“pregnancy center” wasn’t commercial speaker and couldn’t be forced to disclose anti-abortion stance via mandatory label

Greater Baltimore Center for Pregnancy Concerns, Inc. v.
Mayor of Baltimore, 2018 WL 298142 (4th Cir. Jan. 5, 2018)
The court of appeals affirmed the invalidation of an
ordinance requiring pregnancy clinics that do not offer or refer for abortions
to disclose that fact through signs posted in their waiting rooms: “The City
has considerable latitude in regulating public health and deceptive
advertising. But Baltimore’s chosen means here are too loose a fit with those
ends, and in this case compel a politically and religiously motivated group to
convey a message fundamentally at odds with its core beliefs and mission.”
As applied to the Center at issue, the ordinance didn’t
regulate commercial speech.  Its speech
didn’t propose a commercial transaction, certainly not “in the waiting room
where the disclaimer would appear. Even if pregnancy-related services are
discussed there, the Center collects no remuneration of any kind, including
referral fees from physicians. A morally and religiously motivated offering of
free services cannot be described as a bare ‘commercial transaction.’” The fact
that the Center advertised its services, some of which had commercial value in
other context, didn’t itself transform the Center’s ideological and religious
advocacy into commercial activity.  This
distinguished the ordinance from the application of general false advertising
laws to actual advertising by similar clinics; the ordinance applied to
pregnancy centers regardless of whether they advertised at all. The record
didn’t show that the Center had an economic motivation for its speech; even if
its fundraising depended on the ability to attract clients, speculation about
that fact, without more, was too attenuated to be an economic motivation.
The court of appeals also rejected the attempt to defend the
ordinance as a regulation of professional speech.  Professional speech regulations are subject
to sliding-scale review, depending on where the speech is placed on the
continuum from public dialogue on one end to regulation of professional conduct
on the other.  This review “applies to
traditional occupations, such as medicine or accounting, which are subject to
comprehensive state licensing, accreditation, or disciplinary schemes,” and at
its core is when “the speaker is providing personalized advice in a private
setting to a paying client.”
The Center wasn’t like that. 
Maryland doesn’t require pregnancy centers to be licensed or otherwise
subject to a state regulatory scheme.There was no medical or professional board
that certified the Center’s employees, nor any disciplinary panel that
regulates their conduct. The Center had a volunteer “medical director” who was
a licensed physician, but she was “very rarely” on site and didn’t meet
directly with clients. Thus, no one in the Center practiced a “profession” “in
the traditional sense contemplated by our First Amendment jurisprudence.”
Although the Center “provid[es] personalized advice in a private setting,” its
clients weren’t paying.  [I take it that
the court of appeals isn’t saying that pro bono medical/legal services couldn’t
be regulated by professional licensing bodies—but now how do we decide what is
unauthorized practice of law/medicine in individual consultations?]
In a footnote, the court of appeals distinguished the Ninth
Circuit’s decision in Harris, 839 F.3d 823, cert. granted, No. 16-1140 (U.S.
Nov. 13, 2017). That law, which was upheld by the Ninth Circuit, required only licensed clinics to post a notice
informing women of the availability of state-sponsored services, including
abortion, and a phone number to call for more information.  That disclaimer was “markedly” different in
who it covered, and thus in the scrutiny that it received, as well as in
content.  Unlicensed clinics simply had to post a notice stating that their
facilities weren’t licensed by the state; because that compelled speech didn’t
mention abortion, “the burden on the speaker—and therefore the First Amendment
analysis—was different in kind.”
Anyway, because of this noncommercial/nonprofessional context,
the disclosure requirement was subject to strict scrutiny, and failed. Although
the compelled speech was “essentially factual,” that didn’t “divorce the speech
from its moral or ideological implications.” Here, the compelled speech was
particularly troubling because “the disclaimer portrays abortion as one among a
menu of morally equivalent choices. … The message conveyed is antithetical to
the very moral, religious, and ideological reasons the Center exists.”  [Of course, this reasoning will not regularly
be applied to mandatory disclosures of facts/non-facts by clinics that provide
abortion services, because abortion doesn’t get ordinary First Amendment
treatment.]  The court of appeals
cautioned that the Center’s anti-choice mission gave it “no license at all to
lie to women, … [b]ut it does provide some latitude in how to broach a
sensitive topic.”  
Baltimore’s interests in fighting deceptive advertising and
preventing the health risks that can accompany delays in abortions were
“plainly important.” However, the court of appeals agreed with the district
court that “there is insufficient evidence to demonstrate that deception
actually takes place and that health harms are in fact being caused by delays
resulting from deceptive advertising.”  After
seven years, Baltimore didn’t identify “a single example of a woman who entered
the Greater Baltimore Center’s waiting room under the misimpression that she
could obtain an abortion there.” [Note the implicit suggestion that the
evidence must be about the particular entity at issue.  Query whether the same logic could be applied
against a clinic just starting up?  What
about against the FTC’s Franchise Rules, which require a lot of disclosures
based on experience with franchises in general? 
Commercial speech doctrine presently should distinguish that last
example, though rumblings from the DC Circuit suggest otherwise.  My own opinion is that one could coherently say
“generalization from a record of bad behavior within this field is allowed
where the speech is commercial, but must be individualized where the speech is
Plus, Baltimore wasn’t using the most narrow means:
It is scrutiny of means that helps
identify the point on the spectrum where valid disclosures slip silently into
the realm of impermissible compelled speech. Particularly troubling in this
regard is (1) that the ordinance applies solely to speakers who talk about
pregnancy-related services but not to speakers on any other topic; and (2) that
the ordinance compels speech from pro-life pregnancy centers, but not other
pregnancy clinics that offer or refer for abortion.
Thus, the regulation was neither content nor viewpoint
neutral.  [Compare: the Franchise Rules
apply solely to speakers who offer franchises, but not speakers on any other
topic, and the ordinance compels speech from franchisors, but not other
businesses that refuse to franchise/sell things that aren’t franchises.  Without commercial speech doctrine, these are
the same situations, and it seems that only generic fraud law would be constitutional,
even if there are specific industries in which prophylactic and
information-providing measures would be helpful.]
The court of appeals was also unpersuaded that less
restrictive means were unavailable. The government itself could inform citizens
about the scope of services offered at various facilities “through a public
advertising campaign,” and it could enforce laws against misleading
advertising. More fundamentally, there was “only a loose fit between the
compelled disclosure at issue and the purported ills identified by the
government.”  If the problems are deceptive
advertising and consequent delays in abortion services. In that respect the
ordinance is quite overinclusive, it’s overinclusive to apply to pregnancy
centers “without regard to whether their advertising is misleading, or indeed
whether they advertise at all.”

In what one might read on commentary on present matters
beyond abortion, the court of appeals concluded, “[w]eaponizing the means of
government against ideological foes risks a grave violation of one of our
nation’s dearest principles: ‘that no official, high or petty, can prescribe
what shall be orthodox in politics, nationalism, religion, or other matters of
opinion or force citizens to confess by word or act their faith therein.’” 

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