The law required that licensed centers post visible notices that other options for pregnancy, including abortion, are available from state-sponsored clinics.

"[1] The Court ruled on June 26, 2018, in a 5–4 decision that the notices required by the FACT Act likely violate the First Amendment by targeting speakers rather than speech.

[2] A crisis pregnancy center (CPC) is a type of nonprofit organization established to counsel pregnant women against having an abortion.

[3][4][5] CPCs provide peer counseling related to abortion, pregnancy, and childbirth, and they may offer non-medical services such as financial assistance, child-rearing resources, and adoption referrals.

[10][11] Based on a report prepared by NARAL Pro-Choice America, which alleged that CPCs were providing misleading and inaccurate information,[12] the California State Legislature passed the Reproductive FACT (Freedom, Accountability, Comprehensive Care, and Transparency) Act (AB-775) in October 2015.

It required any licensed healthcare facility that provided care services related to pregnancies to post a notice that stated "California has public programs that provide immediate free or low-cost access to comprehensive family planning services (including all FDA-approved methods of contraception), prenatal care, and abortion for eligible women."

NIFLA sought a preliminary injunction to prevent the Reproductive FACT Act from coming into force on January 1, 2016, while the lawsuit continued.

NIFLA specifically asked the Court to decide the question of "Whether the Free Speech Clause or the Free Exercise Clause of the First Amendment prohibits California from compelling licensed anti-abortion centers to post information on how to obtain a state-funded abortion and from compelling unlicensed anti-abortion centers to disseminate a disclaimer to clients on site and in any print and digital advertising.

Observers of the arguments believed the Court favored the CPCs and agreed with their arguments that the legal requirements of the Reproductive FACT Act not only burdened the free speech of the centers, but also put a burden on the centers to post the notice – for example, CPCs in Los Angeles County would be required to post the notice in 13 different languages.

[24] Thomas' opinion rejected the Ninth Circuit's conclusion that the FACT Act was equivalent to "professional speech", defined through Zauderer v. Office of Disciplinary Counsel of Supreme Court of Ohio, 471 U.S. 626 (1985) as "factual, noncontroversial information" that is less protected by the First Amendment, as the FACT Act notice dealt with the controversial topic of abortion.

Justice Kennedy wrote a concurrence, which was also joined by Roberts, Alito, and Gorsuch, which further asserted that the FACT Act was specifically targeting anti-abortion centers, describing it as "This law is a paradigmatic example of the serious threat presented when government seeks to impose its own message in the place of individual speech, thought, and expression".