{"id":3322,"date":"2020-08-24T11:03:09","date_gmt":"2020-08-24T11:03:09","guid":{"rendered":"https:\/\/journals.law.harvard.edu\/lpr\/?p=3322"},"modified":"2025-04-01T19:21:25","modified_gmt":"2025-04-01T19:21:25","slug":"why-whole-womans-healths-balancing-test-still-applies-after-june-medical","status":"publish","type":"post","link":"https:\/\/journals.law.harvard.edu\/lpr\/2020\/08\/24\/why-whole-womans-healths-balancing-test-still-applies-after-june-medical\/","title":{"rendered":"Why Whole Woman\u2019s Health\u2019s Balancing Test Still Applies After June Medical"},"content":{"rendered":"<p>By David S. Cohen*<\/p>\n<p>&nbsp;<\/p>\n<p>What\u2019s the test in lower court cases challenging abortion restrictions? Is it the burdens versus benefits balancing test from <a href=\"https:\/\/www.supremecourt.gov\/opinions\/15pdf\/15-274_new_e18f.pdf\"><em>Whole Woman\u2019s Health v. Hellerstedt<\/em><\/a>? Or is it the substantial obstacle test, with no balancing, from Chief Justice Roberts\u2019 concurring opinion in <a href=\"https:\/\/www.supremecourt.gov\/opinions\/19pdf\/18-1323_c07d.pdf\"><em>June Medical v. Russo<\/em><\/a>? This is the burning question in the post-<em>June Medical <\/em>world. Answering it takes us into the world of pornography, voting paradoxes, horizontal versus vertical stare decisis, and the simple-yet-beguiling dictum\/holding divide.<\/p>\n<p>The solution to this problem bridges two scholarly interests of mine\u2014reproductive rights and Supreme Court decision-making. <a href=\"https:\/\/blog.petrieflom.law.harvard.edu\/2020\/07\/15\/june-medical-abortion-restrictions-john-roberts\/\">I\u2019ve already written about <em>June Medical<\/em>\u2019s implications for future Supreme Court abortion cases<\/a>, with the Chief signaling that he is perfectly fine to allow most restrictions to go into effect. Here, I want to focus on the lower courts, who are bound to follow Supreme Court precedent, as opposed to hints as to what the Court might do in the future. But what is the precedent from the divided decision in <em>June Medical<\/em>?<\/p>\n<p>So far, two lower courts have tackled this problem, reaching opposite conclusions. First, in early July, the District of Maryland found <a href=\"https:\/\/www.courthousenews.com\/wp-content\/uploads\/2020\/07\/093111166803.pdf\">that the FDA\u2019s requirement that abortion pills be dispensed at the clinic rather than being sent by mail is unconstitutional during the coronavirus pandemic<\/a>. In doing so, the court applied the <em>Whole Woman\u2019s Health<\/em> balancing test. It reasoned that the \u201ccommon denominator\u201d between the <em>June Medical<\/em> plurality and concurring opinions was that the Louisiana law was a substantial burden. Beyond that, there was no common denominator about a test, so the <em>Whole Woman\u2019s Health<\/em>\u2019s balancing test continues to be the law.<\/p>\n<p>In early August, the <a href=\"https:\/\/www.courthousenews.com\/wp-content\/uploads\/2020\/08\/17-2879.pdf\">Eighth Circuit ruled otherwise<\/a>. In a case challenging a series of Arkansas abortion restrictions, the Court of Appeals instructed the lower court to re-evaluate the claims based on the Chief\u2019s <em>June Medical<\/em> concurrence. The court reasoned that the Chief\u2019s opinion \u201cis controlling\u201d because his \u201cvote was necessary in holding\u201d that the Louisiana law was unconstitutional. The court also noted, quoting Justice Kavanaugh\u2019s <em>June Medical<\/em> dissent, that five Justices (the Chief and the four <em>June Medical<\/em> dissenters) rejected the <em>Whole Woman\u2019s Health<\/em> test.<\/p>\n<p>In dueling letter briefs to the Fifth Circuit in a case challenging Texas abortion restrictions, attorneys on both sides of the abortion divide have also produced different analyses. The attorneys representing the abortion clinics<a href=\"#_ftn1\" name=\"_ftnref1\">[1]<\/a> told the court that there was no common denominator between the Breyer and Roberts opinions, so neither opinion is controlling, leaving <em>Whole Woman\u2019s Health<\/em> the decisional rule. The attorneys for the state of Texas,<a href=\"#_ftn2\" name=\"_ftnref2\">[2]<\/a> of course, took the opposing position, claiming that Chief Justice Roberts\u2019 rejection of the balancing test in favor of a substantial burden test (without balancing benefits) was now the correct test .<\/p>\n<p>So who\u2019s right here? The District of Maryland and the abortion clinic attorneys have reached the right result, but their analyses are not technically correct.<\/p>\n<p>The right way to get there relies on what\u2019s called the <em>Marks<\/em> rule. <a href=\"https:\/\/www.oyez.org\/cases\/1976\/75-708\"><em>Marks v. United States<\/em><\/a> is a 1977 Supreme Court case that addressed the proper standard for pornography convictions. Deciding the case meant the Justices had to determine what to make of a prior obscenity decision that had fractured opinions from the Justices. Justice Powell\u2019s opinion in <em>Marks<\/em> announced what is now known as the narrowest grounds rule: \u201cWhen a fragmented Court decides a case and no single rationale explaining the result enjoys the assent of five Justices, \u2018the holding of the Court may be viewed as that position taken by those Members who concurred in the judgments on the narrowest grounds.\u2019\u201d<\/p>\n<p>As easy as it is to find and quote this rule, there has been <a href=\"https:\/\/www.stanfordlawreview.org\/print\/article\/questioning-marks\/\">deep<\/a> <a href=\"https:\/\/harvardlawreview.org\/2019\/05\/beyond-the-marks-rule\/\">scholarly<\/a> and <a href=\"https:\/\/www.supremecourt.gov\/opinions\/19pdf\/18-5924_n6io.pdf\">judicial disagreement<\/a> (and confusion) over how it is applied (and even whether it should be the rule in these situations). The best scholarly work about the rule comes from <a href=\"https:\/\/www.law.umaryland.edu\/Directory\/profile.asp?id=373\">Professor Maxwell Stearns<\/a>, who has long written about <em>Marks<\/em>. In an excellent forthcoming article (\u201cModeling Narrowest Grounds\u201d), Professor Stearns describes the theoretical underpinnings of the rule and explains its benefits and limitations. The rest of the analysis in this post is based on my synthesis of emails he and I have traded about his article, which is still in draft form, and <em>June Medical<\/em> over the past two weeks. (Though any flaws in this analysis are mine alone.)<\/p>\n<p>The key issue in determining if and how <em>Marks<\/em> applies is whether the Court\u2019s judgment is based on a single dimension. A single dimension means the Court\u2019s decision turns on determining whether the applicable legal principle should be broader or narrower along a single scale. If there is a second issue that is essential for the judgment, such as determining the applicability of a second legal principle that cannot be scaled consistent with the first issue, there are two dimensions. <em>Marks<\/em> can only apply when there is a single dimension. When there are two dimensions, such as a disagreement over a separate jurisdictional issue, there is a risk of a voting paradox, <a href=\"https:\/\/www.gwlr.org\/wp-content\/uploads\/2012\/08\/79-3-Cohen.pdf\">something<\/a> <a href=\"https:\/\/www.bu.edu\/law\/journals-archive\/bulr\/documents\/cohen.pdf\">I\u2019ve written<\/a> <a href=\"https:\/\/digitalcommons.law.umaryland.edu\/mlr\/vol71\/iss4\/16\/\">about extensively<\/a>.<\/p>\n<p>For instance, in <a href=\"https:\/\/www.supremecourt.gov\/opinions\/09pdf\/08-1521.pdf\"><em>McDonald v. Chicago<\/em><\/a>, the case in which the Supreme Court incorporated the Second Amendment against state and local governments, the split decisions created a voting paradox. In that case, eight Justices rejected incorporation of the Second Amendment under the Privileges or Immunities Clause and five Justices rejected incorporation under the Due Process Clause. Since both claims were rejected by a majority of the Justices, it would seem that the Second Amendment wouldn\u2019t be incorporated. However, because four Justices thought it was incorporated under the Due Process Clause and a separate Justice believed it was incorporated under the Privileges or Immunities Clause, the outcome of the case is that the Second Amendment was incorporated. Thus, the paradox\u2014separating out the dimensions leads to a conclusion that there is no incorporation, but the outcome of the case is that there is incorporation.<\/p>\n<p>In <em>June Medical<\/em>, there is no paradox because there is only one dimension that determines the outcome of the case\u2014how protective the Constitution is of the abortion right. Characteristic of one-dimension cases in which <em>Marks<\/em> applies, the fragmented opinions in the case can be aligned along a spectrum of more protective to least protective: Justice Breyer\u2019s plurality opinion would protect the abortion right the most, the varying dissenting opinions would protect it the least, and Chief Justice Roberts\u2019 opinion is in the middle. Thus, under <em>Marks<\/em>, the Chief Justice\u2019s opinion\u2014the narrowest that supports the judgment in the case\u2014is the controlling opinion.<\/p>\n<p>However, that isn\u2019t the end of the analysis. The Chief\u2019s opinion can be recast as one that has two parts to his analysis of this one dimension. First, he says that he disagrees with the legal analysis in the Breyer plurality because he doesn\u2019t believe the Constitution requires balancing burdens and benefits to determine if an abortion restriction is unconstitutional. Rather, under the Chief\u2019s rule, if an abortion law has a legitimate basis, it is constitutional as long as it doesn\u2019t create a substantial burden. This is a rejection of the legal standard from <em>Whole Woman\u2019s Health<\/em>. But second, the Chief says that, even though he rejects the legal standard from that case, as a matter of stare decisis he will follow the specific factual holding of the case (which he dissented from in 2016)\u2014that admitting-privileges laws constitute a substantial burden. Because he follows this part of <em>Whole Woman\u2019s Health<\/em>, he concludes the Louisiana law is unconstitutional.<\/p>\n<p>If the <em>Marks<\/em> analysis ended with concluding that the Chief\u2019s entire opinion controls, lower courts would have to apply both parts of his opinion\u2014his relaxed test as well as the conclusion that admitting privileges laws are unconstitutional. However, the <em>Marks<\/em> analysis, by its very language, also requires determining the <em>holding<\/em> of the controlling opinion in order to determine what part of the Chief\u2019s controlling opinion creates the binding precedent for lower courts.<\/p>\n<p>Looking for the holding from the Chief\u2019s opinion gets us to our final answer. The first part of his analysis\u2014about the proper test for future cases\u2014is dicta because it is not essential to the resolution of the matter before the Court. Why not? Because he says in the second part of his analysis that he is going to apply the factual holding from <em>Whole Woman\u2019s Health<\/em> to determine that the law is unconstitutional. In other words, the new standard the Chief puts forth in the beginning of his opinion is not necessary to reach his conclusion that <em>Whole Woman\u2019s Health<\/em> should apply to the Louisiana law as a matter of stare decisis.<\/p>\n<p>What this means is that <em>June Medical<\/em> produces a very limited holding, one that is only about the unconstitutionality of admitting privileges. That is all we can take away by applying <em>Marks<\/em> to the fractured opinions. Beyond that, we have no new holding from the Supreme Court about a legal standard to apply in abortion cases. That means <em>Whole Woman\u2019s Health<\/em>\u2019s balancing test, which <em>was<\/em> announced in a majority opinion from the Supreme Court, continues to be the test lower courts must apply going forward.<\/p>\n<p>What the Supreme Court will do as a matter of horizontal stare decisis is a different matter, as five Justices have signaled their support for a test that allows more state abortion restrictions. But, as a matter of vertical stare decisis, <em>Whole Woman\u2019s Health<\/em> continues to bind the lower courts because any language to the contrary in the Chief\u2019s controlling <em>June Medical<\/em> opinion was merely dictum.<\/p>\n<p>&nbsp;<\/p>\n<p>*<em><a href=\"https:\/\/drexel.edu\/law\/faculty\/fulltime_fac\/David%20Cohen\/\">David S. Cohen<\/a> (J.D.) is a Professor of Law at the Thomas R. Kline School of Law at Drexel University.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[1]<\/a> Letter Brief of Plaintiffs-Appellants at 3\u20136, <em>Whole Woman\u2019s Health v. Smith<\/em>, No. 18-50730 (5th Cir. July 10, 2020), 2020 WL 4060434.<\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\">[2]<\/a> Letter Brief of Respondents at 5\u20137, <em>Whole Woman\u2019s Health v. Smith<\/em>, No. 18-50730 (5th Cir. July 10, 2020), 2020 WL 4060435.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By David S. Cohen* &nbsp; What\u2019s the test in lower court cases challenging abortion restrictions? Is it the burdens versus [&hellip;]<\/p>\n","protected":false},"author":177,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[268,2,414],"tags":[],"class_list":["post-3322","post","type-post","status-publish","format-standard","hentry","category-featured-posts","category-blog","category-june-medical-symposium"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/peZQka-RA","_links":{"self":[{"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/posts\/3322","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/users\/177"}],"replies":[{"embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/comments?post=3322"}],"version-history":[{"count":0,"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/posts\/3322\/revisions"}],"wp:attachment":[{"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/media?parent=3322"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/categories?post=3322"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/journals.law.harvard.edu\/lpr\/wp-json\/wp\/v2\/tags?post=3322"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}