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The Indiana Court of Appeals denied Planned Parenthood’s challenge to the state’s near-total abortion ban on Monday, upholding a September 2024 decision by the Monroe Circuit Court.
In upholding the lower court ruling, the appellate court agreed with the trial court’s findings that medical care providers failed to identify any specific physical or mental health condition that would be protected by Article 1, Section 1 of the Indiana Constitution, but not protected under the state’s abortion ban.
Attorneys with the American Civil Liberties Union of Indiana represent Planned Parenthood in this case.
Laura Forbes, communications manager for the ACLU of Indiana, told The Indiana Lawyer, “We are disappointed in the decision, and we continue to believe that these extreme restrictions violate the state constitution by putting pregnant Hoosiers’ health at serious risk.”
The appellate court also found that the state’s Hospital Requirement and Life or Health Exception are not material burdens on the constitutional right to an abortion.
“This ruling is a resounding victory for life and the rule of law in Indiana,” Attorney General Todd Rokita said in a release issued Monday. “Our unwavering commitment to protecting the most vulnerable and upholding our state’s values will continue to guide this office. The overwhelming majority of Hoosiers stand with us in defending the sanctity of life and the health of women across our state.”
Following the Supreme Court of the United States’ decision on abortion rights in 2022, Planned Parenthood and other medical providers challenged the facial validity of Indiana’s abortion ban under the state’s constitution, which provides that “all people” have certain rights, including “life, liberty, and the pursuit of happiness.”
The American Civil Liberties Union of Indiana initially filed the lawsuit challenging Senate Enrolled Act 1 in September 2022 shortly after the law was passed.
SEA1 prohibits abortion in Indiana except in limited cases of rape or incest, fatal fetal anomaly, or to protect the life or health of the pregnant woman. The law also eliminates licensed abortion clinics in the state and instead requires legal abortion procedures to be carried out in a hospital or ambulatory outpatient surgical care.
The trial court entered a preliminary injunction on behalf of the providers.
On the state’s appeal, the Indiana Supreme Court held that Article 1, Section 1, “protects a woman’s right to an abortion that is necessary to protect her life or to protect her from a serious health risk,” and concluded that a facial challenge to the statute could not succeed, and remanded for further proceedings.
On remand, the medical providers amended their complaint to request declaratory and injunctive relief on the theory that there are several circumstances in which the life or health of a woman is at risk by a pregnancy, but that the state’s abortion ban appears to prohibit a woman from obtaining an abortion to resolve the risks.
The providers also argued that the state’s Life or Health Exception imposes a material burden on the constitutional right to an abortion by requiring an invocation of the statutory exception to be based on a “reasonable medical judgment,” Judge Paul Mathias wrote for the appellate court.
Finally, the providers challenged amendments to state law that require all abortions to be performed in either a licensed hospital or in a surgical center that is majority owned by a license hospital, known as the Hospital Requirement, arguing that the requirement materially burdens patients’ rights under Article 1, Section 1 by making abortion care expensive and difficult to access.
With respect to the first point, the appellate court acknowledged that both the physical and mental health conditions identified by the providers all demonstrate some measure of a “serious health risk,” and that the state’s articulation of the right to an abortion might compel physicians to wait to perform an abortion until a patient has a serious condition, but that it is the “balance struck between the unenumerated, reserved right to the people under Article 1, Section 1 and the State’s police power under the Indiana Constitution,” Mathias wrote.
On the second point, the appellate judges rejected the providers’ suggestion that the “reasonable medical judgment” standard is amorphous simply because reasonable physicians can arrive at different judgments regarding the best course of action for their patients.
The appellate court found that both the constitutional right and the statutory exception require a reasonable medical judgment.
Finally, the judges concluded that the Hospital Requirement is not to blame for the reduced access to abortions in Indiana.
A woman who is seeking an abortion is, by definition, facing a risk to her life or a serious health risk, and as the trial court found, a woman in that scenario would likely be receiving care at a hospital anyway, Mathias wrote.
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