Opinion ID: 746244
Heading Depth: 2
Heading Rank: 1

Heading: Congress's Commerce Clause Authority

Text: 15 Relying on United States v. Lopez, 514 U.S. 549, 115 S.Ct. 1624, 131 L.Ed.2d 626 (1995), Bird argues that section 248(a)(1) criminalizes private, noneconomic conduct that is neither commercial in nature nor  'an essential part of a larger regulation of economic activity.'  Accordingly, because the Act lacks a jurisdictional element that would ensure that each instance of proscribed activity had an effect on interstate commerce, Bird contends that the Act  'neither regulates a commercial activity nor contains a requirement that the [prohibited activity] be connected to interstate activity.'  Bird further argues that the congressional findings set forth in the Act's legislative history are not relevant to our inquiry because Congress cannot use findings that a noncommercial activity affected interstate commerce to support a statute that regulates intrastate conduct. Finally, Bird attacks the regulatory means chosen by the Act as not  'reasonably adapted to the end permitted by the Constitution.'  In this regard, Bird contends that the statutory definitions of facility and reproductive health services sweep too broadly and exceed the reach of Congress's Commerce Clause authority. 16 The United States defends the Act as a proper exercise of Congress's authority under the Commerce Clause. First, also relying on Lopez, 514 U.S. at 557-61, 115 S.Ct. at 1629-30, the United States argues that the Act is a proper exercise of Congress' power to 'protect ... persons or things in interstate commerce.'  Second, the government contends that the Act may be sustained as an exercise of Congress' power to regulate 'activities that substantially affect interstate activity.'  The government emphasizes the congressional findings that the proscribed activity threatens in the aggregate to eliminate abortion services from the national commerce. The government also maintains that no jurisdictional element is required provided a criminal statute addresses a class of activity that, in the aggregate, substantially affects interstate commerce. Finally, the government argues that the regulatory scheme adopted by the Act is reasonably adapted to a permissible end. 17 The Supreme Court's opinion in United States v. Lopez, 514 U.S. 549, 115 S.Ct. 1624, 131 L.Ed.2d 626, guides our inquiry. In Lopez, the Court set forth the three areas of permissible congressional regulation pursuant to the Commerce Clause. First, Congress may regulate the use of channels of interstate commerce. Id. at 557-58, 115 S.Ct. at 1629 (citing United States v. Darby, 312 U.S. 100, 114-15, 61 S.Ct. 451, 457, 85 L.Ed. 609 (1941); Heart of Atlanta Motel, Inc. v. United States, 379 U.S. 241, 256-57, 85 S.Ct. 348, 357, 13 L.Ed.2d 258 (1964)). Second, Congress is empowered to regulate and protect the instrumentalities of interstate commerce, or persons or things in interstate commerce, even though the threat may come only from intrastate activities. Id. (citing Shreveport Rate Cases, 234 U.S. 342, 34 S.Ct. 833, 58 L.Ed. 1341 (1914); Southern Ry. Co. v. United States, 222 U.S. 20, 32 S.Ct. 2, 56 L.Ed. 72 (1911); Perez v. United States, 402 U.S. 146, 148-50, 91 S.Ct. 1357, 1359, 28 L.Ed.2d 686 (1971)). Finally, Congress' commerce authority includes the power to regulate those activities having a substantial relation to interstate commerce, i.e., those activities that substantially affect interstate commerce. Id. (citing NLRB v. Jones & Laughlin Steel Corp., 301 U.S. 1, 36-38, 57 S.Ct. 615, 624, 81 L.Ed. 893 (1937); Maryland v. Wirtz, 392 U.S. 183, 196 n. 27, 88 S.Ct. 2017, 2024 n. 27, 20 L.Ed.2d 1020 (1968)). Lopez did not set forth the precise standard by which the federal judiciary shall examine Congress's legislative determination that a particular statute has a nexus with interstate commerce under the third category; rather, the Court emphasized that whether Congress had a rational basis for determining that a regulated activity sufficiently affected interstate commerce was  'ultimately a judicial rather than a legislative question.'  Id. at at 557-58 & n. 2, 115 S.Ct. at 1629 & n. 2 (quoting Heart of Atlanta Motel, 379 U.S. at 273-74, 85 S.Ct. at 366 (Black, J., concurring); Hodel v. Virginia Surface Mining & Reclamation Ass'n, Inc., 452 U.S. 264, 311, 101 S.Ct. 2389, 2391, 69 L.Ed.2d 1 (1981) (Rehnquist, J., concurring) ([S]imply because Congress may conclude that a particular activity substantially affects interstate commerce does not necessarily make it so.)).
18 The first Lopez category of permissible interstate regulation, involving regulation of the channels of interstate commerce, is plainly not applicable to the Act. This category, as described in Perez, 402 U.S. at 148-50, 91 S.Ct. at 1359, reaches the misuse of the channels of interstate commerce. Oft-cited examples include the transportation or shipment of: stolen goods, 18 U.S.C. § 2314, et seq.; kidnaped persons, 18 U.S.C. § 1201, et seq.; prostitutes, 18 U.S.C. § 2421; and drugs, 21 U.S.C. § 841(a); see also United States v. Robertson, 514 U.S. 669, 670-72, 115 S.Ct. 1732, 1733, 131 L.Ed.2d 714 (1995) (affirming federal RICO conviction because gold mine was engaged in commerce); United States v. Darby, 312 U.S. 100, 61 S.Ct. 451, 85 L.Ed. 609 (1941) (upholding the authority of Congress to prohibit the interstate shipment of goods produced by workers whose wages violated the Fair Labor Standards Act); The Lottery Case, 188 U.S. 321, 23 S.Ct. 321, 47 L.Ed. 492 (1903) (affirming conviction for interstate transportation of foreign lottery tickets under the Federal Lottery Act of 1895). Section 248(a) is not a regulation of the use of the channels of interstate commerce, nor is it an attempt to prohibit the interstate transportation of a commodity through the channels of commerce. Lopez, 514 U.S. at 559, 115 S.Ct. at 1630. 6
19 The government argues that the Act falls within the second category of permissible interstate regulation, specifically the protection of persons or things in interstate commerce. The government argues that Congress determined, through legislative inquiry, that (1) doctors travel interstate to provide abortion services, (2) patients travel interstate to receive abortion services, and (3) clinics use medical supplies and equipment that have traveled interstate. 20 We do not find the Act to be a valid exercise of Congress's Commerce Clause authority under the second Lopez category. Although unquestionably many--perhaps most--abortion clinics employ out-of-state doctors, serve out-of-state patients, and utilize medical supplies and equipment that have traveled interstate, there is no allegation or showing that, in the present case, America's Women Clinic ever employed physicians, treated patients, or used supplies that so qualified. Congressional regulation or protection of persons or things that move in interstate commerce must ensure that, in fact, a particular threat--whether posed by an interstate or intrastate activity--actually threatens persons or things with a plain and clear nexus to interstate commerce. Of course, neither medical doctors nor their patients are by their nature involved in interstate commerce. Nor, for that matter, are medical supplies inherently interstate commodities. In the absence of such a plain and clear nexus, a statute must employ some mechanism to ensure the federal regulation in fact regulates persons or things in interstate commerce. Traditionally, this has been achieved by a jurisdictional element or a statutory presumption. In this regard, the Court in Lopez, 514 U.S. at 557-58, 115 S.Ct. at 1629, cited federal statutes criminalizing the destruction of aircraft employed in interstate commerce, 18 U.S.C. § 32(a)(1) (criminalizing the destruction of any aircraft used, operated, or employed in interstate, overseas, or foreign air commerce), and theft from interstate commerce, 18 U.S.C. § 659 (criminalizing the theft of any goods or chattels moving as or which are a part of or which constitute an interstate or foreign shipment). 21 Congress did not set forth a jurisdictional element in section 248(a)(1). Even if there had been such a jurisdictional element, or even if we were able to read the language of the Act to imply such a requirement, United States v. Bass, 404 U.S. 336, 347-50, 92 S.Ct. 515, 522-23, 30 L.Ed.2d 488 (1971) (requiring the government to demonstrate the requisite nexus with interstate commerce for each element of a federal firearm statute ambiguously containing the phrase in commerce or affecting commerce), there was absolutely no allegation nor any evidence produced at trial that America's Women Clinic in Houston employed out-of-state personnel, utilized out-of-state medical supplies, or treated out-of-state patients. To the contrary, Dr. Herring, the only witness, testified that he resided in Dallas, Texas; he was never questioned concerning the supplies or equipment used by the clinic, nor was he asked whether the clinic treated patients from outside of the Houston area, let alone from outside of Texas generally. No documentary evidence addressing the interstate nature of the clinic's business was produced by the government at trial. Without evidence that America's Women Clinic used out-of-state staff or supplies, or that it provided abortion services to out-of-state patients, it is difficult to see how Bird's actions had any affect on interstate commerce in medical supplies, medical personnel, or the provision of medical services to out-of-state patients. 22 Congress's finding that many of the patients who seek services from [abortion providers] engage in interstate commerce by traveling from one state to obtain [the abortion services] in another, S.Rep. No. 103-117, at 31; H. Conf. Rep. No. 103-488, at 7, and that physicians and other related medical personnel often travel across state lines to provide abortion services, is not sufficient to support section 248(a)(1) under this second Lopez category. That many, substantial numbers, or a majority of patients and doctors travel interstate to obtain or to provide abortion services does not establish that this particular clinic was ever so served or attended. Nor can the government's citation of cases involving specific, individualized findings relating to other clinics in unrelated litigation involving a different statute serve as a proxy for the individualized inquiry heretofore required for each violation under this second Lopez category. See, e.g., Bray v. Alexandria Women's Health Clinic, 506 U.S. 263, 312-14, 113 S.Ct. 753, 782, 792, 122 L.Ed.2d 34 (1993) (Stevens, J., dissenting) (stating that between twenty and thirty percent of patients at a targeted Virginia abortion clinic were from outside Virginia and a majority at one of the Maryland clinics were from outside Maryland); New York State N.O.W. v. Terry, 886 F.2d 1339, 1360 (2d Cir.1989) (women referred by out-of-state clinics often travel to New York City seeking its superior medical services), cert. denied, 495 U.S. 947, 110 S.Ct. 2206, 109 L.Ed.2d 532 (1990); Pro-Choice Network v. Project Rescue, 799 F.Supp. 1417, 1430 (W.D.N.Y.1992) (Plaintiffs' health care facilities render services to patients from other states, especially Pennsylvania[,] Ohio, and Canada); Lucero v. Operation Rescue, 772 F.Supp. 1193, 1195 (N.D.Ala.1991) (finding 1.5% of patients resided outside of Alabama). 7 23
24 That the Act fails to qualify under the first two Lopez categories of permissible Commerce Clause regulation is not surprising in light of what appears to be Congress's purpose to reach the prohibited activity at as many abortion clinics as possible. Indeed, the government concedes as much, emphasizing that Congress has the authority to regulate intrastate activity that, in the aggregate, has a substantial effect on interstate commerce. 25 As a federal criminal statute regulating intrastate, noncommercial conduct, section 248(a)(1) must be justified, if at all, as an essential part of a larger regulation of economic activity, in which the regulatory scheme could be undercut unless the intrastate activity were regulated. Lopez, 514 U.S. at 561, 115 S.Ct. at 1631. From the outset, we note, and reject, both the government's and Bird's view of permissible congressional regulation in this Lopez category. 26 Bird insists that Lopez requires a statute regulating intrastate activity pursuant to the Commerce Clause to contain a jurisdictional element. Furthermore, Bird maintains that the intrastate activity that may be regulated must, at a minimum, be commercial. We do not read Lopez so broadly. First, though a jurisdictional element may help to ensure that the exercise of Congress's Commerce Clause authority extends only to those activities that substantially affect interstate commerce, it is only one method, and not always a necessary one, by which Congress may achieve that end. See, e.g., Terry, 101 F.3d at 1418 (Lopez 's fundamental proposition is that Congress must ensure that its Commerce Clause power to regulate noncommercial activities extends to only those activities that substantially affect interstate commerce. Congress may do so either through its own legislative findings or by including a jurisdictional element in the statute; it need not do both.); Wilson, 73 F.3d at 685 (In discussing the lack of a jurisdictional element in Lopez, the Court simply did not state or imply that all criminal statutes must have such an element, or that all statutes with such an element would be constitutional, or that any statute without such an element is per se unconstitutional.). 8 Second, the Court in Lopez did not overrule--indeed, it expressly reaffirmed--the proposition set forth in Wickard v. Filburn concerning congressional regulation of intrastate, noncommercial activity: 27  '[E]ven if appellee's activity be local and though it may not be regarded as commerce, it may still, whatever its nature, be reached by Congress if it exerts a substantial economic effect on interstate commerce, and this irrespective of whether such effect is what might at some earlier time have been defined as direct or indirect. '  Lopez, 514 U.S. at 556, 115 S.Ct. at 1628 (quoting Wickard, 317 U.S. 111, 120-22, 63 S.Ct. 82, 87, 87 L.Ed. 122 (1942)). 28 The Supreme Court reiterated that intrastate, noncommercial activities can, in certain circumstances, substantially affect interstate commerce when considered in the aggregate. After Wickard--and its reaffirmance in Lopez--there can be no question that Congress is able to regulate noncommercial, intrastate activity that substantially affects interstate commerce, 9 an admittedly broad power not without danger to the federalism that is the most fundamental postulate of our constitutional order. 10 The question remains in any given case, however, whether Congress's exercise of power in this manner is properly limited. It is the government's view of this limiting principle that we find flawed. 29 Under the government's view, Congress need only identify a broad class of activities and determine that, viewed in the aggregate, the class substantially affects interstate commerce. Of course, the only limits provided by such a construction as thus stated are the depths of judicial imagination. The government made a similar, unrestricted argument to justify the Gun Free School Zones Act in Lopez. This Court characterized the government's version of the class of activities argument as lacking a limiting feature such as the existence of a national market: 30 The government seeks to rely on the rule that '[w]here the class of activities is regulated and that class is within the reach of the federal power, the courts have no power to excise as trivial, individual instances of the class.' This theory has generally been applied to the regulation of a class of activities the individual instances of which have an interactive effect, usually because of market or competitive forces, on each other and on interstate commerce. A given local transaction in credit, or use of wheat, because of national market forces, has an effect on the cost of credit or price of wheat nationwide. Some such limiting principle must apply to the 'class of activities' rule, else the reach of the Commerce Clause would be unlimited, for virtually all legislation is 'class based' in some sense of the term. Lopez, 2 F.3d at 1367 (quoting Perez, 402 U.S. at 153-54, 91 S.Ct. at 1361; Wirtz, 392 U.S. at 192-94, 88 S.Ct. at 2022). 31 We believe that a requirement for such a limiting principle in the absence of a jurisdictional element, although not expressly adopted by the Supreme Court, is the only legitimate reading of the Wickard-Perez line of cases. Unless there is something that relevantly ties the separate incidents and their effects on interstate commerce together, aside from the desire to justify congressional regulation, the government's class of activities interpretation would transform Justice Breyer's Lopez dissent into the constitutional rule. See Lopez, 514 U.S. at 618-25, 115 S.Ct. at 1659-62 (Breyer, J., dissenting) (arguing that guns in schools undermine the quality of education which, in turn, leads to lagging worker productivity and, eventually, the erosion of our [Nation's] economic 'standing in the international marketplace' ); id. at 563-64, 115 S.Ct. at 1632 (criticizing the government's costs of crime and national productivity arguments). 11 Wickard itself offered, as a limiting principle, the national wheat market. Perez cited the national market for commercial credit. The fungible and untraceable characteristic of narcotics--which Congress found made federal regulation of intra state trafficking an operationally necessary prerequisite to effective regulation of the inter state activity--was itself a tying feature (albeit one which was more relevant to bring intrastate activity within the reach of Lopez 's first category). See Lopez, 2 F.3d at 1351, 1367 n. 51 (citing United States v. Lopez, 459 F.2d 949, 951-53 (5th Cir.), cert. denied sub nom. Llerena v. United States, 409 U.S. 878, 93 S.Ct. 130, 34 L.Ed.2d 131 (1972)). 32 In other words, although activities proscribed by an act of Congress may constitute, generically, a class of activities, and, when viewed in the aggregate, these activities may substantially affect interstate commerce in some broad and general sense, these two features, alone, are not sufficient to justify congressional legislation pursuant to the Commerce Clause. What was missing in Lopez, and what is needed to justify congressional action under the substantial effects category, are judicially enforceable outer limits. Lopez, 514 U.S. at 566, 115 S.Ct. at 1633. 12 33 Accordingly, our inquiry must determine not simply whether section 248(a)(1) proscribes intrastate activity that has (or might have) a substantial affect on interstate commerce, but rather whether there is a national commercial market in abortion-related services such that the regulated conduct--considered in light of the size and scope of the benchmark market--substantially affects interstate commerce. In other words, Congress must have divined the existence of a national commercial market in abortion-related services in which the closing down or obstruction of any clinic (or clinics) in one state (even if only serving local patients with local doctors) substantially affects the ability of clinics in other states to provide abortion-related services. To this end we must examine the congressional findings, the committee reports, and the relevant testimony. 34 We are persuaded that section 248(a)(1) is a legitimate regulation of intrastate activity having a substantial affect on interstate commerce. First, Congress made findings, supported by the testimony presented to the House and Senate committees charged with considering the Act, that there was an interstate commercial market for abortion services. Second, Congress found that the activity prohibited by the Act constituted a nationwide problem, regularly causing the interruption of abortion services at the clinics where the prohibited activity occurred. 13 Third, Congress found that the interruption of abortion services due to the activities prohibited by the Act caused (or was likely to cause) women to travel from the states where abortion services were interrupted to clinics, often out of state, that were able to provide unobstructed abortion services. Finally, it is a fair inference, supported by congressional testimony, that the proportionate increase in demand at unobstructed clinics brought about by those women forced to seek abortion services in the national commercial market because of intrastate activity obstructing local abortion clinics both increased (or was likely to increase) the cost of abortion services and reduced (or was likely to reduce) the availability of abortion services at the unobstructed clinics. Accordingly, in light of the national commercial market in abortion-related services recognized by Congress, we hold that Congress was justified in concluding that the regulation of intrastate activity--the activity prohibited by the Act--was necessary to ensure the availability (both in terms of access and price) of abortion services in the national commercial market. Consistent with Lopez 's admonition, we note that the presence of a national commercial market in abortion-related services, together with the effects on such market of the proscribed conduct, serves as a limiting principle circumscribing Congress's regulation of intrastate activity under the Act. 35 In reaching our determination that the Act satisfies the substantially affects category, we note that the finding set forth in the Conference Committee Report, stating that the activity proscribed by the Act burdens interstate commerce by forcing patients to travel from states where their access to reproductive health services is obstructed to other states is a conclusion derived from months of legislative hearings, research, and debate. As such, it is entitled to deference and should be interpreted, insofar as it is consistent with the information before the Congress at the time of enactment, to support a constitutional reading of the Act. 14 Cf. Rust v. Sullivan, 500 U.S. 173, 190, 111 S.Ct. 1759, 1771, 114 L.Ed.2d 233 (1991) ( 'The elementary rule is that every reasonable construction must be resorted to, in order to save a statute from unconstitutionality.' ) (quoting Hooper v. California, 155 U.S. 648, 656-58, 15 S.Ct. 207, 211, 39 L.Ed. 297 (1895)). 36
37 Congress found that doctors travel across state lines to provide abortion services and that patients also travel interstate to obtain such services. S.Rep. No. 103-117, at 31 (1993) ([M]any of the patients who seek services from these facilities engage in interstate commerce by traveling from one state to obtain services in another.); H. Rep. No. 103-306, at 8 (1993) (Many of the counties that have providers are urban centers. A rural provider is often the only provider in a large geographical area.... The facts are that only 17 percent of U.S. counties have an abortion provider and that clinic owners face a shortage of doctors willing to perform abortions.), reprinted in 1994 U.S.C.C.A.N. 699, 705. Indeed, it is the very shortage of abortion-related services that appears to have created the national market for these services. See S. Rep. at 17 & n. 29 (The availability of abortion services is already very limited in many parts of the United States. Nationwide, 83% of counties have no abortion provider. In South Dakota, the only physician who performs abortions commutes from Minnesota.). 38 The House and Senate reports accurately reflect the testimony presented to the respective committees. See Abortion Clinic Violence: Hearings Before the Subcomm. on Crime and Criminal Justice of the Comm. on the Judiciary, 103d Cong., at 3 (1993) [hereinafter House Hearings ] (letter of Atty. Gen. Reno) (stating that patients and staff frequently travel interstate to receive or to administer abortion-related services); The Freedom of Access to Clinic Entrances Act of 1993: Hearing Before the Comm. on Labor and Human Resources, 103d Cong., at 11, 16-17 (1993) [hereinafter Senate Hearings ] (statement of Atty. Gen. Reno) (stating that abortion clinics are engaged in interstate commerce and that clinics serve significant numbers of out-of-state patients); id. at 59, 64-65 (statement of Willa Craig, Executive Director, Blue Mountain Clinic, Missoula, MT) (A large number of our abortion and our prenatal patients travel an average of 120 miles to their appointments at our clinic due to a lack of services in their own areas. These areas include Idaho, eastern Washington, Wyoming and Canada.); see also 139 Cong. Rec. S15, 658 (daily ed. Nov. 16, 1993) (statement of Sen. Kennedy) (noting the nationwide shortage of abortion-related services). 39
40 of Abortion-Related Services 41 Congress found that the activity proscribed by the Act constituted a national problem, regularly causing the interruption of abortion-related services at the clinics where prohibited activity occurred. The Senate Report states that clinic blockades and violent protests had a significant adverse impact not only on abortion patients and providers, but also on the delivery of a wide range of health care services. This conduct has forced clinics to close, caused serious and harmful delays in the provision of medical services, and increased health risks to patients. It has also taken a severe toll on providers, intimidated some into ceasing to offer abortion services, and contributed to an already acute shortage of qualified abortion providers. S.Rep. No. 103-117, at 14. The Senate Report observed the link between the activity prohibited by the Act and the concomitant shortage in abortion-related services. Id. at 17 (Some providers have succumbed to the intimidation and threats. At least three physicians in Dallas stopped performing abortions in 1992 as a result of pressure by an anti-abortion group. In early 1993, after receiving death threats, two doctors stopped working at an abortion clinic in Melbourne, FL. And since Dr. Gunn was shot in March 1993, at least eight more doctors have stopped offering abortion services.); id. at 80 (statement of Randall Terry, Director, Operation Rescue) (stating that he personally facilitated the withdrawal of half the abortion providers in a community). The House Report also observed that the reduced availability of abortion-related services was at least partially attributable to the violence and intimidation described in this report. Doctors understandably are leaving the field, and new graduate[s] have little desire to enter the field even as part of a wider obstetrics/gynecology practice. H. Rep. No. 103-306, at 8. Congress noted the severity and frequency of abortion clinic violence. Id. (noting that, from 1984 through 1992, there had been 28 bombings, 62 arsons, 48 attempted bombings and arsons, 266 bomb threats, and 394 incidents of vandalism); S.Rep. No. 103-117, at 3 & n. 1 (noting that, from 1977 through 1993, there had been 36 bombings, 81 arsons, 131 death threats, 84 assaults, two kidnappings, 327 clinic invasions, and one murder). Testimony before Congress made clear that the goal of the activity proscribed by the Act was to reduce or eliminate the national market for abortion-related services and that such activity had already achieved partial success. See, e.g., House Hearings, at 2 (statement of Rep. Schuman) (observing that [t]he stated goal of the tactics is to drive doctors and clinics out of the business of providing abortions and the tactics appear to be working and noting the diminishing numbers of physicians willing to provide abortion-related services); Senate Hearings, at 167-68 (statement of Freedom of Choice Action League) (detailing resignation of a Wichita, Kansas, physician from an abortion clinic after she received repeated threats). Floor debates also focused on the interruption of abortion-related services brought about by the activity proscribed by the Act. See, e.g., 139 Cong. Rec. S15,672 (daily ed. Nov. 16, 1993) (statement of Sen. Mikulski) (noting that abortion clinic violence has destroyed clinic facilities--leaving women without access to health care facilities); 139 Cong. Rec. H10,089 (daily ed. Nov. 18, 1993) (statement of Rep. Pelosi) (over 50 percent of clinics across the country offering reproductive health services have undergone extreme violence); id. at H10,090 (statement of Rep. Engel) (The work of many clinics--which often includes low-cost prenatal care, birth control, infertility, and adoption as well as abortion services--has been disrupted regularly by blockades, chemical attacks, and invasions.); id. at H10,091 (statement of Rep. Stokes) ([Activity proscribed by the Act has] damaged clinic facilities or driven away clinic staff, forcing these facilities to reduce their patient load and the wide range of services they provide. Other clinics have had to cease operations altogether after their facilities were destroyed by fire or bombings, leaving thousands of women without adequate health care services.); 139 Cong. Rec. H1501 (daily ed. Mar. 17, 1994) (statement of Rep. Kennelly) (noting the national scope of the abortion clinic violence). 42
Travel to Out-of-State Providers 43 Congress found that the interruption of abortion-related services due to the activities proscribed by the Act caused (or was likely to cause) women to travel from those states where abortion-related services were not reasonably available to clinics in those states where abortion-related services were reasonably available. The Senate Report states: 44 [B]lockades that make access to a health care facility difficult or hazardous can have traumatic effects on patients by delaying their access to urgent medical care and by exacerbating their medical conditions.... For patients seeking abortion services, the adverse effects of a clinic blockade can be particularly serious. Dr. Pablo Rodriguez described the effects on patient health: 45 'Our patients are the ones who suffer. Women who do make it in have a heightened level of anxiety and a greater risk of complications. The delay caused by the invasions has forced some patients to seek care elsewhere due to the fact that their gestational age has gone beyond the first trimester.' S. Rep. No. 103-117, at 15 (quoting testimony of Dr. Pablo Rodriguez). 46 The House Report reaches a similar conclusion. See H. Rep. No. 103-306, at 10. (In addition, patients often cross state lines to obtain services ....) (citing testimony of Silvia Doe). 47 Testimony before Congress made clear that activity proscribed by the Act delayed (and threatened to deny permanently) access to abortion-related services to women who, due to the existing shortage of such services, had traveled (or would be required to travel) interstate to obtain them. Silvia Doe testified about her decision to seek a late-term abortion after learning of a fetal malformation. She further testified that only three clinics in the country offer such a service. She was forced, by the shortage of providers, to travel from Virginia to Kansas. In Wichita, Kansas, she was delayed from obtaining her abortion due to a clinic blockade at the Wichita clinic. Clinic Blockades: Hearing Before the Subcomm. on Crime and Criminal Justice of the Comm. on the Judiciary, 102d Cong., at 9-17 (statement of Silvia Doe). 48 The congressional testimony and the activity described in the committee reports provide sufficient evidence for the Congress to have concluded that entirely intrastate activity--here, the activity proscribed by the Act--had, at the very least, the potential to cause women who had been prevented from obtaining abortion-related services in their home states to travel to unobstructed providers in other states. 49
50 Availability of Abortion-Related Services in the National Market 51 We are persuaded that it is a fair inference that the activity proscribed by the Act--which has (or threatens to have) the effect of precluding access to abortion-related services in the area served by the targeted clinic--can have a substantial affect on the availability of abortion-related services in the national market. Such a conclusion is rational and supported by testimony presented to the committees charged with reviewing the bills that eventually became the Act. 52 The House Subcommittee on Crime and Criminal Justice heard testimony that, because of the continued threats of violence and disruptive activities, abortion clinics have been forced to implement heightened security measures to ensure access. House Hearings, at 25 (statement of Susan Hill, President, Nat'l Women's Health Org.) (noting that [o]bviously, that drives up the costs of providing the service). The Senate Committee on Labor and Human Resources considered a report printed in the American Journal of Obstetrics and Gynecology which noted that abortion clinic violence increases the costs of abortion services at those clinics that remain open. The report stated that abortion patients have been forced, due to clinic violence, to seek other providers or postpone care. Senate Hearings, at 54. Additional testimony before the Senate Committee set forth the Commerce Clause rationale for the Act's regulation of intrastate activities to ensure the availability of abortion-related services in the national market: 53 The pattern of interstate effects produced by the pressured movement of women from State to State under a variegated patchwork of local enforcement against blockades, violence and physical intimidation at abortion clinics is undoubtedly sufficient to warrant Congress's invocation of its commerce power. Similarly, the shift of demand for abortion services from those areas where clinic access is obstructed to those areas where it is not represents the sort of interstate economic effect that is beyond the effective control of any one State and is accordingly a proper subject for congressional regulation under the Commerce Clause. Id. at 97 (statement of Professor Tribe) (citing Summit Health, Ltd. v. Pinhas, 500 U.S. 322, 327-31, 111 S.Ct. 1842, 1846-47, 114 L.Ed.2d 366 (1991)). 54 This described shift in demand from obstructed clinics to unobstructed clinics--given the national scarcity of abortion-related services--supports the legitimacy of Congress's enactment of section 248(a). The patent congressional concern that the activity proscribed by the Act, although intrastate, could have a deleterious impact on the availability of abortion-related services in the national market, makes clear that Congress was addressing an interstate problem rather than a multistate, intrastate problem. Wilson, 73 F.3d at 683. 55 Accordingly, in light of the evident congressional purpose to ensure the availability of abortion-related services in the national commercial market, 15 we hold that the enactment of section 248(a), as applied to the facts of the present case, was a constitutional exercise of Congress's power under the Commerce Clause. Because we conclude that Congress possessed the requisite authority under the Commerce Clause, we pretermit the substantially more questionable assertion of congressional authority to criminalize purely private conduct (not directed at state property or facilities) under Section Five of the Fourteenth Amendment. See The Civil Rights Cases, 109 U.S. 3, 3 S.Ct. 18, 27 L.Ed. 835 (1883). See also City of Boerne v. Flores, 521 U.S. 507, ----, 117 S.Ct. 2157, 2166, 138 L.Ed.2d 624 (1997). 16 56