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RRLI Active Litigation Cases

Trial Court Case No.: A 2203203 (Hamilton County Court of Common Pleas) 

Parties

Plaintiffs: Five abortion clinics and one physician
Defendants: The Ohio Attorney General, the Director of the Ohio Department of Health, the Secretary and the Supervising Member of the State Medical Board of Ohio, and local county prosecutors 

Case Overview

Amended Substitute Ohio Senate Bill 23 (SB23), enacted during the 133rd General Assembly (2019-2020), sought to impose a near-total ban on abortion. Under SB23, abortion was prohibited after the detection of embryonic cardiac activity, which occurs approximately six weeks into a pregnancy. 

SB23 criminalized the act of aiding or abetting the termination of a pregnancy, and violation was classified as a fifth-degree felony. Physicians who violated the law could lose their medical licenses, and clinics could lose their ambulatory surgical facility (ASF) licenses. Additionally, SB23 only allowed two exceptions: to prevent the pregnant person’s death or to prevent damage to major bodily functions—though the law provided no clear definition of what constituted "substantial and irreversible impairment." 

S.B. 23 was scheduled to go into effect on July 11, 2019. But on July 3, 2019, a federal district court preliminarily enjoined S.B. 23 in its entirety. That injunction remained in place until June 24, 2022, when the district court lifted the injunction only hours after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. Five days later, the plaintiffs—reproductive health care providers in Ohio that offer abortion care—filed a petition for a writ of mandamus with the Ohio Supreme Court, seeking an order declaring S.B. 23 unconstitutional. With at least one clinic on the brink of closure, Plaintiffs voluntarily dismissed this petition in September 2022, choosing instead to bring this action in the Hamilton County Court of Common Pleas to address the ongoing harm caused by S.B. 23’s enforcement.

Key Legal Issue

Prior to the passage of the Reproductive Freedom Amendment in November, 2023, the legal argument used to block the enforcement of SB23 relied on the Ohio Constitution. Specifically, plaintiffs argued that SB23 infringed on patients’ individual liberties under the state constitution —independent of rights guaranteed by the federal constitution—by violating due process and equal protection. 

The central question of this case evolved after the Reproductive Freedom Amendment took effect on December 7, 2023: Does the enforcement of SB23 violate the Reproductive Freedom Amendment of the Ohio Constitution? The plaintiffs argued that, under the newly enshrined protections of the amendment, SB23 infringed on Ohioans’ constitutional rights by restricting access to abortion before fetal viability and including an excessively vague medical exception.

Case Status

The 6-week abortion ban is permanently blocked. The case is currently on appeal in Ohio’s First District Court of Appeals (Case No. C 2400668). The State claims that the appeal does not concern the legality of SB23 itself, which it concedes is unconstitutional under the Reproductive Freedom Amendment. Rather, the State is arguing that the trial court made a legal mistake in how it decided which parts of the law could be struck down. The appeal process is ongoing.

Timeline

Trial Court Case No.: 24 CV 2634 (Franklin County Court of Common Pleas) 

Parties

Plaintiffs: Five abortion clinics and two physicians
Defendants: The Ohio Attorney General, the Director of the Ohio Department of Health, the Secretary and the Supervising Member of the State Medical Board of Ohio, and local county and city prosecutors 

Case Overview

The plaintiffs sought a preliminary injunction, followed by a permanent injunction, to block the enforcement of Ohio Revised Code sections 2317.56 and 2919.192-2919.194 (the “Requirements”). These provisions impose several burdensome mandates on individuals seeking abortion care in Ohio as well as abortion providers:

  • Waiting Period Requirement: This provision mandates that patients receive state-mandated information and then wait at least 24 hours before obtaining an abortion. It effectively delays access to care and increases costs for patients.
  • In-Person Requirement: This provision mandates that abortion patients attend an unnecessary in-person appointment before receiving care. Specifically, Ohio law requires patients to receive certain state-mandated information in person during their first visit to an abortion provider, and also requires the provider to test for embryonic and fetal cardiac activity—something that can only be done in person—during that initial visit. 
  • State Information Requirement: This provision forces abortion providers to give potentially harmful and misleading information to patients, including the medically irrelevant mention of embryonic or fetal cardiac activity. This can be particularly traumatic for some individuals, such as those choosing to terminate pregnancies due to fetal conditions and survivors of sexual assault.

Key Legal Issue

This case marks the first legal challenge brought under Ohio’s Reproductive Freedom Amendment, making it a groundbreaking test of the amendment’s scope in the post-Dobbs landscape. The central issue is whether the enforcement of these Requirements violates the amendment’s protections. Plaintiffs argue that the Requirements infringe on individuals’ reproductive decisions by imposing unnecessary delays and burdens.

Case Status

A preliminary injunction was granted on Aug. 23, 2024, and litigation is ongoing.

Timeline

Trial Court Case No.: A 2100870 (Hamilton County Court of Common Pleas) 

Parties

Plaintiffs: Five abortion clinics and one physician
Defendants: The Ohio Department of Health, the Director of the Ohio Department of Health, the State Medical Board of Ohio, and local county prosecutors

Case Overview

Amended Ohio Senate Bill 27 (SB27), introduced during the 133rd General Assembly (2019-2020), would, if enforced, mandate that fetal or embryonic tissue removed during a procedural abortion be disposed of through burial or cremation. The patient would be given the option to decide between these two disposition methods, but if no choice was made, the provider would choose. SB27 does not apply to fetal or embryonic tissue from a miscarriage or a medication abortion, even though this tissue is identical to the tissue from a procedural abortion.

SB27 also requires providers to inform patients about their disposition options, maintain records, and submit them to the state. However, the Ohio Department of Health (ODH) initially failed to provide the necessary forms and guidance for compliance before SB27 took effect. Notably, failure to comply with SB27 could result in civil penalties, the potential loss of medical licensure, and other legal actions.

Key Legal Issue

Before Ohio voters passed the Reproductive Freedom Amendment in November 2023, the legal challenge to SB27 was grounded in the Ohio Constitution. Plaintiffs first argued that the Ohio Department of Health (ODH) had failed to create the forms necessary for compliance with SB27, effectively making compliance impossible. This, plaintiffs claimed, violated their rights to due process and equal protection under the state constitution.

As the case progressed, the legal focus expanded to include whether SB27 also violated Ohioans’ constitutional right to privacy, by imposing medically unnecessary and burdensome requirements that interfered with private reproductive health decisions.
After the passage of the Reproductive Freedom Amendment in December 2023, the central legal issue shifted again: whether the enforcement of SB27 violates the explicit reproductive freedom protections now enshrined in the Ohio Constitution. Plaintiffs argued that under the amendment, SB27’s restrictions on abortion access and its burdensome regulatory requirements were unconstitutional.

Case Status

The enforcement of SB27 is permanently blocked. However, the case is currently on appeal in Ohio’s First District Court of Appeals (Case No. C 2500163). The appeal process is ongoing.

Timeline

Case No.: A 2200704 (Hamilton County Court of Common Pleas) 

Parties 

Plaintiffs: Two abortion clinics
Defendants: The Ohio Department of Health and the Director of the Ohio Department of Health

Case Overview

Under Ohio law, an Ambulatory Surgical Facility (ASF) license is essential for clinics to legally perform surgical procedures, including abortions. Without this license, clinics are prohibited from offering procedural abortions and may face civil penalties if they do.

To obtain and maintain an ASF license, clinics must either enter into a Written Transfer Agreement (WTA) with a local hospital or apply for a variance from the Ohio Department of Health (ODH). For clinics unable to secure a WTA—sometimes due to state policies that prevent public hospitals from entering into agreements with abortion providers—variances are typically supported by backup physicians who have admitting privileges at a nearby hospital. 

In 2013 and 2015, Ohio legislators used the state budget to enact provisions that made it difficult or impossible for abortion clinics to comply with these requirements. In 2015, Ohio abortion providers brought a constitutional challenge in federal court against these medically unnecessary and burdensome laws and ODH’s discriminatory enforcement of them. That case remains pending.

Ohio Senate Bill 157 (SB157), enacted during the 134th General Assembly (2021–2022), imposed new and burdensome licensing requirements on clinics providing procedural (surgical) abortions. SB157 further restricts ASF eligibility by requiring backup physicians entering into an agreement with an abortion clinic to certify that they are neither employed by nor teach at any state-funded medical school, significantly reducing the pool of available physicians.

In this case, the plaintiffs were unable to secure the required agreements and were forced to seek a variance from ODH. However, due to SB157’s constraints, their variance application was denied.

Key Legal Issue

Initially, plaintiffs challenged SB157 under due process and equal protections guaranteed by the Ohio Constitution, claiming these provisions made compliance impossible and unlawfully burdened abortion access. After the Reproductive Freedom Amendment took effect in December 2023, plaintiffs broadened their claims to argue that Ohio's WTA and variance requirements—including both SB 157 and the provisions previously challenged in federal court—violate the protections guaranteed by the new amendment. 

Case Status

The enforcement of SB157 has been blocked through a preliminary injunction, but the WTA requirement is still in effect. The litigation remains ongoing.

Timeline

Case No.: A 2101148 (Hamilton County Court of Common Pleas)

Parties

Plaintiffs: Four abortion clinics and two physicians 
Defendants: The Ohio Department of Health, the Director of the Ohio Department of Health, the Secretary and the Supervising Member of the State Medical Board of Ohio, the President and the Supervising Member for Disciplinary Matters of the Ohio Board of Nursing, and local county prosecutors

Case Overview

Ohio Senate Bill 260 (SB260), introduced during the 133rd General Assembly (2019-2020), bans telemedicine medication abortion (TMAB), which allows patients to take mifepristone and misoprostol at home or in another location after an initial consultation with a physician. SB260 requires physicians to be physically present during the administration of the first abortion medication. Physicians who provide TMAB risk losing their medical licenses and may face criminal charges.

Separate laws, also challenged in this lawsuit, prohibit Advanced Practice Clinicians (APCs)—such as nurse practitioners, physician assistants, and certified nurse midwives—from providing medication abortion and require that the abortion medication mifepristone be provided strictly in accordance with the FDA label, which limits its use to 10 weeks of pregnancy or earlier. 

Key Legal Issue

Plaintiffs initially argued that SB260 violated the Ohio Constitution's guarantees of due process, equal protection, and the right to free choice in health care. After the Reproductive Freedom Amendment was passed, the central issue in this case shifted. Plaintiffs now contend that enforcement of SB260 and the other laws restricting medication abortion infringe upon the fundamental rights protected under the Reproductive Freedom Amendment, which enshrines the right to make and carry out one’s own reproductive decisions, including abortion.

Case Status

SB260 and the requirement of on-label provision of mifepristone are blocked by a preliminary injunction. A third motion for a preliminary injunction, dealing with the limitations on APCs, was filed on 02/26/2025 and remains pending.

Timeline