(CN) — After a legal challenge, a Nebraska law that both bans minors from receiving gender-affirming care and prohibits abortion after 12 weeks of pregnancy was upheld by a majority in the state Supreme Court on Friday.
The decision comes over a year after Planned Parenthood of the Heartlands first sued the state and attorney general, arguing LB 574 violated a state constitutional amendment that prohibits bills from covering multiple unrelated topics. But the Lancaster County District Court ruled in August that the law did not violate the single-subject rule, and the Nebraska Supreme Court agreed.
“If LB 574's main purpose is to regulate the medical care that may be provided within the state, each of its provisions are naturally connected with, and incidental to, that main purpose,” Chief Justice Michael G. Heavican wrote in the ruling.
The court acknowledged abortion and gender-affirming care were two distinct types of medical care but ultimately determined they fell under the same umbrella.
LB 574 was first introduced in January 2023 as the “Let Them Grow Act,” and focused chiefly on banning gender-affirming care for transgender minors.
In May of that year, it was amended to include language limiting abortion after 12 weeks of pregnancy after a separate bill — LB 626 or the “Nebraska Heartbeat Act,” which sought to restrict abortion at six weeks — did not secure enough votes to break a filibuster. LB 574 thus became the “Adopt the Let Them Grow Act and the Preborn Child Protection Act and provide for discipline under the Uniform Credentialing Act.”
Enter Article III, Section 14 of the Nebraska Constitution, which states that “no bill shall contain more than one subject, which shall be clearly expressed in its title.”
Represented by the American Civil Liberties Union, Planned Parenthood argued the law was unconstitutional under Article III and that the legislature had amended LB 574 to include abortion restrictions in order to increase the likelihood of its passage. After Republican Governor Jim Pillen signed the bill into law, the group filed suit.
In its ruling, the state Supreme Court found the title “undisputably covers the contents of the bill" — though the court acknowledged its chief concern was analyzing whether the contents of the bill comprised a single subject.
On that front, the court determined the subject of the bill to be “public health and welfare” and found that the contents were appropriate to that subject.
“LB 574 regulates both abortion and gender-altering care, but both abortion and gender-altering care are medical procedures and thus all provisions regulating the same fall within the subject of ‘public health and welfare,’” Heavican wrote.
The court emphasized that its opinion did not comment on the substance of the bill but instead focused only on whether it complied with the single-subject rule.
“This is a constitutional question, not a political one, and as we have noted, it is one vested with the judiciary,” Heavican wrote.
While the majority of the court agreed with this analysis, Supreme Court Justice Lindsey Miller-Lerman dissented, accusing the majority of inappropriately defining the law’s subject as medical care regulation when that was not clearly defined in the text.
“I respectfully believe that it is an error of law to substitute ‘object’ and ‘purpose’ for the constitutional requirement of ‘subject,'" Miller-Lerman wrote in her dissent. "Therefore, it is analytically inappropriate for the court to invent a main purpose."
Miller-Lerman said the Legislature had a duty to write the bill in accordance with the single-subject rule but that it had failed to do so.
“It is not the role of this court to rescue legislative bills,” she wrote.
Nebraska Attorney General Mike Hilgers, a Republican and one of the state defendants in the case, celebrated the victory on Friday.
“The legislature passed Nebraska’s 12-week abortion ban and its ban on gender-altering procedures for minors," Hilger said in a statement. "We are pleased that the court upheld the constitutionality of the legislature’s work."
Planned Parenthood in turn expressed a continued commitment to fight for access to abortion in Nebraska.
“We will proudly continue providing abortion care up to 12 weeks," Ruth Richardson, president and CEO of Planned Parenthood North Central States, said in a statement. "We remain dedicated to helping our patients in Nebraska access the care they so desperately need, even if it means having to travel out of state."
Mindy Rush Chipman, executive director of the ACLU's Nebraska chapter, said in a statement that the group respectfully disagreed with the court’s ruling.
She encouraged Nebraska residents to continue to stay engaged. “This case will not be the final word on abortion access and the rights of trans youth and their families in Nebraska,” she said. “Despite this loss, we will continue to do all that we can to ensure that Nebraskans can make their own private decisions about their lives, families and futures.”
Under LB 575, abortions are prohibited after 12 weeks of pregnancy unless in the case of rape, incest or threat to the mother's life.
The law also prohibits minors from accessing puberty blockers, hormone treatments and gender-affirming surgeries. The abortion portion of LB 574 took effect last May, while the gender-affirming care restrictions took effect in October.
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