Planned Parenthood Ass’n of Hidalgo County Texas, Inc. v. Suehs: Abortion and the Right To “Affiliate”

In April 2012, nine Planned Parenthood clinics in Texas (referred to collectively as the Texas clinics) were granted a preliminary injunction halting the enforcement of public funding restrictions that the clinics claimed violated their First Amendment rights.[1. Planned Parenthood Ass’n of Hidalgo Cnty. Tex., Inc. v. Suehs, 692 F.3d 343, 346-48 (5th Cir. 2012).]  It was years earlier, in 2005, that Texas created the Women’s Health Program (WHP) to promote health and family planning services for low-income women through a combination of state and federal funds.[2. Id. at 346.]  The Texas legislature charged the Texas Health and Human Services Commission (THHSC) with dispensing these WHP funds to different recipients across the state as long as the health care providers did not “perform or promote elective abortions or be[come] affiliates of entities that perform or promote elective abortions.”[3. Id. (quoting Act of June 17, 2005, ch. 816, § 1(h), 2005 Tex. Gen. Laws 2816, 2818).]  Despite a legal relationship with the Planned Parenthood Federation of America, the clinics were never denied WHP funds because the THHSC never formally interpreted these restrictions.[4. Id. at 346-47.]  It was only in 2011, when Texas reauthorized the WHP, that the THHSC disseminated regulations that defined key terms like “affiliate” and “promote.”[5. Id. at 347 (citing 1 Tex. Admin. Code § 354.1362(1), (6) (2012)).]  Believing they could not comply with the restrictions, the Texas clinics filed suit in the United States District Court for the Western District of Texas to block their implementation.[6. Id.] In their suit, the clinics sought declaratory relief and a preliminary injunction against the THHSC.[7. Id. at 346.]  They alleged that the restrictions violated their First Amendment rights to free speech and association, as well as their right to equal protection under the laws, because health care providers that associate with hospitals that promote or perform abortions were exempt from the restrictions.[8. Id.  For the purpose of standing, the clinics were forced to concede that they promote and affiliate with entities that promote or perform elective abortions.  Id. at 347-48.]  Granting the injunction, the district court reasoned that the Texas clinics showed a substantial likelihood of succeeding on the merits of each claim.[9. Id. at 348.]  The state of Texas appealed the district court’s decision.[10. Id.]  The United States Court of Appeals for the Fifth Circuit held that the clinics failed to demonstrate that the new restrictions violated their First Amendment rights and vacated the injunction because there was not a substantial likelihood that the clinics would succeed on the merits of their claims.  Planned Parenthood Ass’n of Hidalgo County Texas, Inc. v. Suehs, 692 F.3d 343, 352 (5th Cir. 2012).