Box v. Planned Parenthood of Indiana and Kentucky, Inc.
The Court reversed a lower-court ruling that had struck down Indiana's law on how abortion providers must dispose of fetal remains, holding the State had a legitimate interest in respectful disposal and the law was rationally related to it.
At the same time, the Court declined to take up Indiana's separate ban on abortions sought solely because of a fetus's race, sex, or disability, leaving that law blocked and the underlying constitutional question unresolved for now.
How it got here: A federal district court blocked both Indiana laws; the Seventh Circuit affirmed; Indiana asked the Supreme Court to review both rulings.
The Case in Depth
What happened
Indiana passed two abortion-related laws: one changing how abortion providers must dispose of fetal remains (barring incineration alongside surgical waste while allowing simultaneous cremation), and another banning abortions performed when a provider knows the reason is solely the fetus's race, sex, or disability. Planned Parenthood of Indiana and Kentucky sued to block both laws, and lower courts sided with Planned Parenthood on both.
The question before the Court
Could Indiana require abortion providers to cremate or bury fetal remains instead of treating them as medical waste, and could it separately ban abortions sought only because of a fetus's race, sex, or disability?
Why it matters
Indiana can now enforce its fetal-remains disposal rules, meaning providers must treat fetal tissue differently from ordinary medical waste. Meanwhile, Indiana's ban on race-, sex-, or disability-selective abortions stays blocked, so similar state laws elsewhere remain in legal limbo until more appeals courts weigh in, and Justice Thomas's lengthy concurrence signals the issue may return to the Court later.
What changes now
Indiana can immediately enforce its fetal-remains disposal law under the rational-basis standard the Court applied. The selective-abortion ban remains blocked by the lower courts' injunctions, and its constitutionality is still an open question; the Court expects other circuits to weigh in before it revisits the issue. This is a final ruling on the first question but leaves the second question entirely unresolved.
What this does not decide
The Court expressly did not decide whether Indiana's law imposes an undue burden on a woman's right to obtain an abortion, since Planned Parenthood never raised that argument for the fetal-remains provision. It also expressed no view on whether states may constitutionally ban race-, sex-, or disability-selective abortions.
Concurrences and dissents
Concurrence — Justice Thomas
Justice Thomas agreed with reversing the fetal-remains ruling and with denying cert on the selective-abortion ban, but wrote at length about the history of the eugenics movement to argue that laws like Indiana's selective-abortion ban serve a compelling interest in preventing abortion from becoming a tool of modern eugenics. He argued Casey never addressed anti-eugenics laws and predicted the Court would eventually have to confront the issue.
Concurrence in part — Justice Ginsburg
Justice Ginsburg agreed with denying certiorari on the selective-abortion ban but dissented from reversing the fetal-remains ruling. She argued rational-basis review was the wrong standard because the case implicates the right to obtain an abortion without undue interference, so heightened review should apply, and she would have denied Indiana's petition entirely rather than summarily reverse.
How the Court got there
The legal reasoning, step by step
- Because Planned Parenthood had litigated the fetal-remains provision only under rational-basis review — the most lenient constitutional test, asking merely whether a law is reasonably connected to a legitimate government purpose — the Court evaluated the law under that same standard rather than the stricter test used for laws burdening abortion access directly.
- The Court noted it had already recognized, in a prior case, that a state has a legitimate interest in the proper disposal of fetal remains, and concluded the Seventh Circuit erred by treating that interest as illegitimate.
- Applying rational-basis review, the Court held that under that test the challenger bears the burden of ruling out every conceivable justification for a law, and a state need not draw a perfectly tailored line — only a rational one — so Indiana's law survived even though it allowed women to choose disposal methods themselves and permitted simultaneous cremation.
- On the second law, the ban on race-, sex-, and disability-selective abortions, the Court applied its ordinary practice under Supreme Court Rule 10 of declining review when only one court of appeals has addressed a legal question, since only the Seventh Circuit had yet considered this type of law.
- The Court concluded that further percolation among the courts of appeals was warranted before it weighed in on whether such selective-abortion bans are constitutional, so it denied certiorari on that question without expressing any view on the merits.
Doctrinal impact
Cases affected by this decision
Reaffirms Akron v. Akron Center for Reproductive Health, Inc. (462 U. S. 416)
The Court relies on this case's recognition that states have a legitimate interest in proper disposal of fetal remains.
Reaffirms Armour v. Indianapolis (566 U. S. 673)
The Court applies this case's rule that rational-basis review doesn't require a perfectly tailored law, just a rational one.