Whether the Title X family planning program rule is arbitrary and capricious, violates the Title X appropriations act, and violates the Affordable Care Act

QUESTIONS PRESENTED In 2019, the Department of Health and Human Services (HHS) issued a Rule imposing major changes on the Title X family planning program. See 84 Fed. Reg. 7,714 (Mar. 4, 2019). The Rule both prohibits and compels certain pregnancy-related speech between a Title X provider and her patient, proscribing abortionrelated information but requiring information about non-abortion options—regardless of what the patient wants. The Rule also imposes burdensome physicalseparation requirements on any Title X provider engaging in abortion-related activities outside the Title X program. All of the nation’s major medical organizations opposed the Rule, explaining that it would violate fundamental medical ethics, force numerous providers out of the program, and leave patients with deficient health care. The en bane Ninth Circuit upheld the Rule against and contrary-to-law challenges. The en bane Fourth Circuit invalidated the Rule on those same grounds. The questions presented are: 1. Whether the Rule is arbitrary and capricious. 2. Whether the Rule violates the Title X appropriations act, which requires that “all pregnancy counseling” under Title X “shall be nondirective.” 3. Whether the Rule violates Section 1554 of the Affordable Care Act, 42 U.S.C. § 18114, which requires that HHS “shall not promulgate any regulation” that harms patient care in any one of six ways, including by “interfer[ing] with communications” between a patient and her provider. @