Photo Credit: Jacey Max (illustration), 924 C Federal Charge: Understanding What It Entails And How To Deal With It, Legal Space (Jan. 6, 2024), https://legal-space.com/924-c-federal-charge-understanding-what-it-entails-and-how-to-deal-with-it/.

Authored by: Bennett N. Vest

The Fifth Amendment of the United States Constitution prohibits a person from being tried twice for the same offense, a principle known as double jeopardy.[1] This concept is commonly understood in the context of a person not having to physically stand trial twice for the same offense, but the question is trickier when a statute mandates that a convicted criminal be charged with two charges stemming from the same offense. The Supreme Court was asked to address this question in Barrett v. United States and ruled that Congress did not allow for there to be a conviction of both 18 U.S.C. § 924(c)(1)(A)(i) and (j) from a single act.[2]

Dwayne Barrett, the defendant, was initially convicted for a series of robberies under the Hobbs Act robbery and other counts relating to his firearm usage during the commission of the robbery.[3] During the robbery, one of his partners killed a person.[4] Barrett was then charged and convicted of seven different offenses, including a violation of 18 U.S.C. § 924(c)(1)(A)(i) for possessing a gun during the commission of a violent offense and a separate offense under 18 U.S.C. § 924(j), which resulted in a sentence of 90 years.[5]

Prior to the current case, Barrett initially appealed to the Supreme Court to mitigate his charges, but the case was remanded to the Second Circuit to reconsider under the standard established in United States v. Davis and Lora v. United States.[6] Relevant in Barrett, Lora held “that subsection (j) does not incorporate subsection (c)’s consecutive-sentence mandate.”[7] These decisions guided the Second Circuit’s decision to vacate one of his convictions under 18 U.S.C. § 924(c), which reduced his overall sentence to 50 years.[8] However, the Second Circuit instructed the district court to convict Barrett under 18 U.S.C. § 924(c) and (j) under the same set of facts.[9] Barrett appealed this decision, and a writ of certiorari was granted because of the existence of a circuit split.[10] On limited review, the Court agreed to opine whether a person who violates 18 U.S.C. § 924(c)(1)(A)(i) and § 924(j) in a single action can only be convicted of one or two offenses.[11]

In a 9-0 decision, authored by Justice Jackson, the Supreme Court unanimously ruled that Congress did not intend for Barrett to be convicted of 18 U.S.C. § 924(c)(1)(A)(i) and § 924(j) for a single action.[12] The Court started with the presumption in Blockburger v. United States that “Congress ordinarily does not intend to punish the same offense under two different statutes.”[13] Then, looking at  the history of Section 924(c), it was clear that the statute creates a separate offense for a person to carry a weapon during the commission of a crime of violence or drug trafficking crimes, but it opened up questions of whether it could displace or replace the original offense.[14] However, in 1971, Congress clarified that Section 924 was for additional punishments to the original sentence and that the sentences shall be served consecutively.[15] While the question regarding subsection (c) has been clarified, the question remains whether subsection (j) further allows an additional layer of punishment.[16]

Subsection (j) was added “decades after subsection (c)” in 1994  under to further punish offenders who killed people in violation of section 924(c).[17] Subsection (j) also allowed for maximum penalties instead of mandatory minimums.[18] Although subsection (c) did not allow for the death penalty that subsection (j) allows.[19]  The subsection is another tool prosecutors have in their toolboxes to prosecute offenders to get the death penalty for more offenders.[20]

Before addressing Barrett’s constitutional claim of double jeopardy, the Court first engaged in a statutory interpretation. It noted that the term “same offense” is defined as “the lesser included offense to the greater offense.”[21]After resolving this question, the Court then analyzed whether Congress intended to “authorize multiple convictions for one act that violates both § 924(c)(1)(A)(i) and § 924(j).”[22] 

Furthermore, the Court considered whether Congress intended to displace the Blockburger standard. As a threshold matter, Congress is presumed to know the Blockburger standard before writing the statute. Looking at the language of the statute, Congress upheld the idea of Blockburger by incorporating its language throughout the statute; thus, it was clear evidence that Congress meant to incorporate Blockburger’s language.[23]  Therefore, Congress’s silence on the double conviction leads to the presumption that it did not mean to override the Blockburger presumption.[24] Additionally, the government’s “textual evidence” of the consecutive sentence clause was unpersuasive because it confuses sentencing for punishment, and subsections (c) and (j) meant to address different causes of action.[25]

Next, the Court also dispelled the argument that the structure and operation of the statute contribute to the government’s understanding of the statute. Although subsection (c)(1) has mandatory minimums and subsection (j) deals with maximums, it is the minimum punishment plus the punishment under subsection (j).[26] Using textual analysis and prior case law, the Court determined that the difference in language does not beat the overall presumption that “[s]ubsection (j) shares subsection (c)’s elements but not its sentencing scheme.”[27]

Finally, the government’s position on Section 924 lacked support in the legislative history. The legislative history of the statute does provide for double-conviction standards, but there was evidence that Congress intended cumulative punishments.[28] Because the legislative history did not suggest that meaning, the Court ruled that Congress likely did not intend to authorize a violation of both offenses stemming from a single offense.[29]

In a concurrence in part, Justice Gorsuch agreed with the majority’s overall ruling, but he disagreed with part IV(c), or the legislative history portion of the majority opinion.[30] Justice Gorsch acknowledges the complexity of the case, given that the conviction stemmed from a single, not multiple, proceedings.[31] Justice Gorsuch agreed that the Blockburger presumption has not been overturned, but he presents a warning that the ambiguity of double jeopardy needs to be addressed.[32] Justice Gorsuch suggested that the first of two solutions would be that “the same offense” means different things in different contexts, meaning that in the successive-prosecution to be the same offense if they fail the Blockburger test, and the same offense in a concurrent-prosecution if it fails the Blockburger standard, and Congress has had no clear intentions otherwise.[33] The second solution would provide a full stop if the Blockburger test fails.[34]

Overall, the ruling by the Supreme Court reversed and remanded the Second Circuit’s sentence to conform with its ruling. This decision is not only a win for Barrett, but it leaves open several questions about the overall meaning of double jeopardy. Until this concept is clarified, we will live in a world where defendants may have their double jeopardy rights violated without knowing it. Hopefully, the Supreme Court will have a case that will serve as the proper vehicle to resolve this ambiguity.

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[1] U.S. Const. amend V (“[N]or shall any person be subject to for the same offense to be twice in jeopardy of life or limb . . .”).

[2] See Barrett v. United States, No. 24-5774, 2026 WL 96659, at *12 (U.S. Jan. 14, 2026).

[3] See id. at *3.

[4] See id.

[5] See 18 U.S.C. § 924(c)(1)(A)(i) (“Any person who, during and in relation to any crime of violence or drug trafficking crime . . . uses or carries a firearm, or who, in furtherance of any such crime, possesses a firearm, shall, in addition to the punishment provided for such crime of violence or drug trafficking crime (i) be sentenced to a term of imprisonment of not less than 5 years; (ii) if the firearm is brandished, be sentenced to a term of imprisonment of not less than 7 years; and(iii) if the firearm is discharged, be sentenced to a term of imprisonment of not less than 10 years.”); 18 U.S.C. § 924(j) (“A person who, in the course of a violation of subsection (c), causes the death of a person through the use of a firearm, shall . .  . be punished by death or by imprisonment for nay terms of years or for life”); Barrett, 2026 WL 96659 at *3.

[6] See Barrett v. United States, 588 U.S. 918 (2019) (vacating Barrett’s count two charge of using a firearm in committing Hobbs Act robbery conspiracy).

[7] See Lora v. United States, 599 U.S. 453 (2023); see also Barrett, 2026 WL 96659 at *4.

[8] See Barrett, 2026 WL 96659 at *4.

[9] See id.

[10] See Barrett v. United States, 145 S. Ct 1307, 1307 (2025).

[11] See id.

[12] See Barrett, 2026 WL 96659 at *12.

[13] Id. at *6 (quoting Blockburger, 445 U.S. 684, 688 (1980)).

[14] Id. at *5.

[15] See id. at *6.

[16] See id. at *6 (stating that 18 U.S.C. § 924(j) uses the same language from the federal murder statutes of 18 U.S.C. §§ 1111(b) &1112(b)).

[17] 18 U.S.C. § 924(j) (“A person who, in the course of a violation of subsection (c), causes the death of a person through the use of a firearm, shall (1) if the killing is a murder (as defined in section 1111), be punished by death or by imprisonment for any term of years or for life. . .”); see also Barrett, 2026 WL 96659 at *6.

[18] Barrett, 2026 WL 96659 at *6.

[19] See id.

[20] See id.

[21] Id. at *7.

[22] Id.

[23] See id. at *8.

[24] See id. at *11.

[25] See id. at *9.

[26] See id. at *10.

[27] See id. at *11.

[28] See id. at *7.

[29] Barrett, 2026 WL 96659at *12

[30] See id. at *13.

[31] See id.

[32] See id.

[33] See id.

[34] See id. at *14.

Photo Credit: Phil Federico, How to Proceed in a Medical Malpractice Suit in Maryland, Brockstedt, Mandalas, Federico, June 4, 2025, https://www.mdmalpracticelaw.com/legal-blog/how-to-proceed-with-medical-malpractice-suit-md/

Authored by: James David Greene III

The Alabama Medical Liability Act (“AMLA”) requires plaintiffs to amend their complaint “timely upon ascertainment of new or different acts or omissions upon which his claim is based; provided, however, that any such amendment must be made at least 90 days before trial.”[1] In Ex Parte Taylor, the Alabama Supreme Court addressed a defendant’s motion to strike on the grounds that the plaintiff’s complaint was not amended “timely” in accordance with the AMLA.[2] The Court’s holding places plaintiffs on notice to amend their complaint as quickly as possible so they do not endanger their ability to plead newly discovered facts.

On August 24, 2016, Dr. Jeff Segrest performed a vein ablation on Sandra Phillips’s right leg.[3] Mrs. Phillips developed an infection and was referred to Dr. Steven Taylor, who performed three irrigation and debridement (“I & D”) procedures on her.[4] These procedures took place on October 26, 2016, December 1, 2016, and January 30, 2017.[5] On March 28, 2017, Dr. Taylor found and removed a 4” x 4” piece of gauze from Mrs. Phillips’s wound, which had been left in her wound on a previous, unknown date.[6] Mrs. Phillips filed suit against Dr. Taylor in Shelby County Circuit Court on July 9, 2018, alleging malpractice under the AMLA.[7]

Mrs. Phillips’s complaint alleged that Dr. Taylor, not Dr. Segrest, performed the vein ablation on September 21, 2016, not August 24, 2016.[8] Further, it was alleged that a “sponge” was left inside Mrs. Phillips during the vein ablation and was later found by a nurse during an appointment to remove a wound vacuum.[9] The failure to remove the sponge was said to have been the cause of “physical and emotional trauma” to Mrs. Phillips that included “chronic and prolonged medical care . . . including . . . fever and infection.”[10] Dr. Taylor answered the complaint, denying all material allegations.[11]

In February of 2020, Dr. Taylor filed a motion for summary judgment in which he argued that no such vein ablation took place on September 21, 2016, and that no “sponge” was found in Mrs. Phillips.[12] He included his own interrogatory and requests for admission answers, which repeatedly stated that the claimed “incident made the basis of this litigation,” the September 21, 2016 vein ablation, did not occur to his knowledge.[13] Instead, Dr. Taylor admitted to finding a 4” x 4” piece of gauze on March 28, 2017, which he thought was left from a wound dressing, not a surgical procedure.[14] On March 26, 2020, Mrs. Phillips filed a motion asking for an extension to conduct more discovery before summary judgment was ruled on.[15] In this motion, she contended that Dr. Taylor’s deposition had still not been taken and was the result of the defense not timely producing necessary documents.[16] In her motion, Mrs. Phillips continued to reference a “vein ablation procedure on her right leg” on September 21, 2016.[17]

In response to Mrs. Phillips’s motion, Dr. Taylor argued that the documents Mrs. Phillips was referencing were her own medical records that she and her counsel had access to “before this lawsuit was filed.”[18] The COVID-19 pandemic pushed the summary judgment hearing to April 19, 2022. In this hearing, Mrs. Phillips’s counsel admitted that the medical records showed Dr. Taylor did not perform a vein ablation surgery on Mrs. Phillips, but argued there was “substantial evidence” that gauze, not a sponge, was left inside her during Dr. Taylor’s post-operative care.[19] Dr. Taylor’s counsel responded by saying that Mrs. Phillips’ counsel was “talking about a lawsuit that does not exist.”[20] He argued that because the complaint alleged in both of its Counts under the AMLA that the September 21, 2016, surgery was the basis for the lawsuit, it was not pleaded sufficiently under the AMLA’s pleading requirement.[21] The circuit court denied Dr. Taylor’s motion for summary judgment; however, Mrs. Phillips did not amend her complaint and took Dr. Taylor’s deposition in June of 2023.[22]

On September 23, 2024, Dr. Taylor renewed his motion for summary judgment, arguing that the undisputed facts still showed that Dr. Taylor had not performed any surgery on September 21, 2016, on Mrs. Phillips, nor was any sponge ever found inside her.[23] On November 12, 2024, the circuit court held another hearing on the motion, where Mrs. Phillips’s counsel admitted to still not having amended the complaint to address the issues of dates and procedures done by Dr. Taylor.[24] Her counsel argued this was a simple “scriveners’ error” at the outset of the case, and Dr. Taylor knew exactly what he was defending the entire time.[25] The circuit court denied Dr. Taylor’s motion for summary judgment and allowed Mrs. Phillips fourteen days “to correct the date in the Complaint based on a clerical error of counsel.”[26]

On November 26, 2024, over 6 years after filing suit, Mrs. Phillips filed her first amended complaint, which corrected the alleged September 21 surgery to the correct date of the October 26th procedure done by Dr. Taylor.[27] Dr. Taylor filed a motion to “dismiss and or strike” Mrs. Phillips’s first amended complaint, arguing that under the AMLA and Rule 15 of the Alabama Rules of Civil Procedure, it caused undue delay.[28] Mrs. Phillips filed a response arguing Dr. Taylor could not show “actual prejudice” or “undue delay.”[29] The motion to dismiss and or strike was denied by the circuit court, and Dr. Taylor petitioned for a writ of mandamus, asking the Alabama Supreme Court to grant his motion to strike Mrs. Phillips’s first amended complaint.[30]

The Court found that Mrs. Phillips’s amendment was not timely filed as a result of her failure to comply with the AMLA pleading standards, nor did good cause exist to grant her leave to amend.[31] The court cited directly to the AMLA, which states a plaintiff has a duty to “amend his complaint timely upon ascertainment of new or different acts or omissions upon which his claim is based.”[32] It was also noted that the statute provides defendants with the ability to further protect their rights by limiting discovery to only acts or omissions that are pleaded with particularity.[33] The Court was not convinced at all by the “scriveners’ error” argument put forward by Mrs. Phillips and instead found that she clearly failed to satisfy her pleading duties under the AMLA.[34] The discussion then shifted to whether the circuit court was correct in granting leave to Mrs. Phillips under Rule 15(a). Under Rule 15(a), amendments “may be disallowed by the court . . . upon a motion to strike from an adverse party,” specifically when allowing an amendment would create actual prejudice or undue delay.[35] Undue delay was the focus of the Court’s further discussion.

The Court noted that well-established Alabama law held that one example of undue delay is “filing an amendment when the party has had sufficient opportunity to discover the facts necessary to file the amendment earlier.”[36] This would be sufficient grounds for a trial court to deny an amendment.[37] Finally, the Court held that showing prejudice was not necessary when the party attempting to amend showed “truly inordinate and unexplained delay,” and ultimately that Mrs. Phillips had exhibited that kind of delay, along with undue delay regarding Rule 15.[38] The Court granted the petition and issued the writ requiring the circuit court to grant Dr. Taylor’s motion to strike.[39]

The implications of this ruling, while not earth-shattering, are significant for plaintiffs in medical malpractice actions in Alabama. Even though this case is a bit extreme with the time elapsed between Mrs. Phillips’s knowledge of the error and her first amended complaint, it still creates a “no man’s land” for plaintiffs. The court declined to establish a bright-line rule regarding what exactly “timely” would be; they instead made clear this would be a fact-specific application.[40] The ruling will certainly result in plaintiffs taking care to first plead the facts as accurately as possible, but also to amend their complaint as soon as possible when new facts come to light.

Plaintiffs across the state will now ask: How long is too long to amend when a new fact comes out? Is three months of knowing a fact too long? Two months? One month? The other consideration plaintiffs must now contemplate is the likelihood of a flood of motions to strike pleadings based on this ruling from the Court. It will surely take at least a few years for the Court to further clarify its holding here and create a clearer picture. Regardless, the best rule for medical malpractice plaintiffs to live by for now? Plead ‘em if you got ‘em.

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[1] Ala. Code § 6-5-551 et seq. (1975).

[2]  Ex Parte Taylor, SC 2025-0164, 2025 WL 3120230 at *1 (Ala. Nov. 7, 2025).

[3] Id.

[4] Id.

[5] Id.

[6] Id.

[7] Id. at 2.

[8] Taylor, 2025 WL 3120230 at *2.

[9] Id.

[10] Id.

[11] Id.

[12] Id. at *3.

[13] Id.

[14] Taylor, 2025 WL 3120230 at *4.

[15] Id. at *7.

[16] Id.

[17] Id.

[18] Id. at *8.

[19] Id.

[20] Taylor, 2025 WL 3120230 at *9.

[21] Id.

[22] Id. at *11.

[23] Id.

[24] Id. at *14.

[25] Id.

[26] Taylor, 2025 WL 3120230 at *15.

[27] Id.

[28] Id.

[29] Id. at *16.

[30] Id. at *16-17.

[31] See id. at *17 (“Nevertheless, as hereinafter discussed and based on the circumstances before us, we cannot conclude that Phillips’s amendment was timely filed in light of her failure to satisfy her obligations under § 6-5-551 or that good cause would have existed to grant Phillips leave to amend.”).

[32] Taylor, 2025 WL 3120230 at *18.

[33] See id. (“And, in § 6-5-551 the legislature has granted a defendant a right to protect his or her interest, for purposes of discovery or for trial, by limiting a plaintiff to the pleaded acts or omissions rather than “any other act or omission.”); Ex Parte Huntsville Emergency Med. Serv., Inc., 372 So. 3d 538, 546 (Ala. 2022) (“Section 6-5-551 permits discovery related to acts or omissions specifically alleged in the complaint, but it prohibits discovery ‘with regard to any other act or omission’ not properly alleged.”).

[34] See id. (“We will not be distracted by any belated ‘scrivener’s error’ excuse.”).

[35] Id.; R. 15 Ala. R. Civ. P.

[36] Id.; See Stallings v. Angelica Uniform Co., 388 So. 2d 942, 947 (Ala. 1980) (“An unexplained undue delay in filing an amendment when the party has had sufficient opportunity to discover the facts necessary to file the amendment earlier is also sufficient grounds upon which to deny the amendment.”).

[37] Id.

[38] See Taylor, 2025 WL 3120230 at *19 (“Because the materials before us clearly establish ‘[t]ruly inordinate and unexplained delay’ by Phillips regarding the filing of her first amended complaint, i.e., undue delay for purposes of Rule 15(a), especially in light of Dr. Taylor’s timely and repeated assertion of the requirements of § 6-5-551 we conclude that the circuit court exceeded its discretion by denying Dr. Taylor’s motion to strike.”)

[39] Id. (“The circuit court is directed to vacate its order granting Phillips leave to amend her complaint and to grant the motion to strike Phillips’s first amended complaint.”).

[40]  See id. (“In addressing the issue of undue delay in relation to § 6-5-551, we wish to be clear. The issue is fact specific.”).

Photo Credit: Robin Shea, Viewpoint: Vaccination Accommodation—Is that Religious Request Sincere?, SHRM, https://www.shrm.org/topics-tools/news/benefits-compensation/viewpoint-vaccination-accommodation-is-religious-request-sincere (September 14, 2021).

Authored by: Elizabeth Gracie Smith

An employee’s request for religious accommodations is required to be rooted in a “bona fide religious belief,”[1] not simply an employee’s personal preference according to the Ninth Circuit in a 2025 case involving the COVID-19 vaccine.[2]

In that decision, the Ninth Circuit affirmed the district court’s dismissal for failure to state a claim of an employment discrimination action brought under Title VII and Oregon’s parallel state law.[3] The  Court held that in 2021, an employee who worked at a hospital in Oregon, failed to plead a bona fide religious belief that conflicted with her employer’s policy.[4] This policy implemented the Oregon Health Authority’s administrative rule which required healthcare workers to be vaccinated against COVID-19, absent an approved exemption.[5]

The employer did approve the plaintiff’s initial request for a religious exemption from vaccination, and as part of this accommodation, the plaintiff was required to wear personal protective equipment while in the office and to test weekly for COVID-19 antigens.[6] The plaintiff then sought further accommodation to be exempted from the weekly antigen testing due to research she found that led her to believe the antigen testing contained carcinogenic materials which she claimed violated her religious beliefs.[7] The employer denied further accommodations to avoid this testing and later terminated her employment.[8]

The Ninth Circuit has held that, for a claim of religious discrimination, a plaintiff must begin by pleading “a prima facie case of failure to accommodate her religion.”[9] If the plaintiff meets this burden, then the employer must show the refusal to accommodate the religion was justified.[10] The plaintiff demonstrates a prima facie case of discrimination by showing she had a bona fide religious belief, the practice of this belief conflicted with one or more of her employment duties, she informed her employer of the belief and conflict, and the employer then threatened to or subjected her with discriminatory treatment because of the inability to fulfill the job requirements.[11] When an employee requests an accommodation, they are required to show sufficient facts that the accommodation request comes directly from a bona fide religious belief.[12]

The EEOC has refined Title VII and other caselaw to mean an employee’s request for an exemption from the COVID-19 vaccine can be denied if “the employee’s objection . . . is not religious in nature.”[13] Thus, a plaintiff does not state a prima facie case if the belief motivating the request for accommodation is not actually religious.[14] The Ninth Circuit has also not yet endorsed a test for determining whether a belief is religious or secular, instead often relying on the First Amendment doctrine for guidance on assessing a plaintiff’s religious assertions.[15]

Courts are not required to accept entirely conclusory assertions of a plaintiff’s religious beliefs.[16] It is often necessary to inquire into the religious or secular nature of a belief in order to prevent religious labels from becoming free to ignore any obligation imposed on them.[17] Still, courts have struggled to draw this line.[18] However, courts are not allowed to substitute their own judgment in place of the believers,[19] and they must also not judge the reasonableness under the disguise of the claim’s sufficiency.[20]

Overlap between religious and secular bases for a belief poses issues. In the constitutional context, and supported by the EEOC, a belief that is grounded in simultaneous religious and secular considerations is “presumably protected.”[21] Thus, a plaintiff, by asserting a general religious idea and simply connecting that principle with her personal medical judgment, does not state a claim for religious accommodation.

Here, the Court held that the district court does not need to examine the reasonableness or sincerity of a belief, but need only determine if a plaintiff has given enough facts to show that her belief is actually religious rather than purely secular.[22] Because of this, the Ninth Circuit held that the plaintiff’s complaint was not sufficient to show a bona fide religious belief that was in conflict with her former employer’s testing requirement.[23] The Court decided that her belief that the antigen testing swab was carcinogenic was personal and secular rather than actually religious.[24]

They also concluded that the plaintiff’s proposed standard would result in “unmanageable expansion” of Title VII protections.[25] If her assertions in this case were enough for a prima facie claim for a religious exemption, the bounds on typically secular preferences that an employee could define as religious and require an employer to accommodate would be greatly expanded.

This conclusion differed from the majority approach held by other circuits, including the Sixth, Seventh, and Eighth Circuits.[26] Joining the Third Circuit, this Court declined to adopt a more lenient approach which allows a complaint to survive with only conclusory statements about the religious nature of a particular belief.[27] They concluded the plaintiff did not state a claim for religious accommodation since she only asserted a general religious principle and linked it to her personal and medical judgment that she confirmed through personal prayer.[28]

In the dissent, Judge VanDyke wrote that the majority in this opinion adopted a flawed analysis that tries to distinguish a category of purely secular claims only incidentally linked to a general religious principle from a category of “truly religious” claims.[29] He wrote that he would have followed the majority of circuits and assumed as true the plaintiff’s allegation that she requested a religious accommodation from the COVID-19 testing requirement; after her employer denied that request, she was ultimately terminated for refusing to undergo testing.[30] He claims that as pled, her religious beliefs clearly constituted a fundamental element of her objection to antigen testing.[31]

This decision signals that, at least in the Ninth Circuit, employees seeking religious accommodations must plead more than a generalized religious principle coupled with personal or scientific objections. Plaintiffs will need to clearly show how a challenged workplace requirement directly conflicts with a bona fide religious belief, rather than a personal judgment informed by research, health concerns, or individual conscience. For employers, particularly in regulated industries such as healthcare,  the ruling gives greater certainty at the pleading stage and may encourage dismissal of accommodation claims that do not clearly state a religious foundation. At the same time, the decision deepens an existing circuit split, increasing the likelihood of inconsistent outcomes for similarly situated employees depending on jurisdiction and raising the need for future Supreme Court review to clarify the pleading standard for Title VII religious accommodation claims.

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[1] Heller v. EBB Auto Co., 8 F.3d 1433, 1438 (9th Cir. 1993).

[2] Detwiler v. Mid-Columbia Med. Ctr., 156 F.4th 886 (9th Cir. 2025).

[3] Id. at 900.

[4] Id.

[5] Id. at 890.

[6] Id. at 891.

[7] Id.

[8] Detweiler, 156 F.4^th at 891-92.

[9] Bolden-Hardge v. Off. Of Cal. State Controller, 63 F.4th 1215, 1222 (9th Cir. 2023).

[10] Id.

[11] Heller, 8 F.3d at 1438.

[12] See Tiano v. Dillard Dep’t Stores, Inc., 139 F.3d 679, 682–83 (9th Cir. 1998) (holding that the timing of an employee’s religious pilgrimage was a matter of personal preference instead of a bona fide religious belief).

[13] What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws, U.S. Equal Emp. Opportunity Comm’n (Mar. 1, 2022), https://www.eeoc.gov/wysk/what-you-should-know-aboutcovid-19-and-ada-rehabilitation-act-and-other-eeo-laws.

[14] Heller, 8 F.3d at 1438.

[15] Keene v. City and Cnty. of San Francisco, No. 22-16567, 2023 WL 3451687, at *2 (9th Cir. May 15, 2023).  

[16] Bolden-Hardge, 63 F.4th at 1223 (relying on Oklevueha Native Am. Church of Haw., Inc. v. Lynch, 828 F.3d 1012, 1016–17 (9th Cir. 2016)). 

[17] See e.g., Wisconsin v. Yoder, 406 U.S. 205, 215–16 (1972) (explaining that “purely secular considerations” will not merit constitutional religious protections).

[18] See Callahan v. Woods, 658 F.2d 679, 687 (9th Cir. 1981) (“A secular experience can stimulate a spiritual response; lives are not so compartmentalized that one can readily keep the two separate.”).

[19] See Heller, 8 F.3d at 1438 (“[I]t is no business of courts to say . . . what is a religious practice or activity.”).

[20] Id.; Thomas, 450 U.S. at 714 (discussing how the question of whether a belief is religious should not “turn upon a judicial perception of the particular belief or practice in question; religious beliefs need not be acceptable, logical, consistent, or comprehensible to others in order to merit First Amendment protection.”).

[21] Callahan, 658 F.2d at 684.  

[22] Detwiler, 156 F.4th at 895.

[23] Id.

[24] Id. at 896.

[25] Id. at 900.

[26] See e.g., Lucky v. Landmark Med. Of Mich., 103 F.4th 1241, 1243 (6th Cir. 2024) (holding a plaintiff is not required to explain tenant of their religion prohibits vaccinations, and only requires facts “supporting an inference that her refusal to be vaccinated . . . was an ‘aspect’ of her ‘religious observance’ or ‘practice’ or ‘belief.’”); Passarella v. Aspirus, Inc., 108 F.4th 1005, 1007 (7th Cir. 2024) (“Courts should not undertake to dissect religious beliefs . . . because [they] are not articulated with the clarity and precision that a more sophisticated person might employ.”). Ringhofer v. Mayo Clinic, Ambulance, 102 F.4th 894, 902 (8th Cir. 2024) (concluding that by connecting an objection to “specific religious principles,” a plaintiff satisfies the burden at the pleading stage).

[27] See McDowell v. Bayhealth Med. Ctr., Inc., No. 24-1157, 2024 WL 4799870, at *3 (3d Cir. Nov. 15, 2024) (holding that a “general moral commandment” drawn from religion cannot change a medical objection into a religious objection).

[28] Detwiler, 156 F.4th at 900.

[29] Id. at 901.

[30] Id. at 907.

[31] Id.

Photo Credit: Alamy, US Tax Court Building – Washington DC USA, https://www.alamy.com/stock-photo/us-tax-court-building-washington.html?sortBy=relevant (last visited Jan. 28, 2026).

Authored by: Anna L. Dozier

The tax code allows the Internal Revenue Service (“IRS”) the ability to levy a taxpayer’s property if they are liable for a tax they are refusing or unable to pay.[1] Before a levy can be placed on their property, the taxpayer has the right to request a collection due process hearing to raise relevant issues regarding the unpaid tax or proposed levy.[2] An IRS appeals officer will consider the issues raised by taxpayers when making their determination.[3] If the taxpayer disagrees with the determination, they have 30 days to petition the Tax Court to review the appeals officer’s determination.[4] After the Tax Court’s decision, the taxpayer can appeal to a federal court of appeals.[5]

These are the procedural and administrative actions that Jennifer Zuch undertook trying to dispute the debt the IRS claimed she owed.[6] In 2012, both Zuch and her husband filed separate tax returns for the year 2010.[7] Although Zuch’s individual tax return indicated no tax liability, her husband’s separately filed return showed an outstanding balance.[8] After her husband submitted an offer in compromise, the IRS gave them a credit and settled his debts using estimated tax payments Zuch and her husband had previously paid to the IRS.[9]

Subsequently, Zuch amended her 2010 tax return to include additional income that had not been included on her original return.[10] The inclusion of previously unreported income increased her reported tax liability.[11] However, Zuch asserted that she was entitled to a refund on the grounds that the credit from prior payments made by both her and her husband to the IRS exceeded the tax liability due after her amended 2010 return.[12]

Because the IRS already credited the previous payments to her husband’s liability, they notified Zuch of their intent to levy her property.[13] At the requested collection due process hearing, Zuch’s arguments were denied.[14] Following this denial, she sought a different outcome at the Tax Court. The Tax Court sent the case back to the Office of Appeals, which again upheld the levy, so the case continued in the Tax Court.[15] Over the span of many years, while the case was being tried, Zuch kept filing tax returns that resulted in overpayments triggering a refund; however, instead of the refunds going to Zuch, the IRS credited all the refunded money to Zuch’s unpaid tax that is being disputed in Tax Court.[16]

Now that Zuch’s unpaid tax amount is zero, the IRS filed to dismiss the hearing for the levy on her property because, without a balance due, there is no justification for a levy, thus no Tax Court jurisdiction.[17] Zuch argued that the Tax Court still had jurisdiction because she raised the dispute of the allocation of her husband’s credit under the levy action.[18] The Tax Court ruled it lost its jurisdiction, but the Third Circuit Court of Appeals held that the issue was not moot because Zuch was authorized to raise the issue of the misplaced credit, as it is a “challenge to the existence or amount of the underlying tax liability.”[19]

The Supreme Court of the United States (“SCOTUS”) heard this case on Writ of Certiorari from the Third Circuit Court of Appeals. Justice Barrett delivered the opinion of the Court, ruling that the Tax Court lost its jurisdiction when there was no basis for the levy.[20] SCOTUS identified that “the Tax Court is a court of limited jurisdiction,”[21] and the tax code allows the Tax Court to have jurisdiction “to ‘review’ a ‘determination’ made by an appeals officer in a collection due process hearing.”[22] Thus, the issue before the court is what “determination” encompasses under § 6330(d)(1).[23]

To determine whether a “determination” only pertains to a decision regarding the levy or a decision on all issues raised at the collection due process hearing, SCOTUS looks to § 6330(c)(3).[24] This section of the tax code lays out considerations for when the appeals officer is making a determination, importantly, here, the “issues raised by the taxpayer.”[25] So while the appeals officer was required to consider Zuch’s raised issue regarding the allocation of the credit, the ultimate determination concerned only the levy.[26]

In fact, the rule for challenging a tax liability dispute requires the taxpayer to pay the tax before suing for a refund.[27] To dispute the use of her refund, Zuch would have had to sue, but because the IRS proposed the levy, Zuch was able to raise her issue in her collection due process hearing.[28] SCOTUS is clear on the purpose for a collections due process hearing under § 6330, stating “[t]he taxpayer may only raise issues that pertain to the levy.”[29] Recall that once the IRS used the refunds for Zuch’s tax liability, the proposed levy was dropped.[30] Therefore, the issue that Zuch raised in court regarding the allocation of the credit no longer pertained to a levy.[31]

Beyond the power granted by § 6330 to “enjoin any action or proceeding . . . only in respect of the unpaid tax or proposed levy to which the determination being appealed relates,” the Tax Court has no jurisdiction to provide further relief.[32] Zuch argues that the Tax Court can still grant her relief in the form of a declaration on the allocation of the credit because it was raised as an issue to the levy; however, SCOTUS stands firm in its holding that the Tax Court has no authority when there is no levy.[33]            

Thus, the judgment of the Third Circuit was reversed because the Tax Court was correct in its decision to dismiss Zuch’s appeal once there was no levy.[34] The only jurisdiction the Tax Court had in this proceeding was to make a determination on “whether the levy could (or could not) go forward.”[35] While making the initial determination, the Tax Court had to consider Zuch’s allocation issue, but after there was no basis for the levy, “there was no relevant determination for the Tax Court to review.”[36] Justice Gorsuch dissents, emphasizing that the court gave the IRS a “powerful new tool” in its decision, allowing it to avoid accountability while leaving taxpayers like Zuch without a worthwhile way to challenge the IRS.[37]

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[1] I.R.C. § 6331(a).

[2] Id. § 6330.

[3] Id. § 6330(c)(3).

[4] Id. § 6630(d)(1).

[5] Id. § 7482(a).

[6] Comm’r of Internal Revenue v. Zuch, No. 24-416, slip op. at 6 (U.S. June 12, 2025).

[7] Id. at 3.

[8] Id.

[9] Id.

[10] Id.

[11] Id.

[12] Id.

[13] Zuch, No. 24-416, at 3.

[14] Id.

[15] Id.

[16] Id. at 3-4.

[17] Id. at 4.

[18] Id.; see I.R.C. § 6330(c)(2)(B).

[19] Zuch, No. 24-416, at 4; I.R.C. § 6330(c)(2)(B).

[20] Zuch, No. 24-416, at 8.

[21] Id. at 5 (citing Comm’r v. McCoy, 484 U.S. 3, 7 (1987) (per curiam).

[22] Zuch, No. 24-416, at 5; I.R.C. § 6330(d)(1).

[23] Zuch, No. 24-416, at 6.

[24] Id.; I.R.C. § 6330(c)(3).

[25] Zuch, No. 24-416, at 6; see I.R.C. § 6330(c)(3)(B).

[26] Zuch, No. 24-416, at 6.

[27] I.R.C. § 7421(a).

[28] Zuch, No. 24-416, at 6.

[29] Id. at 7; see I.R.C. § 6330(c)(2)(A).

[30] Zuch, No. 24-416, at 3.

[31] Id. at 7.

[32] Id.; I.R.C. § 6330(e)(1).

[33] Zuch, No. 24-416, at 7-8.

[34] Id. at 8.

[35] Id.

[36] Id.  

[37] Id. at 2 (Gorsuch, J., dissenting).

Photo Credit:  Photograph of Hermes Birkins, in Everything You Need to Know About the Hermes Birkin, Sotheby’s (Feb. 21, 2024), https://www.sothebys.com/en/articles/everything-you-need-to-know-about-the-hermes-birkin.

Authored by: Abigail C. Frazier

In Cavalleri v. Hermes International, luxury shoppers brought a class action challenging the sales practices of Hermes International and Hermes of Paris (collectively, “Hermes”).[1] In their complaint, the plaintiffs allege that Hermes requires customers to purchase other Hermes products to qualify for a famed Birkin bag, which plaintiffs argue constitutes an unlawful tying arrangement under the Sherman Act Sections 1 and 2,[2] as well as several California consumer-protection statutes.[3]

Hermes, founded by harness-maker Thierry Hermes in 1837,[4] has evolved into a global luxury brand, famous for its high-end goods, including leather bags, silk scarves, and shoes, to name a few.[5] The Birkin bag, at the center of this case, is famously expensive, notoriously difficult to purchase, and widely viewed as a “symbol of ultimate luxury.”[6] Plaintiffs Tina Cavalleri and others claimed that Hermes conditioned access to a Birkin on a customer’s willingness to purchase other Hermes products first, a practice they characterized as coercive and anticompetitive.[7] The lawsuit, filed in March of 2024 in the Northern District of California, sought class action status and attempted to frame Hermes’ sales strategy as an antitrust violation.[8]

The court previously dismissed the plaintiffs’ First Amended Complaint with leave to amend, finding the allegations insufficient on several core antitrust elements such as relevant product markets, market power, and antitrust injury.[9] As the court explained, the First Amended Complaint “did not plausibly allege relevant product markets, defendant’s market power within those markets, or an injury that the antitrust laws were intended to prevent.”[10]

Before the court in this instance was the plaintiffs’ Second Amended Complaint.[11] Plaintiffs alleged that Hermes “won’t sell them a famed Birkin bag unless they are ‘deemed worthy’ by buying other Hermes products.”[12] Plaintiffs argued that this conduct constitutes an “unlawful tying arrangement in violation of Sherman Act Section 1 and 2” as well as multiple California laws that the court ultimately declined to exercise supplemental jurisdiction over.[13] Hermes moved to dismiss the case pursuant to Federal Rules of Civil Procedure 8 and Rule 12(b)(6). Ultimately, Judge James Donato dismissed the case with prejudice on September 17, 2025, finding the plaintiffs still failed to “plausibly allege[] that Hermes engaged in anticompetitive conduct with respect to the Birkin bag.”[14] According to the court, the plaintiffs’ second attempt “did not provide any new facts that might have filled in the gaps in the prior complaint and raised plaintiffs’ antitrust theories above a purely speculative level.”[15] In other words, the plaintiffs repeated the same conclusions without supplying the factual basis antitrust pleading standards require.[16]

The court’s analysis focused heavily on tying arrangements.[17] Under antitrust law, a tying arrangement occurs when a seller conditions the sale of one product (the tying product) on the purchase of another distinct product (the tied product).[18] More specifically, a tying arrangement requires proof that: (1) two distinct products are tied, (2) the seller has market power in the tying market, and (3) the arrangement affects a significant volume of commerce in the tied product market.[19] Notably, tying practices are not per se illegal; rather, they require a demonstration of market power and harm to competition.[20] Like the First Amended Complaint, the Second Amended Complaint did not adequately define the relevant market for the Birkin bag nor did it establish Hermes’ market power within that market, relying instead on outdated academic sources and conclusory statements.[21]

While Plaintiffs alleged Hermes conditioned Birkin sales on other purchases, the court emphasized that these claims did not rise “above a purely speculative level.”[22] First, the plaintiffs’ market definition, “elitist luxury handbags in the United States,”[23] was conclusory and unsupported. As the court put it, the plaintiffs complaint “simply described consumer perceptions about product quality and exclusivity from more than a decade ago” which under antitrust law is “a far cry from properly defining a relevant market.”[24] Lastly, the Second Amended Complaint failed to allege competitive harm, which is “another essential element of a tying claim.”[25] The court highlights that plaintiffs attempt to allege that a “kaleidoscope of products” are a part of the tied market, practically everything from clothing and accessories to home décor, but also notes that “[t]he [Second Amended Complaint] is bereft of any facts that might support lumping such a hugely diverse array of non-substitutable products into a single market.”[26] Moreover, the Complaint lacks facts that Hermes illegally restrained the competition for the aforementioned goods.[27] The court concedes that Hermes may be reserving Birkins for their biggest spenders, but it emphasizes that this business practice is not illegal under antitrust law.[28]

The dismissal of this case reinforces a longstanding principle pertaining to pleading: courts require factual, rather than conclusory, allegations.[29] Less than a month after the court dismissed the case, plaintiffs filed a notice of appeal, and the case is now before the Ninth Circuit.[30] This appeal gives the plaintiffs another opportunity to test whether luxury-goods distribution practices like Hermes’s can fit within modern tying doctrine, though the Northern District of California’s reasoning suggests the plaintiffs will face the same challenges on review. In its dismissal, the court made a point to acknowledge the fact that this was the plaintiffs’ “third opportunity to state a plausible Sherman Act claim.”[31] The court went as far as saying plaintiffs had ample notice, yet they still failed to cure the deficiencies within their federal claims.[32] The decision in Cavalleri reinforces that luxury brands may remain somewhat exclusive without automatically triggering antitrust scrutiny, so long as they do not wield market power in a way that harms competition.

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[1] Cavalleri v. Hermes Int’l, No. 24-cv-01707-JD, 2025 WL 2662897, at *1 (N.D. Cal. Sept. 17, 2025).

[2] Id.; see also 15 U.S.C. §§ 1, 2.

[3] Id. (“[T]his amounts to an unlawful tying arrangement in violation of. . . the California Cartwright Act, Cal. Bus. & Prof. Code §§ 16720 et seq., the California Unfair Competition Law, Bus. & Prof. Code §§ 17200 et seq., the California False Advertising Law, Bus. & Prof. Code §§ 17200 et seq., and California common law.”).

[4] Hermes, https://www.hermes.com (last visited Jan. 13, 2026).

[5] See id.

[6] David Kully & Jennifer Lada, Hermes Bags Antitrust Win That Clarifies Luxury Tying Claims, Holland & Knight (Jan. 12, 2026), https://www.hklaw.com/-/media/files/insights/publications/2025/10/law360_hermesbagsantitrustwinthatclarifiesluxurytyingclaims.pdf?rev=0bccd15b8d0f4849a409e639a82e51af&hash=F8937FAA2481B6C1367A6982F7BDF4E4

[7] First Amended Class Action Complaint at 8, 11, No. 3:24-cv-01707-JD (N.D. Cal. May 30, 2024).

[8] See id.

[9] Cavalleri, 2025 WL 2662897, at *1.

[10] Id.

[11] Id.

[12] Id.

[13] Id. at*1, 3.

[14] Id. at *3.

[15] Cavalleri, 2025 WL 2662897, at *1.

[16] See generally Jefferson Par. Hosp. Dist. No. 2 v. Hyde, 466 U.S. 2 (1984); N. Pac. Ry. Co. v. United States, 352 U.S. 980 (1957); Int’l Salt Co., Inc. v. United States, 332 U.S. 392 (1947); Illinois Tool Works, Inc. v. Indep. Ink, Inc., 547 U.S. 28 (2006).

[17] Cavalleri, 2025 WL 2662897, at *1-2.

[18] Id. at *2; see also Rick-Mik Enters., Inc. v. Equilon Enters., Inc., 532 F.3d 963, 971 (9th Cir. 2008).

[19] Cavalleri, 2025 WL 2662897, at *1, 2.

[20]Id. at *1.

[21] Id.

[22] Id.

[23] Second Amended Class Action Complaint at 6, No. 3:24-cv-01707-JD (N.D. Cal. Oct. 11, 2024).

[24] Cavalleri, 2025 WL 2662897, at *2.

[25] Id. at *3.

[26] Id.

[27] Id.

[28] Id.

[29] See generally Jefferson Par. Hosp. Dist. No. 2, 466 U.S. 2; N. Pac. Ry. Co., 352 U.S. 980; Int’l Salt Co., Inc., 332 U.S. 392; Illinois Tool Works, Inc., 547 U.S. 28.

[30] See Notice of Appeal, No. 3:24-cv-01707 (Oct. 7, 2025).

[31] Cavalleri, 2025 WL 2662897, at *3.

[32] Id.

Photo Credit: Federal Laws Versus State Laws (illustration), in Federal Laws Versus States Rights Re-Visited, USRESISTNEWS.ORG (Jan. 1, 2022), https://www.usresistnews.org/2022/01/04/federal-laws-versus-states-rights-re-visited/.

Authored by: Mary-Michael Rhodes

I. Introduction

On December 8, 2025, the Supreme Court issued a concise, per curiam opinion in Doe v. Dynamic Physical Therapy, LLC addressing the limits of a state’s authority to confer civil immunity where a plaintiff asserts claims arising under federal law.[1] Although the opinion itself is brief, the Court’s holding clarifies an important constitutional boundary regarding the relationship between state-created immunities and federally created causes of action. Specifically, the Court reaffirmed that while states retain broad authority to define liability under their own laws, they lack the power to immunize defendants from liability imposed by federal statutes.[2]

This decision is significant not because it announces a new doctrinal framework, but because it reinforces long-standing Supremacy Clause principals in a legal landscape increasingly shaped by expansive state immunity statutes. In recent years, particularly following the COVID-19 public health emergency, states have enacted sweeping liability shields designed to protect health care providers, emergency responders, and private entities operating under extraordinary conditions. Doe makes clear that such statutes may validly restrict state-law causes of action, but they cannot operate to bar federal claims, even when those claims are litigated in state court.[3]

As a result, Doe serves as a reminder that federal statutory rights occupy a distinct constitutional space. When Congress creates a federal cause of action, that cause of action must be adjudicated according to federal standards, free from state legislative interference that would otherwise undermine uniform enforcement.

II. Background of the Case

Doe arose out of a civil action brought against a Louisiana physical therapy clinic.[4] The plaintiff asserted claims under federal disability discrimination law, alleging that the clinic engaged in discriminatory conduct during the course of providing health care services.[5] In response, the clinic invoked a Louisiana statute enacted during a declared public health emergency which conferred civil immunity on certain health care providers for actions taken in connection with emergency-related services.[6]

The Louisiana Court of Appeals treated the immunity statute as a categorical bar to liability.[7] Importantly, the state court did not limit the statute’s application to state law claims; rather, it concluded that the immunity provision foreclosed all civil claims arising from the alleged conduct, including those grounded in federal law.[8] Under that reasoning, the source of the plaintiff’s rights—whether state or federal—was immaterial so long as the conduct occurred within the temporal and substantive scope of the state immunity statute.[9]

The United States Supreme Court reversed, rejecting the premise that a state legislature may define the reach of federal law by expanding the scope of immunity beyond state causes of action.[10] The Court emphasized that while Louisiana was free to limit liability under its own laws, it could not dictate the enforceability of rights created by Congress.[11]

III. The Supreme Court’s Holding

The Supreme Court framed the issue in direct and unambiguous terms. While acknowledging that “[d]efining the scope of liability under state law is a State’s prerogative,” the Court held that “a State has no power to confer immunity from federal causes of action.”[12] The Louisiana Court of Appeals therefore erred by applying a state immunity statute to dismiss claims arising under federal law.[13]

Notably, the Court declined to address the underlying merits of the plaintiff’s federal claims. Rather, it observed that those claims “may well fail on other federal grounds” and remanded the case so that the state court court address the federal issues in the first instance.[14] In doing so, the Court cited Cummings v. Premier Rehab Keller, P.L.L.C. as an example of how federal law itself may limit available remedies in certain statutory discrimination actions.[15]

This aspect of the opinion is critical. Doe does not expand federal liability or guarantee recovery for plaintiffs. Instead, it preserves the required order of analysis. Federal claims must be evaluated under federal law, even if they ultimately fail.[16] What states may not do is bypass that inquiry by invoking state law immunity as a threshold bar at the outset of the case.[17]

IV. The Constitutional Limits on State-Created Immunity

The holding in Doe rests squarely on the Supremacy Clause, which provides that federal law “shall be the supreme Law of the Land.”[18] Under this framework, state courts are required to apply federal law when adjudicating federal claims, regardless of contrary state statutes or policies.

The Supreme Court has repeatedly addressed this issue in prior cases. In Howlett v. Rose, the Court held that a state law sovereign immunity defense could not defeat a federal civil rights claim brought in state court.[19] Once Congress creates a federal cause of action, the Court explained, the elements, defenses, and scope of that claim are matters of federal law.[20] A state may not alter those features by invoking its own immunity doctrines.

Similarly, in Haywood v. Drown, the Court invalidated a state statute that effectively stripped state courts of jurisdiction over certain damages actions against corrections officers.[21] Although the statute did not explicitly target federal claims, its practical effect was to discriminate against federal civil rights actions, thereby violating the Supremacy Clause.[22]

More recently, the Court reaffirmed this principle in Williams v. Reed, where it rejected a state procedural scheme that created a “catch-22” preventing plaintiffs from ever bringing certain federal claims.[23] Even though the state framed the scheme as a neutral exhaustion requirement, the court held that states may not use procedural devices to accomplish indirectly what they cannot do directly: immunize defendants from federal liability.[24]

Doe fits neatly within this line of cases. Whether labeled as “immunity,” “jurisdiction,” or “procedure,” state rules that function to extinguish federal causes of action are incompatible with federal supremacy.

V. Practical Implications for Legislatures and Litigants

The Court’s decision in Doe carries meaningful implications for both state legislatures and civil litigants. First, it reinforces that immunity statutes require careful limitation and should not be broadly construed. While states may validly restrict state law tort liability, those restrictions must not be drafted or applied in a manner that reaches federal claims.[25]

Second, the decision reinforces the role of state courts as forums for the enforcement of federal rights. State courts possess concurrent jurisdiction over many federal causes of action and with that jurisdiction comes a constitutional obligation to apply federal law faithfully. A state court may dismiss a federal claim for lack of standing, failure to state a claim, or other valid federal grounds, but it may not rely on state law immunity as the basis for dismissal.[26]

Third, Doe has particular relevance in areas such as health care regulation, emergency response, and privatized public services. As states continue to experiment with liability-limiting statutes to address perceived litigation burdens, Doe serves as a caution that those statutes cannot override federally protected rights.

VI. Conclusion

Although brief, Doe v. Dynamic Physical Therapy, LLC reaffirms a foundational principle of constitutional law: states may define the scope of liability under their own laws, but they may not confer immunity from federal causes of action.[27] In doing so, the Supreme Court preserved the supremacy and uniform application of federal law while respecting the traditional authority of states to regulate state law claims.

For courts and litigants alike, Doe provides clear guidance. When a plaintiff asserts a claim arising under federal law, that claim must rise or fall on federal grounds alone.[28] State-created immunities, however broadly framed, cannot stand as a barrier to the enforcement of federal rights.[29]

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[1] Doe v. Dynamic Physical Therapy, LLC, 223 L. Ed. 2d 222, 223 (2025).

[2] Id.

[3] Id.

[4] Doe v. Dynamic Physical Therapy, LLC, 404 So. 3d 1008, 1011 (La. Ct. App. 2024), rev’d, 223 L. Ed. 2d 222 (2025).

[5] Id.

[6] Id. at 1013-14.

[7] Id. at 1014-16.

[8] Id. at 1017-18.

[9] Id. at 1018.

[10] Doe v. Dynamic Physical Therapy, LLC, 223 L. Ed. 2d 222, 223 (2025).

[11] Id.

[12] Id.

[13] Id.

[14] Id.

[15] Id. (citing Cummings v. Premier Rehab Keller, P.L.L.C., 596 U.S. 212, 222 (2022)).

[16] Doe, 223 L. Ed. 2d at 223.

[17] Id.

[18] U.S. Const. art. VI, cl. 2.

[19] 496 U.S. 356, 383 (1990).

[20] Id. at 376 (citing Owen v. Independence, 445 U.S. 622, 647 n. 30 (1980)).

[21] 556 U.S. 729, 736 (2009).

[22] Id. at 741-42.

[23] 604 U.S. 168, 170 (2025).

[24] Id. at 177.

[25] Doe, 223 L. Ed. 2d at 223; Howlett v. Rose, 496 U.S. 356, 383 (1990); Haywood, 556 U.S. at 740; Williams, 604 U.S. at 174.

[26] Doe, 223 L. Ed. 2d at 223.

[27] Id.

[28] Id.

[29] Id.

Photo Credit: What Is a Hostile Work Environment in California?, Azadian Law Group, PC, https://azadianlawgroup.com/what-is-hostile-work-environment-in-california/ (last visited Jan 4, 2026).

Authored by: Annabelle F. Holliday

Title VII of the Civil Rights Act prevents an employer from discriminating against an individual based on race, color, religion, sex, or national origin.[1] One way a plaintiff may show workplace discrimination is by proving that the discrimination has caused a hostile work environment, defined as conduct that is so severe or pervasive that it alters the conditions of employment and creates an abusive working atmosphere.[2] Recently, the Supreme Court’s decision in Muldrow v. City of St. Louis lowered the harm requirement for certain discriminatory acts.[3] Specifically, the Court held that a Title VII plaintiff challenging a job transfer need only show “some harm” or that the action made them “worse off” with respect to the terms or conditions of employment, thus unanimously rejecting the requirement that the harm be “significant” or “material.”[4]  Since the Muldrow decision, courts have grappled with whether it also impacts hostile work environment claims. The Sixth Circuit in McNeal v. City of Blue Ash applied Muldrow‘s holdingto both discrete action and hostile work environment claims.[5] However, in Russell v. Driscoll, the Tenth Circuit created a circuit split by rejecting the Sixth Circuit’s approach and concluding that Muldrow does not apply to hostile work environment claims.[6]

In Russell, a civilian employee of the U.S. Army alleged that his female supervisor subjected him to gender-based discrimination that created a hostile work environment.[7] The conduct he identified included being excluded from meetings and leadership email chains, being reassigned in ways that reduced his responsibilities, and being required to follow procedural barriers not imposed on female employees.[8] After complaints of the alleged discriminated, an internal Army investigation was conducted.[9] The investigation report concluded that male employees were treated less favorably, a violation of the Army’s equal-opportunity policy.[10] The investigation also reported that the supervisor “created a hostile work environment.”[11] Moreover, the investigation denied any wrongdoing of Russell.[12] Despite these findings, the district court granted summary judgment to the employer, holding that the discrimination was not “sufficiently severe or pervasive to meet the legal standard for a hostile work environment” under Title VII.[13]

On appeal Russell relied on Muldrow, arguing that the Supreme Court’s rejection of the “significant” harm requirement should also apply to hostile work environment claims.[14] In short, Russell argued that the Muldrow decision undermined the requirement that hostile work environment claims be supported by conduct that is “severe or pervasive.”[15] However, the Tenth Circuit rejected that argument and instead drew a distinction between discrete discriminatory acts found in Muldrow and hostile work environment claims.[16] Relying on Supreme Court precedent such as Meritor Savings Bank v. Vinson, Harris v. Forklift Systems, and National Railroad Passenger Corp. v. Morgan, the court emphasized that hostile work environment claims are different from claims based on isolated employment actions because discrete acts, such as transfers or demotions, are actionable on their own, while hostile work environment claims depend on the effect of repeated conduct that affects the workplace.[17] If any workplace slight that made an employee “worse off” were sufficient, the “severe or pervasive” requirement would lose its meaning.[18] Notably, the court explained that “the Supreme Court has made clear that the severity/pervasiveness inquiry is ‘crucial’ for ‘prevent[ing] Title VII from expanding into a general civility code.’”[19] Thus, the Tenth Circuit clarified that not all unfair or unpleasant behavior, even if discriminatory, rises to the level of a hostile work environment. Instead, it must still be severe or pervasive.

The Tenth Circuit also declined to give controlling weight to the Army’s internal investigative findings.[20] While such findings may be relevant, the court made clear that an employer’s internal characterization of a workplace as “hostile” does not override the legal framework governing Title VII claims.[21] Additionally, the court asserted that Russell failed to develop a legal argument connecting those findings to the “severe or pervasive” requirement, and thus the court concluded the argument was waived for lack of development.[22] Importantly, the court recognized that the Sixth Circuit had reached a different result in McNeal, where the court implied that Muldrow applies to hostile work environment claims in the same way it applies to discrete discriminatory acts.[23] However, the Tenth Circuit expressly declined to follow that approach and asserted that it disagreed with the Sixth Circuit’s reasoning.[24] Ultimately, the court affirmed summary judgment for the employer, holding that the conduct alleged did not rise to the level required to establish a hostile work environment.[25] In doing so, the Tenth Circuit’s decision in Russell reinforces that Muldrow did not rewrite the hostile work environment doctrine. Instead, the traditional framework remains intact, and thus plaintiffs still must show that discriminatory conduct was so severe or pervasive as to alter the conditions of employment and create an abusive working atmosphere.

Finally, it is important to note that Russell is only binding within the Tenth Circuit. As a result, courts in other jurisdictions may ultimately take a different view on whether Muldrow applies to hostile work environment claims, such as the Sixth Circuit did in the McNeal decision.[26] Nonetheless, though Muldrow may expand liability for certain discrete employment actions, hostile work environment claims in many courts likely remain subject to the severe/pervasive standard rooted in Supreme Court precedent. Importantly, Russell has clear implications for trial attorneys: in hostile work environment claims, plaintiffs must show severe or pervasive conduct, while defendants should rely on that standard to challenge claims. Accordingly, the Russell decision confirms that some courts will continue to draw a meaningful line between actionable discrimination and workplace conduct that, though inappropriate or unfair, does not meet the standard of a legally hostile work environment.

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[1] Title VII of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000e–2000e-17 (2018).

[2] See, e.g., Harris v. Forklift Sys., Inc., 510 U.S. 17, 21‑22 (1993) (barring harassment based on race, religion, sex, or national origin).

[3] 601 U.S. 346, 355 (2024).

[4] Id. at 354, 359. 

[5] 117 F.4th 887, 900 (6th Cir. 2024).

[6] Russell v. Driscoll, 157 F.4th 1348, 1353 (10th Cir. 2025).

[7] Id. at 1349.

[8] Id. at 1349-50.

[9] Id. at 1350.

[10] Id.

[11] Id. at 1353.

[12] Russell, 157 F.4th at 1353.

[13] Id.

[14] Id. at 1351.

[15] Id.

[16] Id. at 1352 (“Hostile environment claims are different in kind from discrete acts. Their very nature involves repeated conduct . . . over a series of days or perhaps years and, in direct contrast to discrete acts, a single act of harassment may not be actionable on its own.”). 

[17] Id. at 1350-52, See Nat’l R.R. Passenger Corp. v. Morgan, 536 U.S. 101, 110 (2002) (stating that there are two major types of discrimination a plaintiff can allege: discrete discriminatory acts and hostile work environment claims); Harris v. Forklift Sys., Inc., 510 U.S. 17, 21 (1993) (“[T]he workplace is permeated with discriminatory intimidation, ridicule, and insult that is sufficiently severe or pervasive to alter the conditions of the victim’s employment and create an abusive working environment[.]”); Meritor Sav. Bank, FSB v. Vinson, 477 U.S. 57, 67 (1986) (explaining that alleged conduct must be sufficiently severe or pervasive).

[18] Russell, 157 F.4th at 1352 (“[I]f Muldrow implicitly abrogated the severity/pervasiveness analysis for a hostile-environment claim (as Russell contends), then Muldrow abrogated the hostile-environment claim.”).

[19] Id. (quoting Oncale v. Sundowner Offshore Servs., Inc., 523 U.S. 75, 81 (1998)).

[20] Id. at 1353.

[21] Id.

[22] Id.

[23] Russell, 157 F.4th at 1352; McNeal, 117 F.4th at 900.

[24] Russell, 157 F.4th at 1352.

[25] Id.

[26] McNeal, 117 F.4th at 900.

Photo Credit: Fed. Bureau of Investigation, White Collar Crime: Health Care Fraud, https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud (last visited Sep. 10, 2025).

Authored by: Sarah K. Conway

On February 18, 2025, the First Circuit joined two of its sister circuits in ruling that the 2010 amendment to the Affordable Care Act (“ACA”) imposed a “but-for” causation standard for determining whether a violation of the Anti-Kickback Statute may also create liability under the False Claims Act.[1] The Anti-Kickback Statute (“AKS”) makes it a crime to knowingly and willfully solicit or receive “any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind” in exchange for payment made under a federal health care program.[2] Conversely, the False Claims Act (“FCA”) is a civil statute that imposes liability for knowingly presenting false or fraudulent claims to the federal government for payment or approval.[3]

Although distinct, these health care fraud and abuse laws are often interwoven.  The most prominent example of this link is inscribed in the 2010 amendment to the ACA, which allows criminal violations under the AKS to form the basis of civil liability under the FCA.[4] The amendment specifically states that a claim “that includes items or services resulting from a violation” of the AKS will constitute a false or fraudulent claim sufficient to also impose liability under the FCA.[5] Recently, this “resulting from” language within the amendment has become the center of an ongoing circuit split that asks whether the language was intended to impose a “but-for” causation requirement or some lesser causation standard.[6] 

The differences in these standards can be vast.  For instance, a but-for causation standard requires the plaintiff to prove that, without the defendant’s action, they would not have sustained the alleged injuries.[7]  Compare this standard with a “causal link” standard which merely requires some recognizable link between “the alleged kickbacks and the medical care received by at least one of [the defendant’s] federally insured patients.”[8]  Defining the precise causation standard is crucial as it impacts the evidentiary burden for plaintiffs along with the breadth of potential liability for defendants.[9] 

This burden of proof analysis took center stage in the First Circuit case of United States v. Regeneron Pharmaceuticals.[10] At issue in this case is an alleged violation of the AKS that stems from Regeneron’s prescriptions of a costly drug used to treat neovascular age-related macular degeneration.[11] This drug, called Eylea, is administered in office via an injection that costs $1,850 per patient, per dose.[12] As the First Circuit notes, “Medicare Part B has spent over $11.5 billion on Eylea,” making the drug an economic powerhouse for manufacturers like Regeneron.[13]  According to the government, Regeneron developed a rebate scheme to induce Medicare Part B beneficiaries to purchase Eylea by refunding any co-pays associated with the prescription.[14] The alleged refunds were not made directly to beneficiaries.[15] Rather, they took the form of donations to a charity that provides financial assistance to those suffering with the same disease Eylea is designed to treat.[16]  While genuine donations to charitable foundations are permitted under federal law, the Department of Health and Human Services (“HHS”) has warned about the fine line between donations and so-called “rebate conduits,” such as the one Regeneron allegedly developed.[17]

At trial, the government argued that Regeneron’s AKS rebate scheme was sufficient to form the basis of an FCA claim because the words “resulting from” in the 2010 amendment merely require a causal link between patient exposure to the rebate scheme and provider claims for reimbursement.[18] The government’s adoption of this lesser causation standard aligned with that of the Third Circuit, which held that but-for causation was “too exacting” of a standard.[19] Contrarily, Regeneron argued that actual influence or causation, also termed but-for causation, must exist to link a violation of the AKS to an FCA claim.[20] Regeneron’s position aligned with that of the Sixth and Eighth Circuits, which both interpreted the phrase “resulting from” to indicate a but-for causation requirement.[21] 

Upon review, the First Circuit sided with Regeneron’s interpretation—and by extension the Sixth and Eighth Circuits—and ruled that the “resulting from” language imposed a “requirement of actual causality, which in [the] ordinary course takes the form of but-for causation.”[22]  The First Circuit emphasized that the Supreme Court has regularly held the phrase “resulting from” to constitute a but-for causation requirement absent textual indication to the contrary.[23] Despite this, the government continued to argue that imposition of a but-for causation requirement would upend the false certification theory of FCA liability.[24] While the First Circuit agreed that there had been no change to false certification case law which would impose a but-for causation requirement, it clarified that liability under the false certification theory is distinct from liability brought under the 2010 amendment.[25] In other terms, the 2010 amendment offers an alternative pathway for establishing a violation of the FCA that does not require the same elements as the false certification theory.[26]

Other circuits have held similarly to the First.[27]  For example, in 2024, the Seventh Circuit interpreted the phrase “resulting from” to require a causal nexus between a defendant’s violation of the FCA and their involvement with an illegal kickback scheme.[28] Although the Supreme Court has yet to weigh-in on the issue, the ongoing circuit split seems to be gaining enough traction to place it on the Court’s radar.  The resolution of the split is likely to have monumental repercussions for health care attorneys.  If the Supreme Court were to side with the majority and impose a but-for causation requirement, there will be an increased burden on whistleblowers and the government to present evidence of a genuine connection between an AKS violation and the associated false claims.[29]  This heightened causation requirement would also provide defense teams with another avenue to combat AKS based FCA claims, ultimately tipping the burden of proof scale for such health care fraud cases in favor of defendants.[30]

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[1] United States v. Regeneron Pharms., Inc., 128 F.4th 324, 336 (1st Cir. 2025).

[2] 42 U.S.C. § 1320a-7b(b).

[3] 31 U.S.C. § 3729(a)(1).

[4] Patient Protection & Affordable Care Act, Pub. L. No. 111-148, § 6402(f)(1), 124 Stat. 119, 759 (2010) (codified as amendment at 42 U.S.C. § 1320a-7b(g)).

[5] 42 U.S.C. § 1320a-7b(g) (emphasis added).

[6] Regeneron Pharms., Inc., 128 F.4th at 326; see also Andrew McGirty, Cracking Causation: The Need for a Workable Link Between the Anti-Kickback Statute and False Claims Act, 74 Case W. Rsrv. L. Rev. 429, 452-57 (discussing the opinions of the First, Third, Sixth, and Eighth Circuits).

[7] Univ. of Tex. S.W. Med. Ctr. v. Nassar, 570 U.S. 338, 346-47 (2013); Stuart M. Speiser, Charles F. Krause & Alfred W. Gans, 3 American Law of Torts § 11:6 (Monique C. M. Leahy, ed., 2025); see also Robin Dembroff & Issa Kohler-Hausmann, Supreme Confusion About Causality at the Supreme Court, 25 CUNY L. Rev. 57, 69-70 (2022) (discussing the but-for causation test under modern tort law and approaches to alleviating its ambiguity).

[8] United States ex rel. Greenfield v. Medco Health Sols., 880 F.3d 89, 100 (3d Cir. 2018).

[9] See, e.g., Nassar, 570 U.S. at 358 (“Even if the employer could escape judgment after trial, the lessened causation standard would make it far more difficult to dismiss dubious claims at the summary judgment stage.”); Nesbitt v. Candler Cnty., 945 F.3d 1355, 1358 (11th Cir. 2020) (“To avoid losing, [Plaintiff] argues for application of the motivating factor standard.  That more plaintiff-friendly standard requires only a showing that the protected conduct ‘was a motivating factor for any employment [decision].’” (second alteration in original) (quoting Nassar, 570 U.S. at 349)).

[10] Regeneron Pharms., Inc., 128 F.4th at 327-38.

[11] Id. at 326.

[12] Id.

[13] Id.

[14] Id. at 326-27.

[15] Id.

[16] Regeneron Pharms., Inc., 128 F.4th at 327.

[17] Id.; Publication of OIG Special Advisory Bulletin on Patient Assistance Programs for Medicare Part D Enrollees, 70 Fed. Reg. 70623-03 (Nov. 22, 2005).

[18] Regeneron Pharms., Inc., 128 F.4th at 327; see Greenfield., 880 F.3d at 100 (“A kickback does not morph into a false claim unless a particular patient is exposed to an illegal recommendation or referral and a provider submits a claim for reimbursement pertaining to that patient.” (emphasis added)).

[19] Greenfield, 880 F.3d at 100.

[20] Regeneron Pharms., Inc., 128 F.4th at 327-38; see United States ex rel. Martin v. Hathaway, 63 F.4th 1043, 1052 (“The ordinary meaning of ‘resulting from’ is but-for causation.”).

[21] Martin, 63 F.4th at 1052-53; United States ex rel Cairns v. D.S. Med., LLC, 42 F.4th 828, 834 (8th Cir. 2022).

[22] Regeneron Pharms., Inc., 128 F.4th at 330.

[23] Id. at 329.

[24] Id. at 333 (“Under [the false certification] pathway, it is not the AKS violation itself that renders the claim false.  Rather, it is the false representation that there is no AKS violation.”)

[25] Id. at 334.

[26] Id. 333-34.

[27] Stop Ill. Health Care Fraud, LLC v. Sayeed, 100 F.4th 899, 908 (7th Cir. 2024).

[28] Id. at 908-09 (acknowledging the current circuit split but declining explicitly adopt a precise standard for causation); see also United States ex rel Wilkerson v. Allergan Ltd., No. 22-CV-3013, 2025 WL 1181010, at *9-10 (N.D. Ill. Apr. 23, 2025) (relying on Regeneron in holding that “resulting from” indicates a but-for causation requirement).

[29] Compare Greenfield, 880 F.3d at 97 (finding that neither the Anti-Kickback Statute nor False Claims Act “requires a plaintiff to show that a kickback directly influenced a patient’s decision to use a particular medical provider”), with D.S. Med., LLC., 42 F.4th at 836-37 (“[W]hen a plaintiff seeks to establish falsity or fraud through the 2010 amendment, it must prove that a defendant would not have included particular ‘items or services’ but for the illegal kickbacks.”).

[30] See Hathaway, 63 F.4th at 1054 (requiring the government establish at least “one claim for reimbursement identified with particularity . . . that would not have occurred anyway” to meet causation requirements under an AKS-based FCA claim).

Photo Credit: Cara Halligan, Protecting Democracy Through Checks and Balances, The Hawk, https://sjuhawknews.com/36446/opinions/protecting-democracy-checks-balances/ (last visited Aug. 17, 2025).

Authored by: Bennett N. Vest

On June 27, 2025, the Supreme Court addressed the issue of whether federal district courts could issue universal injunctions in Trump v. Casa, Inc.[1] In a 6-3 decision, authored by Justice Barrett, the Court reversed the courts of appeals and granted the government’s applications for partial stays because (1) the government was likely to succeed on the merits that universal injunctions were beyond the power of federal courts under the Judiciary Act and (2) that the government showed a likelihood of irreparable harm.[2]

On January 20, 2025, President Trump issued an executive order revoking automatic birthright citizenship for children born in the United States with alien parents.[3] Almost as soon as President Trump signed the order, many states and groups filed for universal injunctions in federal district courts to stop the President from enforcing the executive order.[4] Three district courts issued universal injunctions against the executive branch and the president, and the court of appeals denied the government’s partial petition to stay.[5] The Supreme Court heard oral arguments on the case after the government filed emergency appeals.[6]

District courts issuing universal injunctions are relatively new, but they have become increasingly popular since George W. Bush’s presidency. [7] They block the executive branch from implementing its own policies that are “unconstitutional.”[8] In the first one hundred days of President Trump’s second term, 25 universal injunctions were issued against President Trump and the Executive Branch.[9] Under the Judiciary Act, federal courts have power over cases “in equity,” but the question is whether universal injunctions are included as part of their equitable powers.[10]

 Without addressing the substance of the executive order, the majority opinion only addressed the power of federal district courts to issue universal injunctions.[11] Under a historical analysis, the majority opinion rejected the dissents arguments that universal injunctions (1) have a historical basis in American law, (2) provide complete relief for parties, and (3) serve “important policy objectives.”[12] Going back to the Court of Chancery in England, the majority opinion concluded that universal injunctions were not historically part of our system of law.[13] Moreover, our current system distinguishes complete relief from universal relief by providing aggregated relief in the form of class action lawsuits or formerly Bills of Peace in England.[14] Therefore, the government proved that it was likely that the Judiciary Act did not include universal injunctions as a form of equitable relief.

To grant the partial stays for the government, the government also had to provide enough evidence to suggest that the executive branch was likely to suffer “irreparable harm” if the stay was not granted.[15] The Court ruled that universal injunction by itself causes irreparable harm because it cannot enforce its own policies.[16]

Justice Thomas, Alito, and Kavanaugh wrote separate concurring opinions, with Justice Gorsuch joining Justice Thomas’ concurrence and Justice Thomas joining Justice Alito’s concurrence.[17]  Justice Thomas advocated for a “plaintiff-specific injunction” while Justice Alito focused on third-party standing and class certification.[18] Finally, Justice Kavanaugh’s concurrence focused on the Supreme Court’s power to rule on such injunctions and equitable relief.[19] In opposition to the majority’s ruling, Justice Sotomayor, joined by Justice Kagan and Jackson, and a separate dissent by Justice Jackson, uphold universal injunctions as an appropriate equitable remedy, but the majority of the dissenting opinions focus on the substance of the executive order.[20]

This ruling comes at a time where the concept of federalism and the power of the presidency are constantly being challenged by President Trump. To date, President Trump is on pace to set a record number of executive orders during his second term.[21] These orders have caused disagreements amongst his “political enemies” over politics and policy, and these battle are being played out in venues favorable to the Plaintiffs, resulting in universal injunctions being granted.[22] As a result of “weaponizing the courts,” there is increasing skepticism that the courts are not impartial but rather that they impose their own political beliefs.[23] Even some members of the Supreme Court have made these accusations of their own colleagues by stating their recent rulings favor of President Trump.[24]

Beyond Casa, the question remains whether Executive Order 14160 is constitutional. Justice Barrett and the other justices joining the majority opinion did not opine or indicate how it would rule on that issue, but the dissenting opinions make it clear that they believe President Trump and the executive branch overstepped their constitutional bounds.[25] It is plausible that the Court would rule that Executive Order 141460 exceeds constitutional bounds in the future.  However, the Casa decision limited district courts’ powers to issue universal injunctions. It does not suggest that district courts cannot rule that executive orders are unconstitutional, but that the remedy needs to be more specific or tailor to the person or persons seeking the relief. With the Supreme Court defining the powers of federal courts, the hope is that courts will not be used as much for favorable rulings and the three branches of government can operate more effectively within their defined constitutional powers.

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[1] See 145 S. Ct. 2540 (2025).

[2] See id. at 2549.

[3] Exec. Order No.14160, 90 Fed. Reg. 8449 (Jan. 20, 2025) (restricting birthright citizenship when “(1) when that person’s mother was unlawfully present in the United States and the father was not a United States citizen or lawful permanent resident at the time of said person’s birth, or (2) when that person’s mother’s presence in the United States at the time of said person’s birth was lawful but temporary (such as, but not limited to, visiting the United States under the auspices of the Visa Waiver Program or visiting on a student, work, or tourist visa) and the father was not a United States citizen or lawful permanent resident at the time of said person’s birth”).

[4] See Mike Catalini, 22 States Sue to Stop Trump’s Order Blocking Birthright Citizenship, AP News (Jan. 21, 2025), https://apnews.com/article/birthright-citizenship-trump-executive-order-immigrants-fc7dd75ba1fb0a10f56b2a85b92dbe53.

[5] See Casa, Inc. v. Trump, 763 F. Supp. 3d 723 (D. Md. 2025); Washington v. Trump, 765 F. Supp.3d 1142 (W. D. Wash. 2025); Doe v. Trump, 766 F.Supp.3d 266 (D. Mass 2025).

[6] See Casa, Inc., 145 S. Ct. at 2540.

[7] See id. at 2553 (stating that universal injunctions were not used until the 20th century).

[8] Id. at 2548.

[9] See Joanna R. Lampe, Nationwide Injunctions in the First Hundred Days of the Second Trump Administration, Congressional Research Service (updated May 16, 2025)https://www.congress.gov/crs-product/R48476.

[10] See Casa, Inc., 145 S. Ct. at 2551.

[11] See id. at 2562-63.

[12] Id. at 2554.

[13] See id. at 2551.

[14] See id. at 2555.

[15] Id. at 2562.

[16] See Casa, Inc., 145 S. Ctat 2562.

[17] See id. 145 S. Ct. at 2563 (Thomas, J., concurring); Casa, Inc., 145 S. Ctat 2565 (Alito, J., concurring); Casa, Inc., 145 S. Ctat 2567 (Kavanaugh, J. concurring).

[18]  See Casa, Inc., 145 S. Ct. at 2565.

[19] See id. at 2567.

[20]  See id. at 2574 (Sotomayor, J. dissenting); Casa, Inc., 145 S. Ctat 1596 (Jackson, J., dissenting).

[21] See Bert Jensen, Everything’s an ‘Emergency’: How Trump’s executive order record pace is testing the courts, USA Today, (April 5, 2025), https://www.usatoday.com/story/news/politics/2025/04/05/trump-executive-orders-lawsuits-emergencies/82792612007/.

[22] See Katrina Kaufman & Matt Clark, The Courts Where Nationwide Injunctions are Originating, CBS News (May 15, 2025, 11:12 P.M.), https://www.cbsnews.com/news/courts-nationwide-injunctions-originating/.

[23] See Benedict Vigers & Lydia Saad, Americans Pass Judgement on Their Courts, Gallup (Dec. 16, 2024), https://news.gallup.com/poll/653897/americans-pass-judgment-courts.aspx.

[24] Trump v. U.S., 603 U.S. 593, 684 (2024) (highlighting that Justice Sotomayor stated that the majority’s opinion made the president “a king above the law”).

[25] See Casa, Inc.,145 S. Ct. at 2674.

Photo Credit: Kevin Dietsch/Getty Images, Photograph of demonstrators outside of the U.S. Supreme Court during arguments regarding a Tennessee law banning controversial gender-affirming care for trans youth in U.S. Department of Justice backs out of Tennessee transgender care case (Dec. 4, 2024), https://tennesseelookout.com/2025/02/07/u-s-department-of-justice-backs-out-of-tennessee-transgender-care-case/.

Authored by: Arielle H. Foster

On March 22, 2023, Tennessee’s Senate Bill 0001 (SB1) was passed, amending the Tennessee Code to prohibit healthcare workers from performing on or administering to a minor certain medical procedures if the purpose of the procedures is to enable the child to “identify with, or live as, a purported identity inconsistent with the minor’s sex.”[1] Following the SB1’s enactment, three families raising transgender youth and a Memphis doctor sued the state of Tennessee in 2023, and the federal government, under President Biden’s administration, stepped in to carry the plaintiff’s challenge. [2] The U.S. Supreme Court heard argument on December 4, 2024 and two months later, the U.S. Department of Justice under President Trump’s administration withdrew their challenge of the Tennessee law stating “the government’s previously stated views no longer represent the United States’ position.”[3] Regardless, the Supreme Court continued toward a ruling, noting that the Government did not request a dismissal and rather requested “prompt resolution” as the ruling will control many pending cases in lower courts.[4]

In a slip opinion decided on June 18, 2025, the U.S. Supreme Court voted in a 6-3 decision to uphold the Tennessee law, ruling that the “law prohibiting certain medical treatments for transgender minors is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment and satisfies rational basis review.”[5] In their opinion, Justice Roberts noted that laws containing “sex-based classifications” are subject to intermediate scrutiny, requiring the State to show the “classification serves important governmental objectives and that the discriminatory means employed are substantially related to the achievement of those objectives.”[6] However, the Court disagreed with Plaintiff’s argument that heightened scrutiny was warranted as this law relies on sex-based classifications, finding that SB1 prohibits the administration of puberty blockers and hormones to “minors for certain medical uses, regardless of a minor’s sex.”[7]

The Supreme Court determined that the only two classifications incorporated in SB1 are (1) based on age, as treatments can be administered to adults, but not minors; and (2) the basis of medical use, as the use of these procedures may be used to treat conditions in minors, but not to treat children for the purpose of treating gender dysphoria or gender identity disorders; both of which are only subject to a rational basis review.[8] Finding that Tennessee established a “legitimate, substantial and compelling interest in protecting minors from physical and emotional harm,” and acknowledges Tennessee’s finding that “the prohibited medical treatments are experimental, can lead to later regret, and are associated with harmful-and sometimes irreversible-risks.”[9]

The plaintiffs further argued that SB1 discriminates against transgender individuals, which constitute a “quasi-suspect class” and thus warrants higher scrutiny, but the Supreme Court again disagreed.[10] The Court emphasized that regulating a medical procedure that only one sex can undergo does not trigger higher scrutiny unless it is a pretext for invidious sex discrimination.[11] This does not qualify as such, because SB1 is not excluding an individual from eligibility because of their sex, “but rather ‘remove[d] one physical condition . . . from the list of compensable disabilities,” ultimately stating that individuals aren’t excluded from medical treatments on the basis of being transgender, it is simply removing those diagnoses from the treatable conditions.[12]

Justice Sotomayor dissented, claiming that the law “expressly classifies on the basis of sex and transgender status.”[13] She was joined by her fellow democratic party appointees, Justices Kagan and Jackson, in explaining that: [i]n addition to discriminating against transgender adolescents, who by definition ‘identify with’ an identity ‘inconsistent’ with their sex, that law conditions the availability of medications on a patient’s sex. Male (but not female) adolescents can receive medicines that help them look like boys, and female (but not male) adolescents can receive medicines that help them look like girls.”[14]

Tennessee is one of 27 states that restrict medical care for transgender youth, and this Supreme Court ruling could affect dozens of states.[15] The Tennessee Attorney General, Jonathan Skrmetti, praised the Supreme Court’s ruling, calling it a “historic Supreme Court win” and further stated, “the common sense of Tennessee voters prevailed over judicial activism.”[16] Alternatively, however, transgender-rights activists called this decision “a punch in the gut for the transgender community,” as she believes the prohibited care in this case is “life-saving” in many cases.[17]

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[1] S.B. 0001, 113th Gen. Assemb., 1st Extra.. Sess. (Tenn. 2023), https://legiscan.com/TN/bill/SB0001/2023 (summarizing Senate Bill 0001 as enacted); SB0001 Bill Summary, Tenn. Gen. Assemb., https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=SB0001&ga=113 (last visited Aug. 11, 2025).

[2] Sam Stockard, U.S. Department of Justice backs out of Tennessee transgender care case, Tenn. Lookout, Feb. 7, 2025, https://tennesseelookout.com/2025/02/07/u-s-department-of-justice-backs-out-of-tennessee-transgender-care-case/.

[3] Id.

[4] Id.

[5] United States v. Skrmetti, 145 S. Ct. 1816, 1821 (2025); Greg Stohr, Supreme Court Upholds Curbs on Care for Transgender Minors, Bloomberg News, Jun. 18, 2025, https://www.bloomberglaw.com/product/blaw/bloombergterminalnews/bloomberg-terminal-news/SY2382DWLU68?criteria_id=8ca6b6280b2dc7ead434cbe7e4f43497.

[6] Skrmetti, 145 S. Ct. at 1828-29 (quoting J. Ginsburg in United States v. Virginia, 518 U.S. 515, 533).

[7] Id. at 1829.

[8] Id.

[9] Id. at 1832.

[10] Id.

[11] Id. at 1833.

[12] Skrmetti, 145 S. Ct. at1833.

[13] Id. at 1868; Stohr, supra note 5.

[14] Skrmetti, 145 S. Ct. at 1868.

[15] Stohr, supra note 5.

[16] Id.

[17] Id.