Mayor and City Council of Baltimore v. Azar (Maryland)
(D. Md. No. 1:19-cv-01103)
This case challenges a Final Rule adopted by the U.S. Department of Health and Human Services (HHS) that imposes restrictions on organizations receiving grants pursuant to Title X of the Public Health Services Act (Title X), 42 U.S.C. §§ 300 -300a-6.
Established in 1970, Title X is a federal grant program dedicated to providing individuals with comprehensive family planning and related preventive health services. These services include birth control; wellness exams; cervical and breast cancer screenings; and testing and treatment for sexually transmitted infections (STIs). Title X benefits low income people; the uninsured; and communities that have historically faced barriers to healthcare access. More than four million U.S. residents rely on Title X-funded healthcare providers for affordable birth control and preventive health services.
The restrictions imposed by the Final Rule include a “gag rule” that prohibits recipients of Title X funds from providing their patients with referrals for abortion care, even when a patient specifically requests a referral; and “separation requirements” mandating that recipients of Title X funds be “physically and financially separate” from any person or entity who provides, refers for, or advocates for abortion care, such that they must maintain separate facilities, personnel, medical records, workstations, signage, and public identities. The Final Rule will harm the intended beneficiaries of Title X by limiting the number of healthcare providers willing and able to serve them, and preventing them from obtaining accurate information about where they may obtain safe abortion care.
The City of Baltimore is challenging the Final Rule to prevent these harms from impacting its residents. The Baltimore City Health Department, founded in 1793, is the oldest continuously operating health department in the United States. It operates a network of health centers that serve over 7,500 Title X clients annually.
In addition to Baltimore’s case, six other cases challenging the Final Rule are pending across the country:
- American Medical Association v. Azar, D. Or. No. 6:19-cv-318
- California v. Azar, N.D. Cal. No. 3:19-cv-01184
- Family Planning Association of Maine v. U.S. Department of Health and Human Services, D. Me. No. 1:19-cv-00100
- National Family Planning and Reproductive Health Association v. Azar, E.D. Wash. No. 1:19-cv-03045
- Oregon v. Azar, D. Or. No. 6:19-cv-00317
- Washington v. Azar, E.D. Wash. No. 1:19-cv-03049
Plaintiff: Mayor and City Council of Baltimore
Defendants: Secretary of the United States Department of Health and Human Services, in his official capacity; United States Department of Health and Human Services; Deputy Assistant Secretary for the Office of Population Affairs, in her official capacity; Office of Population Affairs
Co-counsel: Baltimore City Law Department; Arnold & Porter Kaye Scholer LLP; Yale Law School Reproductive Rights and Justice Project
Timeline and Key Documents:
May 4, 2019 HHS adopts the Final Rule
April 12, 2019 Plaintiff files Complaint
May 30, 2019 District court enters Preliminary Injunction
June 6, 2019 Defendants file Notice of Appeal
June 19, 2019 District court enters Order denying Defendants’ motion to stay the injunction pending appeal
July 2, 2019 Court of appeals enters Order granting Defendants’ motion to stay the injunction pending appeal
September 18, 2019 Court of appeals hears oral argument
[CLICK HERE FOR BRIEFS FILED IN THE FOURTH CIRCUIT]
Mayor and City Council of Baltimore v. Azar—FOURTH CIRCUIT BRIEFS
Brief for Appellants (Secretary of the United States Department of Health and Human Services, et al.)
Brief for Appellee (Mayor and City Council of Baltimore)
Reply Brief for Appellants