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United States v. Health and Human Services

United States District Court, N.D. California

July 2, 2019

STATE OF CALIFORNIA, et al., Plaintiffs,
HEALTH AND HUMAN SERVICES, et al., Defendants.



         In this case, a coalition of thirteen states and the District of Columbia (collectively, “States” or “Plaintiff States”) brought challenges to interim final rules and final rules (collectively, the “Rules”) promulgated by federal agencies that create religious and moral exemptions to the contraceptive mandate contained within the Affordable Care Act. See Second Amended Complaint, Dkt. No. 170.[1] In January, the Court preliminarily enjoined implementation of the Rules within the Plaintiff States. See Dkt. No. 234. A few weeks later, the Court allowed Oregon to join the multi-state coalition, Dkt. No. 274, and now Oregon seeks to expand the geographic scope of the preliminary injunction to prevent the Rules from being implemented in Oregon pending a resolution on the merits. See Motion for Preliminary Injunction (“Mot.”), Dkt. No. 312. The Court finds that the requested extension is warranted and therefore GRANTS Oregon's motion for a preliminary injunction.[2]

         I. BACKGROUND

         The Court recounted the extensive statutory, regulatory, and judicial background to this case in its January 13, 2019 order granting Plaintiffs' motion for a preliminary injunction and incorporates that summary by reference here. See Dkt. No. 234 at 2-15.

         Since the Court granted preliminary relief in the Plaintiff States, Oregon filed its complaint-in-intervention, alleging the injuries that it predicts the state (and its citizens) will sustain if the Rules were to be implemented in Oregon. See Dkt. No. 287 (“Compl.”). Oregon alleges that if the Rules go into effect, women who lose their entitlement to free contraceptives will turn to Oregon's ContraceptiveCare and Reproductive Health Equity Act programs, thereby increasing costs to the state. See Compl. ¶¶ 18-19, 22; see also Declaration of Helene Rimberg (“Rimberg Decl.”), Dkt. No. 211 ¶ 7. And Oregon predicts that some women who lose contraceptive coverage because of the Rules may forgo contraceptive use entirely and unintentionally become pregnant, which could impose costs on the state's Medicaid program. Compl. ¶¶ 22-23; see also Rimberg Decl. ¶ 7-9. Oregon alleges that it expects at least one instate employer-Hobby Lobby, which has five stores in Oregon-to invoke the exemption if it goes into effect. Compl. ¶ 24.

         In its motion, Oregon concedes that granting an injunction would not have any immediate effect because Federal Defendants are currently enjoined from implementing the Rules nationwide based on the district court's order in Pennsylvania v. Trump, 351 F.Supp.3d 791, 835 (E.D. Pa. 2019). However, Oregon contends that because the Pennsylvania injunction is “subject to appellate review and attack for its scope, ” there is an “imminent risk that the nationwide injunction could be lifted and thousands of Oregonian women left without contraceptive coverage.” Mot. at 8.

         Federal Defendants and Defendant-Intervenors March for Life opposed the extension of the preliminary injunction. See Dkt. Nos. 361 (“Fed. Opp.”), 359 (“March Opp.”). Oregon replied. See Dkt. No. 365 (“Reply”).


         “A plaintiff seeking preliminary injunctive relief must establish that [it] is likely to succeed on the merits, that [it] is likely to suffer irreparable harm in the absence of preliminary relief, that the balance of equities tips in [its] favor, and that an injunction is in the public interest.” Winter v. Nat. Res. Def. Council, Inc., 555 U.S. 7, 22 (2008). Alternatively, an injunction may issue where “the likelihood of success is such that serious questions going to the merits were raised and the balance of hardships tips sharply in [the plaintiff's] favor, ” provided that the plaintiff can also demonstrate the other two Winter factors. All. for the Wild Rockies v. Cottrell, 632 F.3d 1127, 1131-32 (9th Cir. 2011) (citation and internal quotation marks omitted). Under either standard, the plaintiff bears the burden of making a clear showing that it is entitled to this extraordinary remedy. Earth Island Inst. v. Carlton, 626 F.3d 462, 469 (9th Cir. 2010).


         The Court previously concluded that the Plaintiff States were entitled to a preliminary injunction because they had shown that: they were likely to succeed (or had at least raised serious questions going to the merits) on their claim that the Rules violated the Affordable Care Act, they would suffer irreparable harm absent preliminary relief, the balance of hardships tipped sharply in their favor, and the public interest favored injunctive relief. See Dkt. No. 234 at 21. Because the Court finds that there have not been any subsequent developments that would alter its analysis as to the likelihood of success, balance of the hardships, and public interest factors, the Court incorporates by reference its prior discussion of these factors. See Id. at 21-39, 40-42.

         That leaves irreparable harm. Oregon contends that “[i]f the nationwide injunction is lifted, the Rules will inflict irreparable harm.” Mot. at 28. According to Oregon, the Rules will likely cause unintended pregnancies to rise and women to turn to state family planning programs, imposing unrecoverable costs on the state. Id. at 28-30. Federal Defendants respond that Oregon has not established irreparable injury because of the pre-existing nationwide injunction and its delay in moving for a preliminary injunction. See Fed. Opp. at 11-13. The Court considers each of Federal Defendants' arguments in turn.

         A. Nationwide Injunction

         Federal Defendants contend that this Court should not “enter a duplicative injunction” with the one issued by the district court in Pennsylvania. Fed. Opp. at 11. Federal Defendants cite to Hawai'i v. Trump, in which a district court granted the government's motion for an emergency stay pending an appeal in a similar case in the same circuit and noted that a parallel “nationwide injunction already provides [Hawai'i] with the comprehensive relief it seeks in this lawsuit.” 233 F.Supp.3d 850, 853 (D. Haw. 2017). However, this example is belied by the fact that the district court later issued a preliminary injunction that overlapped with one issued by a Maryland district court. See State v. Trump, 265 F.Supp.3d 1140, 1146 (D. Haw. 2017).[3] Moreover, overlapping injunctions appear to be a common outcome of parallel litigation, rather than a reason for the Court to pass on exercising its duty to determine whether litigants are entitled to relief. For example, in recent litigation challenging the Secretary of Commerce's decision to add a citizenship question to the census, three district courts issued parallel injunctions against the policy. See New York v. United States Dep't of Commerce, 351 F.Supp.3d 502, 677 (S.D.N.Y. 2019)[4]; State v. Ross, ...

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