89-1391 & 89-1392 -- OPINION v. SULLIVAN
NOTICE: This opinion is subject to formal revision before publication in the preliminary
print of the United States Reports. Readers are requested to notify the Reporter of
Decisions, Supreme Court of the United States, Wash- ington, D. C. 20543, of any
typographical or other formal errors, in order that corrections may be made before the
preliminary print goes to press.
Nos. 89-1391 and 89-1392
RUST, etc., et al., PETITIONERSv.89-1391
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
YORK, et al., PETITIONERSv.89-1392
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
on writs of certiorari to the united states court of appeals for the second circuit
[May 23, 1991]
Chief Justice Rehnquist delivered the opinion of the Court.
These cases concern a facial challenge to Department of Health and Human Services
(HHS) regulations which limit the ability of Title X fund recipients to engage in abortion-
related activities. The United States Court of Appeals for the Second Circuit upheld the
regulations, finding them to be a permissible construction of the statute as well as
consistent with the First and Fifth Amendments of the Constitution. We granted certiorari
to resolve a split among the Courts of Appeals. [n.1] We affirm.
I
A In 1970, Congress enacted Title X of the Public Health Service Act (Act), 84 stat.
1506, as amended, 42 U.S.C. 300 -300a-41, which provides federal funding for family-
planning services. The Act authorizes the Secretary to "make grants to and enter into
contracts with public or non- profit private entities to assist in the establishment and oper-
ation of voluntary family planning projects which shall offer a broad range of acceptable
and effective family planning meth- ods and services." 42 U.S.C. 300 (a). Grants and
con- tracts under Title X must "be made in accordance with such regulations as the
Secretary may promulgate." 42 U.S.C. 300a -4. Section 1008 of the Act, however,
provides that "[n]one of the funds appropriated under this subchapter shall be used in
programs where abortion is a method of family planning." 42 U.S.C. 300a -6. That
restriction was in- tended to ensure that Title X funds would "be used only to support
preventive family planning services, population re- search, infertility services, and other
related medical, in- formational, and educational activities." H. R. Conf. Rep. No. 91-
1667, p. 8 (1970).
In 1988, the Secretary promulgated new regulations de- signed to provide "  clear and
operational guidance' to grant- ees about how to preserve the distinction between Title X
programs and abortion as a method of family planning." 53 Fed. Reg. 2923-2924 (1988).
The regulations clarify, through the definition of the term "family planning," that
Congress intended Title X funds "to be used only to support preventive family planning
services." H. R. Conf. Rep. No. 91-1667, p. 8 (emphasis added). Accordingly, Title X
services are limited to "preconceptual counseling, education, and general reproductive
health care," and expressly exclude "pregnancy care (including obstetric or prenatal
care)." 42 CFR 59.2 (1989). [n.2] The regulations "focus the emphasis of the Title X
program on its traditional mission: The provision of preventive family planning services
specifically designed to enable individuals to determine the number and spacing of their

89-1391 & 89-1392 -- DISSENT v. SULLIVAN
Nos. 89-1391 and 89-1392
RUST, etc., et al., PETITIONERSv.89-1391
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
YORK, et al., PETITIONERSv.89-1392
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
[May 23, 1991]
Justice Stevens, dissenting.
In my opinion, the Court has not paid sufficient attention to the language of the
controlling statute or to the consistent interpretation accorded the statute by the
responsible cabi- net officers during four different Presidencies and 18 years.
The relevant text of the "Family Planning Services and Population Research Act of 1970"
has remained unchanged since its enactment. 84 Stat. 1504. The preamble to the Act
states that it was passed:
The declaration of congressional purposes emphasizes the im- portance of educating the
public about family planning serv- ices. Thus, 2 of the Act states, in part, that the purpose
of the Act is:
"(1) to assist in making comprehensive voluntary fam- ily planning services readily
available to all persons de- siring such services;
"(5) to develop and make readily available information (including educational materials)
on family planning and population growth to all persons desiring such informa- tion." 42
U.S.C. 300 (Congressional Declaration of Purpose).
In contrast to the statutory emphasis on making relevant information readily available to
the public, the statute con- tains no suggestion that Congress intended to authorize the
suppression or censorship of any information by any Govern- ment employee or by any
grant recipient.
Section 6 of the Act authorizes the provision of federal funds to support the establishment
and operation of volun- tary family planning projects. The section also empowers the
Secretary to promulgate regulations imposing condi- tions on grant recipients to ensure
that "such grants will be effectively utilized for the purposes for which made." 300a-4(b).
Not a word in the statute, however, authorizes the Secretary to impose any restrictions on
the dissemination of truthful information or professional advice by grant recipients.
The word "prohibition" is used only once in the Act. Sec- tion 6, which adds to the Public
Health Service Act the new Title X, covering the subject of population research and vol-
untary planning programs, includes the following provision:
"PROHIBITION OF ABORTION "SEC. 1008. None of the funds appropriated under this
title shall be used in programs where abortion is a method of family planning." 84 Stat.
1508, 42 U.S.C. 300a -6.
Read in the context of the entire statute, this prohibition is plainly directed at conduct,
rather than the dissemination of information or advice, by potential grant recipients.
The original regulations promulgated in 1971 by the Secre- tary of Health, Education and
Welfare so interpreted the statute. This "  contemporaneous construction of [the] stat- ute
by the men charged with the responsiblity of setting its machinery in motion' " is entitled
to particular respect. See Power Reactor Development Co. v. Electrical Workers, 367
U.S. 396, 408 (1961) (citation omitted); Udall v. Tallman, 380 U.S. 1, 16 (1965);
Aluminum Co. of America v. Central Lincoln Peoples' Utility District, 467 U.S. 380, 390

89-1391 & 89-1392 -- DISSENT v. SULLIVAN
Nos. 89-1391 and 89-1392
RUST, etc., et al., PETITIONERSv.89-1391
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
YORK, et al., PETITIONERSv.89-1392
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
[May 23, 1991]
Justice O'Connor, dissenting.
"[W]here an otherwise acceptable construction of a statute would raise serious
constitutional problems, the Court will construe the statute to avoid such problems unless
such con- struction is plainly contrary to the intent of Congress." Ed- ward J. DeBartolo
Corp. v. Florida Gulf Coast Building & Construction Trades Council, 485 U.S. 568, 575
(1988). Justice Blackmun has explained well why this long-stand- ing canon of statutory
construction applies in this case, and I join Part I of his dissent. Part II demonstrates why
the challenged regulations, which constitute the Secretary's in- terpretation of 1008 of the
Public Health Service Act, 84 Stat. 1508, 42 U.S.C. 300a -6, "raise serious constitutional
problems": the regulations place content-based restrictions on the speech of Title X fund
recipients, restrictions directed precisely at speech concerning one of "the most divisive
and contentious issues that our Nation has faced in recent years." Ante, at 12.
One may well conclude, as Justice Blackmun does in Part II, that the regulations are
unconstitutional for this reason. I do not join Part II of the dissent, however, for the same
reason that I do not join Part III, in which Jus- tice Blackmun concludes that the
regulations are uncon- stitutional under the Fifth Amendment. The canon of con-
struction that Justice Blackmun correctly applies here is grounded in large part upon our
time-honored practice of not reaching constitutional questions unnecessarily. See DeBar
tolo, supra, at 575. "It is a fundamental rule of judicial re- straint . . . that this Court will
not reach constitutional ques- tions in advance of the necessity of deciding them." Three
Affiliated Tribes of Fort Berthold Reservation v. Wold Engi- neering, P. C., 467 U.S.
138, 157 (1984). See also Alexan- der v. Louisiana, 405 U.S. 625, 633 (1972); Burton v.
United States, 196 U.S. 283, 295 (1905); Liverpool, New York and Philadelphia S. S. Co.
v. Commissioners of Emigration, 113 U.S. 33, 39 (1885) (In the exercise of its
jurisdiction to pro- nounce unconstitutional laws of the United States, this Court "has
rigidly adhered" to the rule "never to anticipate a ques- tion of constitutional law in
advance of the necessity of decid- ing it").
This Court acts at the limits of its power when it invali- dates a law on constitutional
grounds. In recognition of our place in the constitutional scheme, we must act with "great
gravity and delicacy" when telling a coordinate branch that its actions are absolutely
prohibited absent constitutional amendment. Adkins v. Children's Hospital of District of
Columbia, 261 U.S. 525, 544 (1923). See also Blodgett v. Holden, 275 U.S. 142, 147-148
(1927) (Holmes, J., con curring). In this case, we need only tell the Secretary that his
regulations are not a reasonable interpretation of the statute; we need not tell Congress
that it cannot pass such legislation. If we rule solely on statutory grounds, Congress
retains the power to force the constitutional question by leg- islating more explicitly. It
may instead choose to do noth- ing. That decision should be left to Congress; we should
not tell Congress what it cannot do before it has chosen to do it. It is enough in this case
to conclude that neither the language nor the history of 1008 compels the Secretary's

 Rust v. Sullivan (89-1391), 500 U.S. 173 (1991)
 89-1391 & 89-1392 -- DISSENT v. SULLIVAN
Nos. 89-1391 and 89-1392
RUST, etc., et al., PETITIONERSv.89-1391
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
YORK, et al., PETITIONERSv.89-1392
W. SULLIVAN, SECRETARY OF HEALTHAND HUMAN SERVICES
on writs of certiorari to the united states court of appeals for the second circuit
[May 23, 1991]
Justice Blackmun, with whom Justice Marshall joins, with whom Justice Stevens joins as
to Parts II and III, and with whom Justice O'Connor joins as to Part I, dissenting.
Casting aside established principles of statutory construc- tion and administrative
jurisprudence, the majority in these cases today unnecessarily passes upon important
questions of constitutional law. In so doing, the Court, for the first time, upholds
viewpoint-based suppression of speech solely be- cause it is imposed on those dependent
upon the Government for economic support. Under essentially the same rationale, the
majority upholds direct regulation of dialogue between a pregnant woman and her
physician when that regulation has both the purpose and the effect of manipulating her
decision as to the continuance of her pregnancy. I conclude that the Secretary's regulation
of referral, advocacy, and counseling activities exceeds his statutory authority, and, also,
that the Regulations violate the First and Fifth Amendments of our Constitution.
Accordingly, I dissent and would reverse the divided-vote judgment of the Court of
Appeals.
I The majority does not dispute that "[f]ederal statutes are to be so construed as to avoid
serious doubt of their constitu- tionality." Machinists v. Street, 367 U.S. 740, 749 (1961).
See also Hooper v. California, 155 U.S. 648, 657 (1895); Crowell v. Benson, 285 U.S.
22, 62 (1932); United States v. Security Industrial Bank, 459 U.S. 70, 78 (1982). Nor
does the majority deny that this principle is fully applicable to cases such as the instant
one, in which a plausible but con- stitutionally suspect statutory interpretation is
embodied in an administrative regulation. See Edward J. DeBartolo Corp. v. Florida Gulf
Coast Building & Construction Trades Council, 485 U.S. 568, 575 (1988); NLRB v.
Catholic Bishop of Chicago, 440 U.S. 490  (1979); Kent v. Dulles, 357 U.S. 116, 129-
130 (1957). Rather, in its zeal to address the con- stitutional issues, the majority sidesteps
this established canon of construction with the feeble excuse that the chal- lenged
Regulations "do not raise the sort of  grave and doubt- ful constitutional questions,' . . .
that would lead us to as- sume Congress did not intend to authorize their issuance." Ante,
at 15, quoting United States v. Delaware and Hudson Co., 213 U.S. 366, 408 (1909).
This facile response to the intractable problem the Court addresses today is disingenuous
at best. Whether or not one believes that these Regulations are valid, it avoids reality to
contend that they do not give rise to serious constitutional questions. The canon is
applicable to this case not because "it was likely that [the Regulations] . . . would be
challenged on constitutional grounds," ante, at 15, but because the ques- tion squarely
presented by the Regulations -- the extent to which the Government may attach an
otherwise unconstitu- tional condition to the receipt of a public benefit -- implicates a

                                  U.S. Supreme Court
                          REYNOLDS v. SIMS, 377 U.S. 533 (1964)

                                            377 U.S. 533

                          REYNOLDS, JUDGE, ET AL. v. SIMS ET AL.
     APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE MIDDLE
                                             DISTRICT
                                      OF ALABAMA. No. 23.
                                    Argued November 13, 1963.
                                     Decided June 15, 1964. *

[ Footnote * ] Together with No. 27, Vann et al. v. Baggett, Secretary of State of Alabama, et al.,
and No. 41, McConnell et al. v. Baggett, Secretary of State of Alabama, et al., also on appeal
from the same court.

Charging that malapportionment of the Alabama Legislature deprived them and others similarly
situated of rights under the Equal Protection Clause of the Fourteenth Amendment and the
Alabama Constitution, voters in several Alabama counties brought suit against various officials
having state election duties. Complaints sought a declaration that the existing state legislative
apportionment provisions were unconstitutional; an injunction against future elections pending
reapportionment in accordance with the State Constitution; or, absent such reapportionment, a
mandatory injunction requiring holding the 1962 election for legislators at large over the entire
State. The complaint alleged serious discrimination against voters in counties whose populations
had grown proportionately far more than others since the 1900 census which, despite Alabama's
constitutional requirements for legislative representation based on population and for decennial
reapportionment, formed the basis for the existing legislative apportionment. Pursuant to the
1901 constitution the legislature consisted of 106 representatives and 35 senators for the State's
67 counties and senatorial districts; each county was entitled to at least one representative; each
senate district could have only one member; and no county could be divided between two senate
districts. A three-judge Federal District Court declined ordering the May 1962 primary election
to be held at large, stating that it should not act before the legislature had further opportunity
take corrective measures before the general election. Finding after a hearing that neither of two
apportionment plans which the legislature thereafter adopted, to become effective in 1966, would
cure the gross inequality and invidious discrimination of the existing representation, which all
parties generally conceded violated the Equal Protection Clause, and that the complainants' votes
were unconstitutionally debased under all of the three plans at issue, the District Court ordered
temporary reapportionment for the 1962 general [377 U.S. 533, 534]   election by combining
features of the two plans adopted by the legislature, and enjoined officials from holding future
elections under any of the invalid plans. The officials appealed, claiming that the District Court
erred in holding unconstitutional the existing and proposed reapportionment plans and that a
federal court lacks power affirmatively to reapportion a legislature; two groups of complainants
also appealed, one claiming error in the District Court's failure to reapportion the Senate
according to population, the other claiming error in its failure to reapportion both houses on a
population basis. Held:

       1. The right of suffrage is denied by debasement or dilution of a citizen's vote in a state
       federal election. Pp. 554-555.