Whole Woman's Health v. Hellerstedt

231 F. Supp. 3d 218, 2017 U.S. Dist. LEXIS 116393, 2017 WL 462400
CourtDistrict Court, W.D. Texas
DecidedJanuary 27, 2017
DocketCase No. A-16-CA-1300-SS
StatusPublished
Cited by3 cases

This text of 231 F. Supp. 3d 218 (Whole Woman's Health v. Hellerstedt) is published on Counsel Stack Legal Research, covering District Court, W.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Whole Woman's Health v. Hellerstedt, 231 F. Supp. 3d 218, 2017 U.S. Dist. LEXIS 116393, 2017 WL 462400 (W.D. Tex. 2017).

Opinion

ORDER

SAM SPARKS, UNITED’STATES DISTRICT JUDGE

BE IT REMEMBERED on the 3rd and 4th days of January 2017, the Court held a hearing in the above-styled cause, and the parties appeared in person or through counsel. Before the Court are Plaintiffs Whole Woman’s Health, Brookside Women’s Medical Center PA d/b/a Brookside Women’s Health Center and Austin Women’s Health Center, Dr. Lendol L. Davis, Alamo City Surgery Center PLLC d/b/a Alamo Women’s Reproductive Services, and Nova Health Systems, Inc. d/b/a Reproductive Services (Plaintiffs)’ Motion for a Temporary Restraining Order, or Alternatively, a Preliminary Injunction and Memorandum of Law in Support [# 6], Defendant John Hellerstedt’s Response [# 17] in opposition, Plaintiffs’ Proposed Findings of Fact and Conclusions of Law [# 47] in support, and Defendant’s Proposed Findings of Fact and Conclusions of Law [# 46] in opposition. Having reviewed the documents, the evidence presented at the hearing, the arguments of counsel, the relevant law, and the file as a whole, the Court now enters the following opinion and orders.

’Tis the season as the litigation war between pro-life and pro-choice advocates renews with battles before this Court.1 The last skirmish involving abortion issues in Texas resulted in two district court cases, both continuing to the Fifth Circuit Court of Appeals and one traveling to the United States Supreme Court. See Planned Parenthood of Greater Tex. Surgical Health Servs. v. Abbott, 951 F.Supp.2d 891 (W.D. Tex. 2013), rev’d in part, 748 F.3d 583 (5th Cir. 2014); Whole Woman’s Health v. Lakey, 46 F.Supp.3d 673 (W.D. Tex. 2014) [hereinafter Lakey], aff'd in part, vacated in part, rev’d in part sub nom. Whole Woman’s Health v. Cole, 790 F.3d 563 (5th Cir. 2015) [hereinafter Cole], rev’d and remanded sub nom. Whole Woman’s Health v. Hellerstedt, — U.S. —, 136 S.Ct. 2292, 195 L.Ed.2d 665 (2016). Ultimately, the Supreme Court struck down two provisions of Texas’s House Bill 2 (H.B. 2) as violating the Federal Constitution. Whole Woman’s Health, 136 S.Ct. at 2318. In particular, the Supreme Court invalidated the provisions mandating (1) a physician performing an abortion have admitting privileges at a local hospital no more than 30 miles from that abortion facility and (2) abortion facilities meet minimum standards for ambulatory surgical centers. The Court concluded these provisions imposed undue burdens on a wom[222]*222an’s right to seek a previability abortion. Id. at 2309-28.

Facing the threat of an unfavorable decision from the Supreme Court in Whole Woman’s Health, the Texas Department of State Health Services (DSHS) began plans for the next battle. Before the ink on the Supreme Court’s opinion in Whole Woman’s Health was dry, DSHS had already drafted amendments to Title 25 of the Texas Administrative Code §§ 1.132-1.136 (the Amendments), modifying the methods for disposal of fetal tissue. Four days after the Supreme Court issued its decision in Whole Woman’s Health, the first draft of the proposed Amendments was published. See 41 Tex. Reg. 4772 (July 1, 2016).

After revisions and public hearings on the Amendments, DSHS announced its intention to begin enforcement of the Amendments immediately before the Christmas holiday break. DSHS would not agree to delay enforcement despite the filing of this lawsuit, so the Court entered its order scheduling an evidentiary hearing and mandating the non-enforcement of the Amendments until after the hearing. See Order of Dec. 15, 2016 [# 24].

Basically, the Amendments eliminate four methods of disposal — including the most used and least expensive methods— for specific tissue resulting from miscarriages, elective abortions, and other gynecological procedures performed before the twenty-week gestational mark. The Amendments inferentially establish the beginning of life and create a new term “fetal tissue,” defined as “a fetus, body parts, organs or other tissue from a pregnancy” but not including “the umbilical cord, placenta, gestational sac, blood, or bodily fluids.” 41 Tex. Reg. 9709, 9733 (Dec. 9, 2016) (codified at 25 Tex. Admin. Code § 1.132 (28)).

The changes made by Amendments are not insubstantial and require interpretation, easily given, by DSHS. But the lack of clarity in the Amendments inviting such interpretation allows DSHS to exercise arbitrary, and potentially discriminatory, enforcement on an issue connected to abortion and therefore sensitive and hotly contested.

But the problem extends beyond vagueness in a regulation related to a sensitive constitutional right. DSHS admits the Amendments have no health benefits and the prior version of regulations governing tissue disposal induced no health problems. Instead, DSHS maintains the singular purpose of the Amendments is to promote respect for life and protect the dignity of the unborn while also claiming fetal tissue is not human remains. Unlike the legitimate state interests recognized by the Supreme Court, DSHS’s professed interest regulates a time when there is no potential life and may be pretext for restricting abortion access.

And while the record at this point is slight on the specific additional costs faced by facilities as well as the direct and indirect costs faced by women, both Plaintiffs and DSHS recognize the Amendments will increase overall costs for healthcare facilities. DSHS provides only an approximation of costs using simple, back-of-the-envelope math, which is unsupported by any research and relies heavily on assumptions. Plaintiffs confirm DSHS’s simple math as the lower bound for the cost increases but emphasize costs associated with the Amendments would likely be greater than DSHS anticipates in light of DSHS’s failure to consider vendor availability, administrative costs, and logistical challenges.

It is also undisputed there may be only one facility in the entire State of Texas both willing and currently able to handle disposal of fetal tissue as required by the Amendments. It is therefore reasonable to [223]*223conclude there may be insufficient vendors to handle the disposal of fetal tissue in compliance with the Amendments, which would deliver a major, if not fatal, blow to healthcare providers performing abortions. Consequently, there is sufficient evidence to grant injunctive relief, given herein, to preserve the status quo to allow discovery followed by a trial on whether the Amendments violate the Fourteenth Amendment of the United States Constitution.

Background

This case involves claims by Plaintiffs, healthcare providers offering a variety of medical care to Texas women, that Texas’s new rules for the disposal of fetal tissue violate the Fourteenth Amendment of the United States Constitution, as interpreted by the United States Supreme Court. Today, this Court only considers whether Plaintiffs have met their burden establishing entitlement to a preliminary injunction. The Court now reviews the Amendments and their context in more detail.

I. Medical Waste Disposal Since 1989

In 1989, Texas adopted regulations governing the treatment and disposal of special human waste such as body fluids, microbiological, or pathological waste. 14 Tex. Reg. 1457, 1457-62 (adopted Mar. 14, 1989).

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Bluebook (online)
231 F. Supp. 3d 218, 2017 U.S. Dist. LEXIS 116393, 2017 WL 462400, Counsel Stack Legal Research, https://law.counselstack.com/opinion/whole-womans-health-v-hellerstedt-txwd-2017.