NCYL Establishes Itself As Expert in Adolescent Health Law with Early Court Wins
NCYL’s Adolescent Health Care Project was founded in 1984, at a time when few attorneys were focused on this area of law. As legislatures nationwide were moving to curb long-established rights of minors to access health care, NCYL stepped into the field to protect the constitutional rights of youth and their access to the reproductive health care they needed. Early on, NCYL established itself as an expert in adolescent health law with several major victories in the California Supreme Court. The cases proved critical to protecting the privacy rights of adolescents in California at a time when both the federal government and the California Legislature were seeking to curtail those rights.
Committee to Defend Reproductive Rights v. Myers
The California Supreme Court’s decision in Committee to Defend Reproductive Rights v. Myers, 29 Cal. 3d 252 (1981), safeguarded the right of poor women and adolescent girls in California to access state funding for abortions at a time when much of the country had declared it would not make such funding available.
In passing the Hyde Amendment in 1976, Congress began prohibiting federal Medicaid funds from being used to pay for abortion, with limited exceptions. In 1980, in Harris v. McRae, the United States Supreme Court not only upheld the constitutionality of the Hyde Amendment but also ruled that states participating in Medicaid were not required to pay for abortions for which federal reimbursement was unavailable. Simultaneously, the California Legislature moved to restrict Medi-Cal funding for abortion. In the 1978, 1979, and 1980 California Budget Acts, the California Legislature barred Medi-Cal coverage for abortion, except in certain limited circumstances. Medi-Cal would continue to pay the costs of prenatal care if the Medi-Cal recipient chose to continue her pregnancy rather than have an abortion.
In this climate, NCYL, the ACLU of Northern California, and other advocates stepped forward to represent the plaintiffs challenging the restrictions in the California Budget Acts. The Superior Court issued a temporary stay order to stop the restrictions from going into effect but refused to grant injunctive relief. In a two-to-one decision, the California Court of Appeal affirmed.
On March 20, 1981, the California Supreme Court issued its decision in Myers, reversing the judgment of the courts below and striking down the abortion restrictions in the Budget Acts as “plainly unconstitutional.” Departing from the test the United States Supreme Court applied in McRae, the California Supreme Court emphasized that, “[a]lthough the state [of California] has no constitutional obligation to provide medical care to the poor, . . . once the state has decided to make such benefits available, it bears a heavy burden of justification in defending any provision which withholds such benefits from otherwise qualified individuals solely because they choose to exercise a constitutional right.” The Myers court explained that the California Constitution recognizes that “rich and poor alike . . . possess a fundamental constitutional right to choose whether or not to bear a child” and that the “invidious” effect of the Budget Act restrictions was “to deny to poor women the right of choice guaranteed to the rich.” In its ruling, the court relied on the inalienable right of privacy guaranteed under the California Constitution, article I, section 1, which it explained is broader than the federal right.
Myers thus marked California’s divergence from federal law. As later summed up by the California Supreme Court, “[i]n the more than 15 years that [followed] the Myers decision, California courts repeatedly and uniformly . . . recognized that our state Constitution has been construed to provide California citizens with privacy protections encompassing procreative decisionmaking-- broader, indeed, than those recognized by the federal Constitution.” In that way, Myers laid the groundwork for NCYL’s subsequent victory in American Academy of Pediatrics v. Lungren.
American Academy of Pediatrics v. Lungren
For some 20 years, minors in California had the right to obtain an abortion without parental consent. Then, in September 1987, the California legislature passed Assembly Bill 2274, which would require that an unemancipated minor seeking an abortion must first obtain parental consent or else must get a court order from the Juvenile Court.
Representing several groups of adolescent health care providers, NCYL and co-counsel sued in state court. On December 28, 1987, just days before AB 2274’s effective date, the Superior Court issued a preliminary injunction finding the law unconstitutional. The State appealed the decision, and the California Court of Appeal affirmed the injunction on October 12, 1989. In so doing, the Court of Appeal explained that the right to privacy guaranteed by the California Constitution is broader than the right to privacy under the Federal Constitution, citing to the California Supreme Court’s earlier decision in Committee to Defend Reproductive Rights v. Myers.
A month-long trial in Superior Court followed, with 25 expert witnesses testifying. On May 27, 1992, Judge Maxine M. Chesney issued a permanent injunction invalidating AB 2274. On June 30, 1994, the California Court of Appeal unanimously affirmed.
On August 5, 1997, the California Supreme Court agreed that AB 2274 was unconstitutional. In its decision, American Academy of Pediatrics v. Lungren, 16 Cal. 4th 307 (1997), the court made several important findings: Minors’ privacy rights under the California Constitution are protected to the same extent as those of adults; the right to privacy includes the right to decide whether to continue or terminate a pregnancy; and mandating parental consent could harm the health of minors as well as the parent child relationship. The California Supreme Court agreed with the Superior Court and Court of Appeal that AB 2274 violated the right to privacy guaranteed by article I, section 1, of the California Constitution. The court was unpersuaded by the defendants’ reliance on a recent series of United States Supreme Court cases that upheld similar laws in other states.
Evaluating the evidence at trial, the California Supreme Court noted, “[T]he primary determinant of whether a pregnant minor will consult her parent or parents is the quality of the parent-child relationship that existed before the minor became pregnant, and not the presence or absence of a parental consent statute such as Assembly Bill 2274. The evidence further indicated that to the extent the provisions of Assembly Bill 2274 were to cause a pregnant minor from an abusive or potentially abusive family to seek parental consent, the statute would endanger the minor by leading her to place herself at physical or mental risk and would exacerbate the instability and dysfunctional nature of the family relationship.” The so-called “judicial bypass” option of going to Juvenile Court would only “inevitably delay the minor’s access to a medically safe abortion, thereby increasing the medical risks posed by the abortion procedure[.]”
At the time the case was pending, California had the highest teen pregnancy rate of any state in the country. Approximately 30,000 girls in California sought an abortion every year. American Academy of Pediatrics v. Lungren affirmed the right of minors in California to access reproductive health care and was especially crucial for those girls who could not easily obtain parental consent for abortion, such as girls living in abusive households, those who feared being kicked out of their homes, and those in foster care.
NCYL represented the plaintiffs with co-counsel from the ACLU of Northern California, the ACLU of Southern California, and the law firm Morrison & Foerster. The plaintiffs in the case were the American Academy of Pediatrics, California District IX; the California Medical Association; the American College of Obstetricians and Gynecologists, District IX; Planned Parenthood of Alameda—San Francisco; and Philip Darney, M.D.
