Neese v. Becerra

United States Court of Appeals for the Fifth Circuit · January 31, 2025 · No. 23-10078

Summary

The United States Court of Appeals for the Fifth Circuit issued an order denying a petition for rehearing en banc in a challenge to HHS guidance interpreting Section 1557 of the Affordable Care Act and Title IX regarding gender-affirming medical care for minors. A previous panel had vacated a district court ruling against the plaintiff physicians, holding that they lacked Article III standing to challenge the guidance. The en banc denial order notes that the challenged guidance has been superseded by new regulations and subsequently rescinded by an executive order, rendering the case moot. Judge Ho dissented from the denial, contending that the panel's standing ruling improperly validated administrative overreach.

Court
United States Court of Appeals for the Fifth Circuit
Writing for the Court
Jones; Haynes; Douglas
Jurisdiction
United States Court of Appeals for the Fifth Circuit
Decision date
January 31, 2025
Docket number
23-10078
Procedural posture
Denial of rehearing en banc after the panel held the plaintiffs lacked Article III standing to challenge HHS guidance.
Precedential value
nonprecedential
Parties
Xavier Becerra, in his official capacity as Secretary of Health and Human Services, United States of America v. Susan Neese, James Hurly
Disposition
other

Topics

standingadministrative procedure actstatutory interpretationcivil rights

Practice areas

administrative lawcivil rightshealth law

Questions Presented

  1. Whether the plaintiffs have Article III standing to challenge the HHS guidance interpreting §1557 of the Affordable Care Act.

Holdings

  1. The panel affirmed that the plaintiff physicians lacked Article III standing to challenge the guidance.
  2. The court denied the petition for rehearing en banc.

Key quotations

The poll failed 16–1. That should surprise no one, because there was no plausible reason to rehear this case. (at 1)
The panel unanimously held the plaintiff physicians lacked standing to challenge the guidance at issue. (at 2)

Factual background

Dr. Susan Neese, an internal‑medicine physician, refuses to provide gender‑affirming hormone therapy or referrals to minors, fearing exclusion from federally funded health programs under HHS guidance interpreting §1557 of the ACA. The United States argued that the guidance, informed by Bostock, required such care, while the plaintiffs claimed lack of standing to challenge the guidance.

Procedural history

The district court granted summary judgment to Dr. Neese. The Fifth Circuit panel affirmed, holding the physicians lacked standing. The losing party sought rehearing en banc, which the full court denied.

Court Document

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