Posted by Eugene Volokh:
The Humana Controversy and Government Funding:
http://volokh.com/archives/archive_2009_09_20-2009_09_26.shtml#1253725442


   Various people defended the Department of Health & Human Services
   "instruct[ing]" Humana to stop distributing allegedly "misleading and
   confusing" political advocacy, on the grounds that Humana gets huge
   benefits from participating in various DHS programs. But while the
   government has substantial control over how government program dollars
   are spent by people and institutions hired to administer the programs,
   the government may not impose blanket limits on everything the
   recipients say, as a condition of participating in the program.
   Rather, the recipients must retain the right to speak using their own
   money (at least unless their speech is otherwise punishable).

   Here's the relevant passage from [1]Rust v. Sullivan:

     The Secretary's regulations [restricting the use of government
     funds for abortion-related speech] do not force the Title X grantee
     to give up abortion-related speech; they merely require that the
     grantee keep such activities separate and distinct from Title X
     activities. Title X expressly distinguishes between a Title X
     grantee and a Title X project. The grantee, which normally is a
     health care organization, may receive funds from a variety of
     sources for a variety of purposes. The grantee receives Title X
     funds, however, for the specific and limited purpose of
     establishing and operating a Title X project. The regulations
     govern the scope of the Title X project's activities, and leave the
     grantee unfettered in its other activities. The Title X grantee can
     continue to perform abortions, provide abortion-related services,
     and engage in abortion advocacy; it simply is required to conduct
     those activities through programs that are separate and independent
     from the project that receives Title X funds.

     In contrast, our "unconstitutional conditions" cases involve
     situations in which the government has placed a condition on the
     recipient of the subsidy rather that on a particular program or
     service, thus effectively prohibiting the recipient from engaging
     in the protected conduct outside the scope of the federally funded
     program. In [2]FCC v. League of Women Voters of Cal., we
     invalidated a federal law providing that noncommercial television
     and radio stations that receive federal grants may not "engage in
     editorializing." Under that law, a recipient of federal funds was
     "barred absolutely from all editorializing" because it "is not able
     to segregate its activities according to the source of its funding"
     and thus "has no way of limiting the use of its federal funds to
     all noneditorializing activities." The effect of the law was that
     "a noncommercial educational station that receives only 1%" of its
     overall income from [federal] grants is barred absolutely from all
     editorializing" and "barred from using even wholly private funds to
     finance its editorial activity." ...

   So if the government simply directed Humana not to use
   federally-provided funds for its political advocacy to recipients,
   that would be permissible. It's possible that if Humana used a
   federally-provided mailing list for its mailing (I don't know whether
   that's true), the government could attach similar restrictions on the
   use of the mailing list. But the government went further: It
   instructed Humana even to take the advocacy off its Web site, without
   regard to whether Humana used government-provided money for such
   advocacy. That, it seems to me, is unconstitutional under FCC v.
   League of Women Voters.

   To be sure, because money is fungible, this League of Women Voters
   principle in effect does stop the government from making sure that its
   subsidies aren't indirectly used for certain speech. If the government
   gives someone $1 million (whether as a subsidy or as fair market
   compensation for the value of its services), and the speaker continues
   speaking using what is ostensibly its own money, that speech will
   still be much facilitated by the government grant -- the $1 million
   will free up money that the recipient would otherwise have had to
   spend, and will let the recipient use that freed-up money for its own
   speech.

   But the Court considered that argument in League of Women Voters and
   rejected it. And when the government (federal, state, and local)
   controls 25-30% of the GNP, and provides valuable range of contracts
   and subsidies to a vast range of institutions, including private
   universities, think tanks, newspapers, and so on, giving the
   government a free hand to restrict recipients' speech as a condition
   of its contracts would give the government vast power over public
   debate.

References

   1. http://www.law.cornell.edu/supct/html/89-1391.ZO.html
   2. 
http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=US&vol=468&invol=364

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