Federal ruling allows California to pursue enforcement against clinics promoting unproven treatment, including those accepting insurance payments
On June 13, 2025, a federal judge in San Diego ruled that a Catholic-affiliated clinic’s advertisements for “abortion pill reversal” (APR) are commercial speech that can be regulated under California’s false advertising laws, even if they are connected to the clinic’s religious mission. The decision centers on whether statements about APR—such as its safety, effectiveness, and success rate—are protected by the First Amendment.
Culture of Life Family Services (COLFS), a nonprofit clinic that offers APR, had argued that the state’s enforcement actions threatened its right to speak and act based on religious convictions. The clinic sought a preliminary injunction to stop California Attorney General Rob Bonta from potentially enforcing laws against it, as he is doing in a separate lawsuit targeting Heartbeat International, which now runs the national APR provider network originally created by COLFS.
Judge Gonzalo Curiel denied that request, finding that COLFS’s APR-related speech is commercial in nature and potentially misleading. Crucially, the court also pointed to COLFS’s financial model, which includes accepting insurance payments and patient fees for the APR procedure. While COLFS claims to offer the treatment for free to women in financial need, it also advertises APR online and at fundraising events, suggesting an economic motive.
“This belies the fact that [COLFS] still accepts insurance and payment for APR treatments from women who do have the ability to pay,” Judge Curiel wrote, citing the clinic’s website. The court determined that such financial arrangements reinforce the conclusion that COLFS’s speech about APR is commercial, not merely religious.
California officials have alleged that APR claims—such as a 64-68% success rate and statements that “thousands of lives have been saved”—lack support from credible scientific studies. The court agreed, noting that the primary research backing these claims was methodologically flawed and lacked control groups. The ruling also raised doubts about the safety of halting a medication abortion mid-process, with studies reporting instances of severe bleeding.
Medical groups, including the American College of Obstetricians and Gynecologists, have rejected APR as unsupported by evidence, and some experts say claims about reversing abortion mislead patients about the true risks and outcomes.
By declining to enjoin potential enforcement, the court left open the possibility that California could pursue future actions against COLFS under state consumer protection laws. While COLFS may continue offering APR, it must navigate these legal uncertainties, particularly if its promotional statements remain unchanged.
The court’s decision keeps alive one First Amendment claim in the case, but for now allows state regulation to proceed. An appeal by COLFS or further district court proceedings are possible in the coming months.
Why This Case Matters:
This case shows how courts treat speech about medical treatments differently depending on whether that speech is commercial and whether it’s backed by credible science. Scientific credibility was a concern when it came to COVID vaccines and it is a concern here as well.
The key point here is that the clinic wasn’t just sharing religious views or offering advice in a private setting. It was advertising a specific medical treatment, abortion pill reversal, through public platforms such as its website and fundraising materials. It also accepted insurance payments and patient fees from those who could afford to pay. That made it commercial speech in the court’s view.
Commercial speech, unlike religious or political speech, can be regulated if it is false or misleading. Courts do not protect advertising that makes medical claims without solid scientific support. In this case, the judge reviewed the evidence and found that the clinic’s statements about APR’s safety and effectiveness lacked credible support.
The lesson is clear: public claims about medical services, especially those involving reproductive health, must be based on reliable, peer-reviewed evidence. Ideological or religious beliefs are not enough to shield those claims from scrutiny. When patients are making major health decisions, it is essential to provide information that is accurate and medically sound.
Freedom of speech protects open discussion, but it does not guarantee freedom from legal accountability. In healthcare, credibility and honesty are not optional—they are legal requirements.