Case: Planned Parenthood of Montana v. State of Montana

Planned Parenthood of Montana and a physician brought this lawsuit challenging several laws restricting abortion, including a 20-week abortion ban, a heartbeat bill, ultrasound viewing, and restrictions on the use of abortion-inducing medications.

On August 16, 2021, Planned Parenthood of Montana and a private physician who provided abortion care at Planned Parenthood of Montana (collectively, “PPMT”), sued, on behalf of themselves and their patients, the State of Montana through their Attorney General (collectively, “State”) in Montana’s Thirteenth Judicial District Court. In April 2021, Montana’s Governor signed four statutes into law that aimed at when and how a woman could receive abortion care, and PPMT alleged that each one violated the fundamental rights of PPMT and their patients under the Montana constitution. 

• House Bill 136 (“20-week ban”) criminalized the provision of an abortion beginning 20 weeks after the first day of a woman’s last menstrual period (LMP), subject to allegedly limited and vague exceptions. Providers were subjected to both civil damages and felony criminalization. PPMT argued that this ban infringed on Montana Constitution’s right to privacy; right to individual dignity; right to seek safety, health, and happiness by banning constitutionally protected pre-viability abortions; equal protection guarantee by unlawfully singling out women seeking abortions and abortion providers and unlawfully targeting women seeing abortions beginning at 20-weeks; and it violated due process because it did not give fair notice of the conduct it prohibited. 
• House Bill 171 (“MAB Restriction”) restricted access to abortion provided early in pregnancy by imposing a litany of restrictions on the provision of medication abortion. This law required patients to make at least two trips for in-person appointments with the same health care provider for care that could be provided by telemedicine, a 24-hour mandated delay between those visits, and other allegedly medically unnecessary requirements. The MAB Restriction also imposed higher restrictions on who could provide a medicated abortion, by mandating that only a qualified medical practitioner could provide abortion medication, verify the existence of the pregnancy, and determine the patient’s blood type. This qualified medical practitioner had to be credentialed and competent to handle complications management, including emergency transfers, or be contracted with an associated medical practitioner who could do those things. This law imposed felony criminal penalties and civil liability for violation of its provisions, including actual and punitive damages, professional disciplinary action, and recovery for the patient’s survivors for the wrongful death of the patient. PPMT argued that this restriction infringed on Montana Constitution’s right to privacy; right to individual dignity; right to seek safety, health, and happiness by restricting access to a constitutional and safe medical procedure; equal protection guarantee by unlawfully singling out women seeking abortions and abortion providers; right to free speech because it compelled particular speech by the provider, even when that information was false and the provider objected to the content of that speech; and it violated due process because it did not give fair notice of the conduct it prohibited. 
• House Bill 140 (“Ultrasound Offer Law”) mandated that abortion providers ask patients whether they wanted to view an active ultrasound or “listen to the fetal heart tone” and required patients to sign a State-created form that indicated their answers to those questions. If an abortion provider failed to comply with any of these requirements, they were liable to a civil penalty of $1,000. PPMT argued that this offer law infringed on Montana Constitution’s right to privacy; right to individual dignity; right to seek safety, health, and happiness by restricting access to a constitutional and safe medical procedure; equal protection guarantee by unlawfully singling out women seeking abortions and abortion providers; and right to free speech because the State lacked a compelling interest in forcing providers to ask patients stigmatizing questions irrespective of the provider’s medical judgment regarding whether those questions were in the patient’s best interest, and to sign a State-developed form that records patients’ answers.
• Lastly, House Bill 229 (“Coverage Ban”) prohibited subsidized health insurance plans on the Affordable Care Act (“ACA”) exchange in Montana from providing coverage for abortions, even though no state funds were involved. PPMT argued that this ban infringed on the Montana Constitution’s right to privacy; right to individual dignity; right to seek safety, health, and happiness by restricting access to a constitutional and safe medical procedure; and equal protection guarantee by unlawfully singling out women seeking abortions. 

Each of these laws were slated to go into effect on October 21, 2021, and PPMT sought declaratory judgments, and preliminary and permanent injunctive relief. PPMT was represented by Planned Parenthood Federation of America and private counsel. This case was assigned to District Judge Gregory R. Todd.

On the same day as filing this complaint, PPMT also filed a motion for preliminary injunction to prevent the 20-week ban, the MAB restriction, and the Ultrasound Offer Law from going into effect. 

On September 29, 2021, the State filed a motion to disqualify a judge, and Judge Todd recused himself the same day. The case was then assigned to District Judge Michael G. Moses.

On September 30, 2021, PPMT filed a motion for a temporary restraining order to prevent the 20-week ban, the MAB restriction, and the Ultrasound Offer Law from going into effect on October 1. The same day, the court granted the temporary restraining order until the motion for preliminary injunction was decided.

On October 7, 2021, the court granted the preliminary injunction preventing all aspects of the 20-week ban, the MAB restriction, and the Ultrasound Offer Law from going into effect while this case was pending. The court found that PPMT had standing to bring these claims. For the 20-week ban, PPMT established a prima facie case that the law violated Montana’s constitutional guarantee of equal protection and due process. Regarding the MAB restriction claim, the court found that PPMT established a prima facie case that this law violated a patient’s right to privacy and violated PPMT’s right to free speech.Lastly, the court found that PPMT established a prima facie case that the Ultrasound Offer Law violated the rights to privacy, dignity, and equal protection. Having found that PPMT’s patients will suffer concrete and irreparable harm absent a preliminary injunction, the court found that PPMT met their burden showing they needed one.  

On October 19, 2021, the State appealed the preliminary injunction to Montana Supreme Court, and also filed a motion to stay district court proceedings. On November 11, the court denied the motion to stay proceedings.

On August 9, 2022, Montana’s Supreme Court upheld the preliminary injunction. The Supreme Court found that that the district court correctly analyzed the issues under a strict scrutiny standard, applied the right preliminary injunction standard of prima facie, and that they did not abuse their discretion or make an error of law in any of the three claims.

On April 4, 2023, the parties filed a joint stipulation for partial dismissal of claims relating to the Coverage Ban.

On April 21, 2023, PPMT filed a motion for summary judgment regarding the 20-week ban, the MAB restriction, and the Ultrasound Offer Law.

On May 12, 2023, the State filed a cross-motion for summary judgment regarding the 20-week ban only, asking the court to declare the legislation constitutional and to rule there was no explicit right to abortion in the Montana Constitution.

On October 24, 2023, the case was reassigned to District Judge Kurt Krueger.

On February 29, 2024, the court granted PPMT summary judgment. The court found that the 20-week ban was unconstitutional in its entirety because it regulated elective abortions without a basis in recognized medical risks, arbitrarily discriminated between patients who chose abortion and those who chose pregnancy to term, and imposed criminal penalties without reliable standards. The MAB restriction was also found unconstitutional because it violated the right to privacy by imposing numerous restrictions and severe burdens on patients and providers, violated the right to free speech by engaging in content and viewpoint discrimination and compelling speech, and was constitutionally vague because it set criminal penalties based on overly subjective reasonable standards and broad, inscrutable definitions. Lastly, the Ultrasound Offer Law violated the right to privacy by requiring providers to offer medical interventions that may have violated their own best judgment and potentially stigmatized patients in the process and violated PPMT’s right to freedom of expression because this law compelled PPMT to make certain offers in treatment.. 

On April 4, 2024, the State appealed.

This case is ongoing as of April 18, 2025.