New York v. Sullivan

889 F.2d 401
CourtCourt of Appeals for the Second Circuit
DecidedNovember 1, 1989
DocketNos. 575, 633, Dockets. 88-6204, 88-6206
StatusPublished
Cited by21 cases

This text of 889 F.2d 401 (New York v. Sullivan) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New York v. Sullivan, 889 F.2d 401 (2d Cir. 1989).

Opinions

WINTER, Circuit Judge:

This appeal involves the validity of regulations promulgated by the Secretary of Health and Human Services (the “Secretary”). The statutory authority for these regulations is Section 1008, 42 U.S.C. § 300a-6, of Title X of the Public Health Service Act, 42 U.S.C. §§ 300 to 300a-41 (1982 & Supp. V 1987) (“Title X”). Section 1008 states: “None of the funds appropriated under this subchapter shall be used in programs where abortion is a method of family planning.” 42 U.S.C. § 300a-6. The regulations in question were promulgated in early 1988 and constitute a divergence from past agency policy. The new regulations limit the activities of Title X grantee projects with regard to counseling and referral for abortion, require physical and financial separation of Title X projects from prohibited activities, and restrict advocacy concerning abortions by Title X projects.

In challenging the new regulations, plaintiffs raise three principal issues: (i) whether the regulations are consistent with Section 1008; (ii) whether the prohibition on counseling concerning abortion within Title X projects violates the First and Fifth Amendment rights of pregnant women; and (iii) whether the regulations on counseling and advocacy infringe the First Amendment rights of health care providers. We hold that the regulations in question are a permissible construction of the statute and do not violate the constitutional rights of women or Title X grantees.

BACKGROUND

The facts are not in dispute and are amply described in the district court opinion, State of New York v. Bowen, 690 F.Supp. 1261 (S.D.N.Y.1988), familiarity with which is assumed. A brief recounting will therefore suffice for purposes of this opinion. Title X of the Public Health Service Act, 42 U.S.C. §§ 300 to 300a-41 authorizes the Secretary to make grants to public and private nonprofit entities to establish and operate family planning projects. It is the single largest source of federal funding of family planning services. Appellants include a number of Title X grantees — the State of New York, which receives Title X funds through the New York State Department of Health; the City of New York; the New York City Health and Hospitals Corporation; Planned Parenthood of New York City, Inc.; Planned Parenthood of Westchester/Rockland; Medical and Health Research Association of New York City, Inc.; Health Services of Hudson County, New Jersey; and Dr. Irving Rust and Dr. Melvin Padawer, doctors who supervise Title X-funded programs, who are suing on behalf of themselves and their patients. The defendant is the Secretary of the Department of Health and Human Services.

The Secretary has the power to make Title X grants “in accordance with such regulations as [he] may promulgate.” 42 U.S.C. § 300a-4(a). On February 2, 1988, the Secretary promulgated the regulations in question pursuant to Section 1008. The new regulations impact on counseling concerning abortion, geographic and administrative relationships between Title X grantees and those engaging in activities concerning abortion, and advocacy concerning abortion. There is little doubt that the new regulations were intended as a departure from prior administrative practice. While Title X funds were never permitted in the past to be used either to perform or to subsidize actual abortions, see 36 Fed.Reg. 18,465, 18,466 (1971) (codified at 42 C.F.R. § 59.5(a)(9) (“The project will not provide abortion as a method of family planning.”); [405]*405see also 42 C.F.R. § 59.5(a)(5) (1986), administrative interpretations at first permitted, and later required, Title X projects to provide information about, and referral for, abortions, including names and addresses of abortion clinics. See U.S. Dep’t of Health, Educ. & Welfare, Program Incentives for Project Grants for Family Planning Services (Jan.1976); U.S. Dep’t of Health and Human Services, Program Guidelines for Project Grants for Family Planning Services § 8.6 (1981). Title X programs thus included “non-directive” counseling about abortion as a method of family planning. Abortion-related activities permissible under the earlier practice have been summarized as follows:

[T]he provision of information concerning abortion services, mere referral of an individual to another provider of services for an abortion, and the collection of statistical data and information regarding abortion are not considered to be proscribed by § 1008. The provision of “pregnancy counseling” in the sense of encouraging persons to obtain abortions and the provision of transportation to persons to enable them to obtain abortions, on the other hand, are considered to be proscribed by § 1008. The test to be applied, then, appears to be whether the immediate effect of the activity in question is to encourage or promote the use of abortion as a method of family planning. If the immediate effect of the activity is essentially neutral as in the cases of mere referral or collection of statistical data, then the activity does not fall afoul of § 1008.

Memorandum from C. Conrad, Office of the General Counsel, Department of Health, Education and Welfare, to E. Sullivan (Apr. 14, 1978) (footnotes omitted) (reproduced in Brief of the Secretary of Health and Human Services as Amicus Curiae at Attachment B, Valley Family Planning v. North Dakota, 661 F.2d 99 (8th Cir.1981) [hereinafter Memorandum of Apr. 14, 1978].

The new regulations expressly prohibit those activities that “assist” a woman to obtain an abortion, while not interfering with the right to receive information about abortion from sources other than Title X projects. See 42 C.F.R. § 59.10 (1988); see also 53 Fed.Reg. 2941-42 (1988). The regulations thus curtail counseling, nondirec-tive or not, by Title X projects concerning abortion. In attempting to “set specific standards for compliance with the statutory requirement that none of the funds appropriated under Title X may be used in programs where abortion is a method of family planning,” 53 Fed.Reg. 2922 (1988), Section 59.8(a)(1) of the regulations states that “[a] Title X project may not provide counseling concerning the use of abortion as a method of family planning.” 42 C.F.R. § 59.8(a)(1) (1988). Section 59-8(a)(3) goes on to explain:

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889 F.2d 401 (Second Circuit, 1989)

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889 F.2d 401, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-york-v-sullivan-ca2-1989.