51. What action should the court take?

The U.S. Supreme Court employs one of three tests in reviewing laws under equal protection and due process, depending on the circumstances. Strict scrutiny is used when a suspect classification or fundamental right is involved. Under strict scrutiny, a law will be upheld only if it is necessary to achieve a compelling government purpose. Intermediate scrutiny is used when a quasi-suspect classification based on gender or legitimacy is involved. Under intermediate scrutiny, a law will only be upheld here if it is substantially related to an important government purpose. Lastly, rational basis scrutiny, the minimum level of scrutiny, is used when the other two standards of review are not applicable. Under the rational basis standard, a law will be upheld if it is rationally related to a legitimate interest. It is difficult to fail this test, so most governmental action under this standard is upheld unless it is arbitrary or irrational.

To avoid issuing advisory opinions, federal courts require that a dispute be «ripe,» meaning that it has matured sufficiently to warrant a decision. Courts avoid getting involved in abstract disagreements over government policies, preferring to wait until a policy has been formalized and can be felt in a concrete way. A court will hold that an issue is fit for a judicial decision even if it relies on uncertain or contingent future events when the future events have an immediate impact.

B is correct. The law does not trigger heightened judicial scrutiny because it neither classifies regulatory subjects on a constitutionally suspect (or quasi-suspect) basis nor does it unduly burden the exercise of a fundamental right. The appropriate standard of review is whether the law is rationally related to a legitimate government interest. The apparent legislative judgment that diagnostic centers not affiliated with hospitals would be less reliable than hospitals is rational, regardless of whether it is in fact correct. Moreover, the governmental interest is not arbitrary or irrational. On this basis, the statute should be upheld as constitutional.

A is incorrect. This answer reaches the correct answer with the wrong reasoning. Even if it were true that medical services are typically a matter of local regulatory concern, this does not authorize states to have unlimited authority to enact any regulations. State laws are always subject to constitutional limits. As explained above, the law is subject to rational basis review, which is satisfied here.

C is incorrect. The «undue burden» test applies to the regulation of fundamental rights, and the Court has not held access to medical services to be a fundamental right. Therefore, even if the law unduly burdens access to medical services, heightened judicial scrutiny would not apply.

D is incorrect. Ripeness exists even when the issue relies on uncertain or contingent future events if those events will have an immediate impact on the interests of a party. Here, the suit is ripe because the physicians' group has immediate plans to open a diagnostic center in the state.