether PPINK may assert patients’ Fourteenth Amendment privacy/abortion-right claims (third-party standing) and whether the rules unduly burden patients | PPINK asserts third-party standing and argues the rules are not medically reasonable for Lafayette clinic | State questions PPINK's third-party standing and contends the regulations rationally protect maternal health and do not impose an undue burden | Denied: Even assuming standing, PPINK did not argue or show an undue burden on patients’ abortion access and thus failed to show likely success |
Key Cases Cited
- Planned Parenthood of Ind., Inc. v. Comm’r of Ind. State Dep’t Health, 699 F.3d 962 (7th Cir. 2012) (preliminary-injunction standard and analysis of abortion‑provider regulation)
- Planned Parenthood v. Danforth, 428 U.S. 52 (1976) (state may regulate abortion providers differently than other medical providers, but not authorize arbitrary unequal treatment among similar abortion providers)
- Gonzales v. Carhart, 550 U.S. 124 (2007) (state may regulate abortion procedures if regulation has a rational basis and does not impose an undue burden)
- Roe v. Wade, 410 U.S. 113 (1973) (established constitutional right to obtain an abortion under Fourteenth Amendment privacy/due process principles)
- LaBella Winnetka, Inc. v. Vill. of Winnetka, 628 F.3d 937 (7th Cir. 2010) (equal protection principle that similarly situated persons must be treated alike)
- Maguire v. Thompson, 957 F.2d 374 (7th Cir. 1992) (legislatures may phase regulation; cited by State but distinguished by court where regulation treats identical actors differently)