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Harris v. McRae (1980)

In Depth


Congress enacted the Hyde Amendment which restricted the use of federal Medicaid funds for abortions except in the cases in which a pregnancy jeopardized the life of the woman or the pregnancy was a result of rape or incest. Cora McRae, a Medicaid recipient, sought Medicaid funds for an abortion that did not meet these exceptions.   She brought suit on her behalf and on behalf of other women similarly situated. The New York City Health and Hospitals Corporation, a hospital system that serves Medicaid recipients, was also a plaintiff. They brought suit in a federal district court in New York against Patricia Harris, then the Secretary of Health and Human Services (HHS).[1] The sponsor of the funding restriction, Congressman Henry Hyde, and Senators James Buckley and Jesse Helms, intervened as defendants.   The district court entered a preliminary injunction against enforcement of the funding restriction. Harris appealed to the Supreme Court. The Court vacated the injunction and ordered the district court to further consider the issues in light of recent Supreme Court case law.  The district court allowed additional plaintiffs to intervene: four Medicaid recipients, several doctors who perform abortions, the Women's Division of the Board of Global Ministries of the United Methodist Church and two members of that division. Following a trial, the district court invalidated the Hyde Amendment, ordering Harris not to implement the amendment to the extent that it prohibited federal funds for "medically necessary" abortions.

Harris again appealed to the Supreme Court.

The Statute under Review

Since 1976, Congress has prohibited use of federal funds to pay for abortions under the Medicaid program except in certain specified circumstances.  This funding restriction, passed as an amendment to the annual HHS appropriations bill or by a joint resolution, is known as the Hyde Amendment, after its original sponsor.  Initially the Hyde Amendment permitted federal funds to pay for abortions only  when continued pregnancy would jeopardize the mother's life.  Subsequent versions of the Hyde Amendment sometimes permitted abortion funding under additional circumstances, such as in cases of rape or incest.

The Court's Holding

The Court held that under the Medicaid program states are not obligated to fund abortions for which no federal funds are available, and that the Hyde Amendment was constitutional.

The opinion was authored by Justice Stewart and joined by Chief Justice Burger and Justices White, Powell and Rehnquist.  Justice White wrote a concurring opinion.  Justices Brennan, Marshall, Blackmun and Stevens wrote dissents.

The Court's Reasoning

The Court first addressed the question of whether the Medicaid statute required the states to fund abortions that the federal government declined to fund. The Court concluded that the statute created a cooperative funding scheme and that if the federal government declined payment then the state did not have to provide the funds.

The Court then turned to various constitutional challenges to the Hyde Amendment.

Due Process. The Court held that the Hyde Amendment did not violate the Due Process Clause.  Roe v. Wade created a limitation on the government's power to interfere with a woman's decision whether to have an abortion.  The government does not interfere with the abortion decision simply by refusing to pay for it.  Put another way, Roe created no right to a government-funded abortion.  Thus, it is permissible, the Court said, for the government to use its funding powers to show a preference for childbirth over abortion.

First Amendment.  Plaintiffs made two claims under the Religion Clauses of the First Amendment.  First, they claimed that the Hyde Amendment violated the Establishment Clause by embodying Catholic views about the sanctity of human life. The Court rejected the claim.  The fact that a law "happens to coincide or harmonize with the tenets of some or all religions," it wrote, does not create an Establishment Clause violation.  For example, a law that forbids stealing is not unconstitutional simply because stealing happens to violate certain religious precepts.  The plaintiffs also claimed that the Hyde Amendment violated the Free Exercise Clause.  The Court concluded that the plaintiffs lacked standing to make this claim because none of them had alleged, let alone proved, that they had sought an abortion for religious reasons.

Equal Protection. Last, the Court addressed an argument that the Hyde Amendment violated the Equal Protection Clause by distinguishing between medically necessary health care services and abortions.  The Court rejected the invitation to apply a higher level of scrutiny to the Hyde Amendment and upheld the distinction as one reasonably related to the government's interest in protecting unborn life.

The Concurrence

Justice White. Justice White reiterated that Roe forbade government interference with the abortion decision, but did not require the government to pay for abortions.  The government's legitimate interest in protecting unborn life, he said, justified its refusal to pay for abortions while paying for other procedures.

The Dissents

Justice Brennan (joined by Justices Marshall and Blackmun). Justice Brennan dissented from the Court's opinion, saying that the denial of funding under the Hyde Amendment was tantamount to governmental coercion because it discouraged poor women from exercising the abortion right granted by Roe.

Justice Marshall. In his dissent, Justice Marshall said that denial of funding for abortions for the poor was "equivalent" to a denial of legal abortion.  Justice Marshall also says that he would strike down the amendment under the Equal Protection Clause.  His own test for determining whether there has been a violation of the Equal Protection Clause would take into account "the governmental benefits denied, the character of the class [affected by the challenged law], and the asserted state interests." He said in this case the governmental benefit in the form of funding is vital because the woman would either seek an illegal abortion or carry to term a child and lose control over the direction of her life. He said the class of poor women affected by the Hyde Amendment included many minorities and he said the governmental interest at issue -- the protection of potential life -- did not measure up to the rights of the women at issue. He predicted that decision would have a "devastating" impact on the lives and health of poor women.

Justice Blackmun. Justice Blackmun authored a dissent in which he largely quoted from prior dissents he authored in Beal v. Doe, Maher v. Roe and Poelker v. Doe.  He suggested that the Court was not being sensitive to the plight of the poor.

Justice Stevens. In his dissent, Justice Stevens said that the denial of payment for abortions was "tantamount to severe punishment." He also made a fiscal argument saying that the cost to the government of funding childbirth instead of abortions was greater. And, as a result, he said there would be less funds available for all of the beneficiaries of Medicaid. He said that once the government provides benefits it must be neutral in its distribution of them.  The government, he concluded, cannot attach greater importance to the interest in protecting potential life than to the interest in protecting maternal health.

[1] Then known as the Department of Health, Education, and Welfare.

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