Heather Swanson, et al. v. Michael T. Hilgers, Attorney General of Nebraska, et al.

A certified nurse-midwife and her medical practice brought a constitutional challenge to Nebraska statutes that prohibit certified nurse-midwives from attending home births and bar them from working at all unless they purchase a “practice agreement” with a physician. Petitioners alleged in detailed factual terms how the scheme undermines maternal safety, restricts access to care—particularly in rural areas— and bears no rational relationship to the State’s asserted health and safety interests. At the pleading stage, those allegations were required to be accepted as true. Nevertheless, the district court dismissed the complaint, and the Eighth Circuit affirmed in a brief opinion that disregarded the complaint’s factual allegations, reasoning that the legislature could have rationally believed that restrictions on nurse midwives would generally promote health and safety. The questions presented are:

1. Does rational basis review permit courts, at the Rule 12(b)(6) stage, to treat plaintiffs’ wellpleaded factual allegations as irrelevant?

2. Does rational basis review permit courts to uphold a law without any inquiry into whether the means bear a rational connection to the government’s stated ends?