Associate Justice Harry Blackmun wrote a dissenting opinion in which Associate Justice Thurgood Marshall joined and in which Associate Justice Sandra Day O'Connor joined as to Part I. Associate Justice John Paul Stevens joined Blackmun's opinion as to Parts II and III. Associate Justices Stevens and O'Connor filed separate dissenting opinions.
Facial challenges to a statute's constitutionality must demonstrate that the statute is constitutionally infirm as to any and all circumstances. A successful facial challenge to the constitutionality of a law renders that law void. Facial challenges are contrasted to "as applied" challenges which makes the case that the law as applied to a particular plaintiff or set of plaintiffs would be unconstitutional.
Rust v. Sullivan is a case about a facial challenge to the Department of Health and Human Services (HHS) regulations limiting the ability of Title X fund recipients to engage in abortion-related activities. The United States Court of Appeals for the Second Circuit upheld the regulations, finding them to be a permissible construction of the statute as well as consistent with the First and Fifth Amendments to the Constitution.
Here the majority affirms the Court of Appeals.
Congress enacted Title X of the Public Health Service Act (Act) providing for federal funding for family-planning services. The Act authorizes the Secretary of Health and Human Services to "make grants to and enter into contracts with public or non-profit private entities to assist in the establishment and operation of voluntary family planning projects which shall offer a broad range of acceptable and effective family planning methods and services." Grants and contracts under Title X must "be made in accordance with such regulations as the Secretary may promulgate." Section 1008 of the Act, however, provides that "[n]one of the funds appropriated under this subchapter shall be used in programs where abortion is a method of family planning." That restriction was intended to ensure that Title X funds would "be used only to support preventive family planning services, population research, infertility services, and other related medical, informational, and educational activities."
The regulations attach three principal conditions on the grant of federal funds for Title X projects. First, the regulations specify that a "Title X project may not provide counseling concerning the use of abortion as a method of family-planning or provide referral for abortion as a method of family planning."
Second, the regulations broadly prohibit a Title X project from engaging in activities that "encourage, promote or advocate abortion as a method of family planning." 59.10(a). Forbidden activities include lobbying for legislation that would increase the availability of abortion as a method of family planning, developing or disseminating materials advocating abortion as a method of family planning, providing speakers to promote abortion as a method of family planning, using legal action to make abortion available in any way as a method of family planning, and paying dues to any group that advocates abortion as a method of family planning as a substantial part of its activities.
Third, the regulations require that Title X projects be organized so that they are "physically and financially separate" from prohibited abortion activities.
Petitioners are Title X grantees and doctors who supervise Title X funds suing on behalf of themselves and their patients. Respondent is the Secretary of the Department of Health and Human Services.
The Court found the language of Title X ambiguous. We need not dwell on the plain language of the statute because we agree with every court to have addressed the issue that the language is ambiguous. The language of 1008 — that "[n]one of the funds appropriated under this subchapter shall be used in programs where abortion is a method of family planning" — does not speak directly to the issues of counseling, referral, advocacy, or program integrity. If a statute is "silent or ambiguous with respect to the specific issue, the question for the court is whether the agency's answer is based on a permissible construction of the statute."
Addressing "Program Integrity" Rehnquist said it was permissible for separate facilities and record keeping be maintained as a way to insure that federal funds were only used in a manner prescribed by the rules imposed by the Secretary of Health and Human Services.
The Court's majority also rejected, by tiptoeing through a long line of cases, the argument that the rules advanced here violated the First Amendment. The opinion said "The regulations, which govern solely the scope of the Title X project's activities, do not in any way restrict the activities of those persons acting as private individuals. The employees' freedom of expression is limited during the time that they actually work for the project; but this limitation is a consequence of their decision to accept employment in a project, the scope of which is permissibly restricted by the funding authority"
Finally the Court summarily dismissed any claims predicated on denial of a woman's Due Process Rights under the Fifth Amendment. "Under the Secretary's regulations, however, a doctor's ability to provide, and a woman's right to receive, information concerning abortion and abortion-related services outside the context of the Title X project remains unfettered. It would undoubtedly be easier for a woman seeking an abortion if she could receive information about abortion from a Title X project, but the Constitution does not require that the Government distort the scope of its mandated program in order to provide that information."
The fact that this program was applicable to indigent women did not disturb the majority. "The financial constraints that restrict an indigent woman's ability to enjoy the full range of constitutionally protected freedom of choice are the product not of governmental restrictions on access to abortion, but rather of her indigency."
Associate Justice Harry Blackmun's called the majority's opinion disingenuous. He said: "Because I conclude that a plainly constitutional construction of 1008 is not only `fairly possible' but entirely reasonable,' [he] would reverse the judgment of the Court of Appeals on this ground without deciding the constitutionality of the Secretary's Regulations"
Blackmun rejected the majority's analysis regarding the First Amendment and Fifth Amendment claims.
In the dissent by Associate Justice Stevens, he said: " I am convinced that the 1970 Act did not authorize the Secretary to censor the speech of grant recipients or their employees, I would hold the challenged regulations invalid and reverse the judgment of the Court of Appeals."
In her dissent Associate Justice Sandra Day O'Connor said: " In this case, we need only tell the Secretary that his regulations are not a reasonable interpretation of the statute; we need not tell Congress that it cannot pass such legislation. If we rule solely on statutory grounds, Congress retains the power to force the constitutional question by legislating more explicitly. It may instead choose to do nothing. That decision should be left to Congress; we should not tell Congress what it cannot do before it has chosen to do it. It is enough in this case to conclude that neither the language nor the history of 1008 compels the Secretary's interpretation, and that the interpretation raises serious First Amendment concerns. On this basis alone, I would reverse the judgment of the Court of Appeals and invalidate the challenged regulations.
Rust v. Sullivan was decided in 1991