Justia Civil Rights Opinion Summaries
Articles Posted in Health Law
Baker v. USD 229 Blue Valley
Plaintiff-appellant Terri Baker appealed the dismissal of this putative class action for lack of standing. She sued on behalf of herself and her son, S.F.B., to challenge Kansas laws and school district policies that: (1) required children to be vaccinated to attend school and participate in child care programs; and (2) provided a religious exemption from these requirements. She claimed these immunization laws and policies violated various federal and state constitutional provisions and statutes. Baker argued she and S.F.B. had standing because the immunization requirements and religious exemptions injured them in two ways: (1) the District misapplied Kansas law when it granted a religious exemption for S.F.B. to attend preschool despite being unvaccinated - her fear that the District would revoke S.F.B.'s religious exemption was an injury in fact that established standing; and (2) Baker "would like the option" of placing S.F.B. in a non-accredited private school (i.e., home school), school programs, or licensed child care - she contended Kansas law inhibited her from exercising these options and caused an injury in fact because she would be unable to secure a religious exemption for S.F.B. if she tried. Finding no reversible error in the district court's dismissal, the Tenth Circuit affirmed. View "Baker v. USD 229 Blue Valley" on Justia Law
In re Von Staich
Von Staich is incarcerated at San Quentin State Prison, based on 1986 second-degree murder and attempted murder convictions. In May 2020, he sought habeas corpus relief, citing the COVID-19 pandemic. Shortly thereafter, San Quentin suffered a COVID-19 outbreak that infected approximately 75 percent of the inmate population and dozens of prison staff in just weeks. Von Staich is 64 years old and suffers respiratory problems resulting from bullet fragments lodged in his lung; he claimed that he and a 65-year-old cellmate, both of whom had tested positive for COVID-19 (Van Staich was asymptomatic), were in an extremely small open cell and that there is no opportunity for social distancing.The court directed the Warden to transfer Von Staich to a suitable quarantine location, finding that the Warden and the California Department of Corrections and Rehabilitation (CDCR) have acted with deliberate indifference. There is ongoing federal litigation concerning inadequate medical care due to severe overcrowding in the California correctional system and San Quentin has particular risk factors, caused by the age and architecture of the facility. The court acknowledged that the existing Eighth Amendment violation will continue until the population at San Quentin can be reduced to the 50 percent level. Unless CDCR’s existing expedited release programs are sufficient to promptly achieve this population reduction—which, the sheer numbers indicate they cannot be—CDCR will have to find additional means of releasing or transferring prisoners out of San Quentin. View "In re Von Staich" on Justia Law
Dierlam v. Trump
Plaintiff filed suit challenging the Affordable Care Act (ACA), seeking retrospective and prospective relief for myriad alleged violations of the United States Constitution and the Religious Freedom Restoration Act. The Fifth Circuit declined to reach the merits of plaintiff's claims. The court held that, given the altered legal landscape and the potential effects of plaintiff's request for prospective relief, a mootness analysis must precede the merits. In this case, a year after plaintiff filed his lawsuit, Congress passed and President Trump signed the Tax Cut and Jobs Act, which reduced the shared responsibility payment (imposed on individuals who fail to purchase health insurance) to $0. In the same year, the Department of Health and Human Services created new exemptions to the contraceptive mandate, including an exemption for individuals like plaintiff. These exemptions were enjoined until the Supreme Court's recent decision in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania. Therefore, the court vacated the district court's dismissal of plaintiff's claims and remanded for the district court to conduct a mootness analysis in the first instance. The court also remanded to allow plaintiff to amend his complaint where the parties agreed that the district court incorrectly dismissed plaintiff's claim for retrospective relief. View "Dierlam v. Trump" on Justia Law
Whole Woman’s Health v. Paxton
Senate Bill 8 -- a statute that requires a woman to undergo an additional and medically unnecessary procedure to cause fetal demise before she may obtain a dilation and evacuation (D&E) abortion, the safest and most common method of second trimester abortions -- imposes an undue burden on a woman's right to obtain an abortion before fetal viability in violation of the Fourteenth Amendment's Due Process clause.The Fifth Circuit affirmed the district court's judgment holding that SB8 is facially unconstitutional and permanently enjoining its enforcement. Applying the undue burden test in Whole Woman's Health v. Hellerstedt, 136 S. Ct. 2292, 2309 (2016), rather than June Medical Services, L.L.C. v. Russo, 140 S. Ct. 2103, 2114 (2020), the court held that SB8's burdens substantially outweigh its benefits and constitutes an undue burden on a woman's right to obtain a previability abortion. Under the statute, the court explained that all women seeking a second trimester abortion starting at 15 weeks LMP would be required to endure a medically unnecessary and invasive additional procedure that provides no health benefit; for most women, the length of the procedure would increase from one day to two, adding to the costs associated with travel, lodging, time away from work, and child care; and SB8 forces abortion providers to act contrary to their medical judgment and the best interest of their patient by conducting a medical procedure that delivers no benefit to the woman. Weighing SB8's significant burdens upon female patients against its nonexistent health benefits and any other limited benefits it may actually confer, the court concluded that it is clear that the law places a "substantial obstacle in the path of a woman seeking" a previability abortion. View "Whole Woman's Health v. Paxton" on Justia Law
Nasello v. Eagleson
Most people eligible for Medicaid benefits are “categorically needy” because their income falls below a threshold of eligibility. People with higher income but steep medical expenses are “medically needy” once they spend enough of their own assets to qualify, 42 U.S.C. 1396a(a)(10). Plaintiffs contend that medical expenses they incurred before being classified as “medically needy” should be treated as money spent on medical care, whether or not those bills have been paid, which would increase Illinois's payments for their ongoing care.The Seventh Circuit affirmed the dismissal of their suit. Medicaid is a cooperative program through which the federal government reimburses certain expenses of states that abide by the program’s rules. Medicaid does not establish anyone’s entitlement to receive particular payments. The federal-state agreement is not enforceable by potential beneficiaries. Plaintiffs bypassed their administrative remedies and do not have a judicial remedy under 1396a(r)(1)(A). Section 1396a(a)(8) provides that a state’s plan must provide that all individuals wishing to apply for medical assistance under Medicaid shall have the opportunity to do so and that assistance shall be furnished with reasonable promptness to all eligible individuals; some courts have held that this requirement can be enforced in private suits. If such a claim were available, it would fail. Plaintiffs are receiving benefits. The court also rejected claims under the Americans with Disabilities Act, 42 U.S.C. 12131–34, and the Rehabilitation Act, 29 U.S.C. 794. Plaintiffs receive more governmental aid than nondisabled persons. View "Nasello v. Eagleson" on Justia Law
Mayor and City Council of Baltimore v. Azar
Baltimore filed suit against the Government, alleging that HHS's Final Rule, prohibiting physicians and other providers in Title X programs from referring patients for an abortion, even if that is the patient's wish, violates the Administrative Procedure Act (APA). The Final Rule, instead, requires them to refer the patient for prenatal care. Furthermore, the Final Rule requires entities receiving Title X funds, but offering abortion-related services pursuant to another source of funds, to physically separate their abortion-related services from the Title X services. After the district court issued a preliminary injunction enjoining the Government from implementing or enforcing the Final Rule because the Final Rule is likely not in accordance with law, the Government appealed. While the appeal of the preliminary injunction was pending and after discovery, the district court issued a permanent injunction on different grounds.The Fourth Circuit consolidated the appeals and a majority of the full court voted to hear both cases en banc. The court upheld the district court's grant of the permanent injunction on two grounds: first, the Final Rule was promulgated in an arbitrary and capricious manner because it failed to recognize and address the ethical concerns of literally every major medical organization in the country, and it arbitrarily estimated the cost of the physical separation of abortion services; and second, the Final Rule contravenes statutory provisions requiring nondirective counseling in Title X programs and prohibiting interference with physician/patient communications. Accordingly, because the court affirmed the permanent injunction in Case No. 20-1215, the appeal of the preliminary injunction in Case No. 19-1614 is moot and the court dismissed it. View "Mayor and City Council of Baltimore v. Azar" on Justia Law
Hoffer v. Secretary, Florida Department Corrections
Hepatitis C (HCV) is a bloodborne virus. Only about 1% of the general population suffers from HCV; its prevalence among prison inmates is much higher. HCV primarily attacks the liver, causing scarring, or “fibrosis,” which is measured from F0 (no fibrosis) to F4 (cirrhosis). Many people “spontaneously clear” HCV without treatment. HCV patients were previously prescribed weekly injections of Interferon, which caused unpleasant side effects, and succeeded in eradicating HCV only about 30% of the time. In 2013, a new HCV treatment became available—direct-acting antiviral (DAA) pills, with few side effects and a 95% cure rate. DAAs are very expensive.Chronic-HCV inmates incarcerated in Florida prisons filed a class action under 42 U.S.C. 1983, alleging deliberate indifference to inmates’ serious medical needs. Florida then hired Dr. Dewsnup, who had developed and implemented an HCV-treatment plan for the Oregon prison system. Florida adopted Dewsnup's proposal of providing DAAs for all inmates at level F2 and above and monitoring F0- and F1-level inmates and treating them with DAAs under certain circumstances. Ultimately, the court ordered DAA treatment of all F0s and F1s within two years of their initial staging. The Eleventh Circuit reversed. The state’s plan to monitor all HCV-positive inmates, including those who have not exhibited serious symptoms, and provide DAAs to anyone with an exacerbating condition, showing signs of rapid progression, or developing even moderate fibrosis, satisfies constitutional requirements. View "Hoffer v. Secretary, Florida Department Corrections" on Justia Law
Atkins v. Parker
Hepatitis C is a contagious, progressive virus that can lead to cirrhosis of the liver, liver cancer, and ultimately death. There is no vaccine for hepatitis C. Doctors previously treated the virus using interferons; that treatment brought little success and severe side effects. In 2011, the FDA approved new direct-acting antivirals that halt the progress of hepatitis C and eventually cause the virus to disappear. In 2015, the cost of a single course of treatment using direct-acting antivirals was $80,000-$189,000. By the time of trial, those prices was $13,000-$32,000.A 2016 policy specified that the Tennessee Department of Corrections would provide the antivirals only to infected inmates with severe liver scarring. By 2019, approximately 4,740 of Tennessee's 21,000 inmates had hepatitis. Under a 2019 guidance, every new inmate is tested for hepatitis C. Inmates who test positive undergo a baseline evaluation; an advisory committee of healthcare professionals evaluates each infected inmate and determines his course of treatment. The guidance establishes criteria that make antivirals available to “individuals [who] are at higher risk for complications or disease progression," includes a series of procedural steps for local providers, and provides for continuous care and monitoring of infected inmates, regardless of their treatment plan.The Sixth Circuit affirmed the rejection of inmates' claims under 42 U.S.C. 1983, alleging deliberate indifference to their serious medical needs. The 2019 guidance showed reasonable medical judgment to care for the class of infected inmates. While the best course of action might be to treat all infected inmates with antivirals, the defendant could not spend more than was allocated and had repeatedly sought budget increases. View "Atkins v. Parker" on Justia Law
Whole Woman’s Health v. Paxton
Almost three years after a federal district court declared that Texas Senate Bill 8 placed an undue burden on a woman's right to access a previability abortion and enjoined its enforcement, the State seeks to stay the judgment.The Fifth Circuit denied the state's motion for a stay and held that June Medical Servs. LLC v. Russo, 140 S. Ct. 2103 (2020), has not disturbed the undue-burden test, and Whole Woman's Health v. Hellerstedt, 136 S. Ct. 2292 (2016), remains binding law in this circuit. Under this circuit's reading of the Marks principle, that the challenged Louisiana law posed an undue burden on women seeking an abortion is the full extent of June Medical's ratio decidendi. The court stated that the decision does not furnish a new controlling rule as to how to perform the undue-burden test. Therefore, the court held that Hellerstedt's formulation of the test continues to govern this case, and because the district court correctly applied Hellerstedt's balancing test, remand is not warranted.The court also held that the state's law is patently procedurally defective where the state's failure to show the impracticability of moving first in the district court under Federal Rule of Appellate Procedure 8(2) is sufficient grounds to deny its motion. View "Whole Woman's Health v. Paxton" on Justia Law
Liberian Community Ass’n v. Lamont
Plaintiffs filed suit challenging the quarantine decisions of certain Connecticut state officials in response to an Ebola epidemic in West Africa. On appeal, plaintiffs challenged the district court's denial of their motion for class certification and dismissing their suit for lack of standing and based on qualified immunity. Plaintiffs primarily argue that they suffered actual or imminent injuries that create standing to seek prospective relief to avert allegedly unconstitutional future quarantines; clearly established law required that any quarantine imposed be medically necessary and comport with certain procedural safeguards; and their class is sufficiently numerous to merit certification.The Second Circuit affirmed and held that the district court properly deemed plaintiffs' injuries too speculative to support standing. In this case, plaintiffs failed to plead a sufficient likelihood that, under the revised policy, any of them faces a substantial risk of suffering a future injury. The court also held that the law surrounding quarantines was not clearly established such that a state official may be held liable for the actions taken here. The court did not reach the class certification issue because it is mooted by the court's conclusion as to standing. Accordingly, the court remanded with instructions to amend the judgment to clarify that the state law claims were dismissed without prejudice. View "Liberian Community Ass'n v. Lamont" on Justia Law