Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caDC-05-05406/USCOURTS-caDC-05-05406-0/pdf.json

Nature of Suit Code: 890
Nature of Suit: Other Statutory Actions
Cause of Action: 

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United States Court of Appeals 

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued September 8, 2006 Decided November 14, 2006 

No. 05-5406 

NATIONAL FAMILY PLANNING AND REPRODUCTIVE HEALTH 

ASSOCIATION, INC.,

APPELLANT

V. 

ALBERTO GONZALES, ATTORNEY GENERAL OF THE UNITED 

STATES, ET AL., 

APPELLEES

Appeal from the United States District Court 

for the District of Columbia 

(No. 04cv02148) 

James L. Feldesman argued the cause for appellant. With 

him on the briefs were Kathy S. Ghiladi and Robert A. 

Graham. 

August E. Flentje, Attorney, U.S. Department of Justice, 

argued the cause for appellees. With him on the brief were 

Peter D. Keisler, Assistant Attorney General, Kenneth L. 

Wainstein, U.S. Attorney, and Robert M. Loeb, Attorney. 

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Stephen H. Aden argued the cause for appellees Christian 

Medical Association and American Association of Pro-Life 

Obstetricians and Gynecologists. With him on the brief was 

Benjamin W. Bull. 

Jay Alan Sekulow, Colby M. May and James M. 

Henderson, Sr. were on the brief for amici curiae for U.S. 

Representative Henry J. Hyde, et al. in support of appellees. 

Before: GINSBURG, Chief Judge, and SENTELLE, Circuit 

Judge, and WILLIAMS, Senior Circuit Judge. 

Opinion for the Court filed by Senior Circuit Judge

WILLIAMS. 

WILLIAMS, Senior Circuit Judge: At the end of 2004 

Congress adopted a provision commonly known as the 

Weldon Amendment (named after Representative David 

Weldon), prohibiting recipients of federal grant funds from 

discriminating against individuals or entities that refuse to 

provide or refer for abortions. Consolidated Appropriations 

Act, 2005, Pub. L. No. 108-447, § 508(d), 118 Stat. 2809, 

3163. It reenacted the same provision the next December. 

Departments of Labor, Health and Human Services, and 

Education, and Related Agencies Appropriations Act, 2006, 

Pub. L. No. 109-149, § 508(d), 119 Stat. 2833, 2879–80. 

Five days after the initial enactment, the National Family 

Planning and Reproductive Health Association filed suit in 

district court. Its substantive claims—at least the ones making 

it to the appeal—are that the amendment’s alleged vagueness 

violates the First Amendment, for which it cites Rust v. 

Sullivan, 500 U.S. 173 (1991), and the limits of Congress’s 

spending power, for which it cites Pennhurst State School and 

Hospital v. Halderman, 451 U.S. 1, 17 (1981) (holding that a 

statute exercising Congress’s spending power imposes legally 

binding conditions on a recipient state only if it expresses the 

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binding character unambiguously). The district court found 

standing but on the merits denied the requested injunction and 

granted summary judgment for the government. We find no 

standing. 

* * * 

Under Title X of the Public Health Service Act, 42 U.S.C. 

§ 300, the Secretary of Health and Human Services “is 

authorized to make grants to and enter into contracts with 

public or nonprofit private entities to assist in the 

establishment and operation of voluntary family planning 

projects . . . .” Most Title X funds flow initially to state and 

local governmental agencies and non-profit organizations. 

These grantees function as intermediaries that in turn 

distribute the funds to subgrantees who actually administer the 

programs. The plaintiff association is an organization 

comprised largely of Title X grantees and subgrantees, 

including state and local agencies, nonprofit organizations, 

clinics, and individuals employed by such entities. 

The association’s vagueness theory rests in large part on 

an alleged conflict between the Weldon Amendment and a 

Health and Human Services (“HHS”) regulation governing 

Title X funds. The regulation, most recently amended in 

2000, requires all recipients of Title X funds to “offer 

pregnant women the opportunity to be provided information 

and counseling regarding . . . pregnancy termination.” 65 Fed. 

Reg. 41,270, 41,279/1 (July 3, 2000). Neither party disputes 

that the regulation was an appropriate exercise of the 

Secretary’s rulemaking authority (though the government 

notes, and plaintiff doesn’t contest, that in the event of 

conflict the regulation must yield to a valid statute). The 

Weldon Amendment, on the other hand, protects institutional 

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and individual providers that wish not to provide or refer for 

abortions: 

(1) None of the funds made available in this Act may be 

made available to a Federal agency or program, or to a 

State or local government, if such agency, program, or 

government subjects any institutional or individual health 

care entity to discrimination on the basis that the health 

care entity does not provide, pay for, provide coverage of, 

or refer for abortions. 

(2) In this subsection, the term “health care entity” 

includes an individual physician or other health care 

professional, a hospital, a provider-sponsored 

organization, a health maintenance organization, a health 

insurance plan, or any other kind of health care facility, 

organization, or plan. 

Consolidated Appropriations Act, 2005, § 508(d). 

 The complaint asserts that the association’s members do 

not know how to abide by the 2000 HHS regulation as well as 

the Weldon Amendment and are therefore in jeopardy of 

losing federal grants. Arguing that its members face 

pervasive uncertainty as to their obligations under the two 

provisions, it seeks declaratory relief and a preliminary 

injunction against enforcement of the amendment. 

* * * 

Constitutional standing requires that a plaintiff show 

“injury in fact,” which the Supreme Court has defined as “an 

invasion of a legally protected interest which is (a) concrete 

and particularized and (b) actual or imminent, not conjectural 

or hypothetical.” Lujan v. Defenders of Wildlife, 504 U.S. 

555, 560 (1992) (citations and internal quotations omitted). 

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An actual withdrawal of funding from the association’s 

members would clearly qualify, but the association doesn’t 

suggest that any such withdrawal has occurred. 

The association does say, however, that its members face 

an imminent threat of injury, including loss of funding, 

because of the alleged conflict between the regulation and the 

amendment. They claim to be in a Catch-22: If they obey the 

amendment, they’ll violate the regulation, and vice versa. 

Either way, they say, they are bound to violate one of the 

conditions of their funding. Although of course a valid statute 

always prevails over a conflicting regulation, the alleged 

vagueness of the statute leaves the association uncertain 

whether the amendment or the regulation will govern a variety 

of situations. Compare Abbott Laboratories v. Gardner, 387 

U.S. 136, 153–54 (1967), where the plaintiff firms faced the 

hardship of choosing (without authoritative guidance) 

between compliance with a possibly unlawful regulation at 

considerable expense, and non-compliance, at the risk of 

being subjected to after-the-fact enforcement that would entail 

fines and reputational losses. But even if the same standard 

applied to challenges to a statute as to a regulation, cf. Seegars 

v. Gonzales, 396 F.3d 1248, 1254 (D.C. Cir. 2005) (noting a 

possible distinction), the association falls far short of showing 

the necessary likelihood of any injury.

We start by noting a background point—the association’s 

complete failure to show that HHS’s enforcement mechanism 

is one that would really burden a grantee that guessed wrong. 

There is no suggestion in its papers that good-faith conduct 

violating a grant condition would trigger an immediate 

funding cut-off, much less the sort of retroactive penalty that 

was involved in Abbott Labs. 

Turning to the interaction of the substantive provisions 

themselves, we must look separately at the Weldon 

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Amendment’s conditions on Title X grantees with respect to 

individuals who refuse to refer for or provide abortions, and 

organizations so refusing. We start with grantees’ obligations 

to individuals. 

The association asserts that if an individual caregiver 

objects to providing abortion counseling to a pregnant woman 

but wants to retain a pregnancy counseling job, reassigning 

that caregiver to another job might amount to “discrimination” 

banned by the amendment. But Congress enacted a provision 

in 1974 similarly protecting exercises of individual rights of 

conscience, saying that no individual could be compelled to 

perform a service, in conjunction with an HHS program, that 

“would be contrary to his religious beliefs or moral 

convictions.” National Research Act, Pub. L. No. 93-348, 

§ 214, 88 Stat. 342, 353 (codified at 42 U.S.C. § 300a-7(d)). 

Despite the apparently similar potential for conflict 

between the pre-Weldon conscience provisions and the 

current Title X regulation (dating from 2000), they have 

enjoyed a quite peaceful co-existence. Plaintiff doesn’t point 

to a single instance in which the government has treated the 

reassignment of a caregiver who refuses to provide abortion 

counseling as “discrimination” against that caregiver, or in 

which it has questioned a member’s funding because of the 

way the member navigated between the regulations and the 

conscience provisions. The association’s anomalous equation 

of reassignment with discrimination is particularly suspect 

because Congress, since 1996, has forbidden “discrimination” 

against an individual who “refuses . . . to perform . . . 

abortions, or to provide referrals for . . . abortions.” Omnibus 

Consolidated Rescissions and Appropriations Act of 1996, 

Pub. L. No. 104-134, § 515, 110 Stat. 1321, 1321-245 

(codified at 42 U.S.C. § 238n(a)(1), (c)(2)). But the 1996 

provision hasn’t given rise to the parade of horribles that 

plaintiff hypothesizes—not even to a single horrible. 

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To support its notion that the Weldon Amendment’s 

protection of individual caregivers may impose different 

requirements on Title X grantees than do the earlier 

conscience provisions, plaintiff points to the absence of any 

reference to “conscience” in the amendment. This is a red 

herring. Let us assume that under the amendment individual 

caregivers may lawfully refuse to participate in abortion 

provision or referral, without any adverse employment 

consequences, on broader grounds than formerly—conscience 

and, to state it as broadly as possible, “any other grounds.” 

We cannot see how a broadening of the grounds for resisting 

abortion activity would suddenly transform an 

accommodating agency’s reassignment into an act of 

discrimination. Plaintiff offers us no help on this. 

Plaintiff has thus failed to identify any reason why the 

concept of discrimination forbidden by the earlier conscience 

provisions and the amendment at all hinges on the scope of 

those various provisions. Furthermore, plaintiff does not 

point to any desired change in its members’ conduct that 

would create some new risk for their funding. Accordingly, 

the association has shown no material change since 2000 in 

terms of members’ obligations to respect individual views on 

abortion, and the risk that its members will face the claimed 

dilemma appears to be nil. See American Library Ass’n v. 

Barr, 956 F.2d 1178, 1188 (D.C. Cir. 1992). 

As to members’ duties to “health care entit[ies]” that are 

not individuals, the association alleges that the HHS 

regulation requires that recipients distribute funds only to 

subgrantees that agree to provide abortion counseling, 

whereas the Weldon Amendment, for the first time (with 

narrow exceptions), forbids discrimination against potential 

subgrantees (i.e., not individuals) that refuse to refer for 

abortions. Because the Weldon Amendment appears to 

extend pre-existing conscience rights to hitherto uncovered 

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entities, we do not have the benefit, in this context, of a sixyear track record. Nonetheless, we think that here too 

plaintiff has failed to show the imminence of any serious 

dilemma. 

First, the association has about 4000 members, yet in the 

period between enactment and the district court’s September 

28, 2005 denial of a preliminary injunction plaintiff offered no 

suggestion that any member encountered the slightest hint 

from HHS that its practices might imperil its funding under 

Weldon. Moreover, there are structural reasons to doubt that 

the issue will ever come up. In 2000 HHS Secretary Shalala 

declined to create a specific exception from the pending 

regulation’s mandatory referral requirement for organizations 

resisting provision of abortion counseling or referrals; she 

explained that she was “unaware of any current grantees that 

object to the requirement for nondirective options counseling, 

so this suggestion appears to be based on more of a 

hypothetical than an actual concern.” 65 Fed. Reg. at 

41,273/3 (emphasis added). Nowhere in its papers has 

plaintiff claimed that such grantees in fact existed. “Litigants 

are . . . not entitled to an adjudication of every question they 

perceive after reading through the text of legislation.” 

American Library Ass’n, 956 F.2d at 1197. 

The supposed dilemma is particularly chimerical here 

because the association’s asserted injury appears to be largely 

of its own making. We have consistently held that selfinflicted harm doesn’t satisfy the basic requirements for 

standing. Such harm does not amount to an “injury” 

cognizable under Article III. National Treasury Employees 

Union v. United States, 101 F.3d 1423, 1429 (D.C. Cir. 1996); 

Fair Employment Council of Greater Washington, Inc. v. 

BMC Marketing Corp., 28 F.3d 1268, 1276–77 (D.C. Cir. 

1994). Furthermore, even if self-inflicted harm qualified as an 

injury it would not be fairly traceable to the defendant’s 

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challenged conduct. Brotherhood of Locomotive Engineers 

and Trainmen v. Surface Transportation Board, 457 F.3d 24, 

28 (D.C. Cir. 2006); Petro-Chem Processing, Inc. v. EPA, 866 

F.2d 433, 438 (D.C. Cir. 1989). Here the association has 

within its grasp an easy means for alleviating the alleged 

uncertainty. It could inquire of HHS exactly how the agency 

proposes to resolve any of the conflicts that it claims to spot 

between the amendment and the regulations. Under the 

Administrative Procedure Act, the association has the right to 

petition HHS to adopt a rule clarifying the responsibilities of 

Title X grantees. 5 U.S.C. § 553(e). It has never done so. 

Plaintiff’s briefs constantly lament that the government has 

failed to answer its hypotheticals, see, e.g., Plaintiff’s Br. at 

13–17, but the association refers only to questions posed to 

the government’s litigation counsel. Failure to seek 

clarification from the agency is especially troubling here 

because HHS is entitled to deference in interpreting its own 

regulation and (under many circumstances) the statutes that it 

administers. National Mining Ass’n v. Babbitt, 172 F.3d 906, 

911 (D.C. Cir. 1999); Chevron U.S.A., Inc. v. Natural 

Resources Defense Council, Inc., 467 U.S. 837 (1984). As the 

association has chosen to remain in the lurch, it cannot 

demonstrate an injury sufficient to confer standing. 

* * * 

As plaintiff lacks standing to challenge the Weldon 

Amendment, the judgment below is vacated and the case 

remanded to the district court to dismiss for lack of 

jurisdiction. 

So ordered. 

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