## Facts

- Maureen M. Britell, the dependent spouse of an Air National Guard officer, was covered by CHAMPUS, a federal health benefits program for military dependents.
- During pregnancy, Britell learned at approximately 20 weeks that the fetus had anencephaly, a lethal defect; the diagnosis was confirmed by a second ultrasound.
- After consultation with medical and counseling professionals and clergy, Britell chose to terminate the pregnancy.
- Britell underwent an induced-labor abortion at a hospital; the fetus died during delivery and the diagnosis was confirmed.
- CHAMPUS denied reimbursement because 10 U.S.C. § 1093(a) and implementing regulations barred use of Department of Defense funds for abortions except when the mother’s life would be endangered if the pregnancy continued.
- Britell ultimately bore the cost and sued the United States seeking reimbursement under the Little Tucker Act, arguing the funding restriction was unconstitutional as applied.

## Issues

1. Whether the CHAMPUS statutory and regulatory scheme is money-mandating such that a reimbursement claim may be brought under the Little Tucker Act.
2. Whether 10 U.S.C. § 1093(a)’s ban on federal funding for abortions (with a life-of-the-mother exception) violates the equal protection component of the Fifth Amendment as applied to an abortion for anencephaly.

## Decision

- The Federal Circuit held the claim was properly brought under the Little Tucker Act because the CHAMPUS framework is money-mandating in the relevant sense and Britell sought monetary reimbursement for expenses already incurred.
- The court applied rational basis review to the constitutional claim.
- The court reversed the district court’s judgment for Britell and held § 1093(a) constitutional as applied, even in cases of anencephaly.
- The case was remanded for proceedings consistent with the appellate decision, foreclosing reimbursement under CHAMPUS.

## Legal Principles

- A federal benefits statute and implementing regulations can be “money-mandating” for Little Tucker Act purposes when they create an entitlement to payment subject to statutory exclusions, allowing a suit for reimbursement as monetary damages.
- The government’s decision not to subsidize abortion, while funding pregnancy and childbirth-related care, is generally reviewed under rational basis when framed as a funding classification rather than a direct restriction on access to abortion.
- Under rational basis review, Congress may express a preference for childbirth over abortion through funding choices and may draw clear categorical lines, so long as the classification is rationally related to a legitimate governmental interest.
- A life-of-the-mother exception, coupled with a categorical funding ban for other abortions, can be justified by interests in promoting respect for potential human life and in administrable, predictable funding rules, even where fetal survival is not expected.

## Conclusion

The Federal Circuit concluded that CHAMPUS reimbursement disputes may proceed under the Little Tucker Act when the plaintiff seeks repayment under a money-mandating benefits scheme, but it upheld 10 U.S.C. § 1093(a)’s abortion-funding restriction under rational basis review, rejecting an as-applied equal protection exception for anencephaly.


Britell v. United States, 372 F.3d 1370 (Fed. Cir. 2004)