Appellant
Maher, Connecticut Commissioner of Social Services
Appellees
Mary Poe, Susan Roe
Appellant's Claim
That the Connecticut Welfare Department regulation that limits state Medicaidbenefits for first trimester abortions to those that are "medically necessary" violates the Fourteenth Amendment rights of low-income women to equal protection under the law, since the state did provide Medicaid benefits to coverchildbirth expenses.
Chief Lawyer for Appellant
Lucy V. Katz
Chief Lawyer for Appellees
Edmund C. Walsh, Assistant Attorney General of Connecticut
Justices for the Court
Warren E. Burger, Lewis F. Powell, Jr. (writing for the Court), William H. Rehnquist, John Paul Stevens, Potter Stewart, Byron R. White
Justices Dissenting
Harry A. Blackmun, William J. Brennan, Jr., Thurgood Marshall
Place
Washington, D.C.
Date of Decision
20 June 1977
Decision
That states have a right to favor childbirth over abortion by funding one under Medicaid while refusing to fund the other.
Significance
The decision represented a trend to limit the availability of abortion, particularly to poor women, by denying state and federal funds for abortions.
In 1973, the Supreme Court handed down a landmark decision, Roe v. Wade, certifying that a woman's constitutional right to privacy also guaranteedher right to choose to have an abortion. State laws against abortion had to be struck down in the wake of this decision, which pro-choice advocates hailedas a victory.
But the decision also created a backlash of anti-abortion sentiment. Althoughthe Supreme Court had made it impossible to outlaw abortion outright, thosewho believed abortion was wrong tried to stop women from having this procedure in many other ways.
For example, Congress passed the Hyde Amendment to the Social Security Act, which provided that federal funds could not be used to reimburse states for Medicaid-funded abortions unless the life of the mother was threatened by the pregnancy, or unless the pregnancy was due to rape or incest. Medicaid is a federally funded program administered by the states to help low-income people get medical care. Although the Hyde Amendment left states the option of payingfor women's abortions out of their own funds, most states felt they could not afford that. Thus, cutting off federal funds made it very unlikely that low-income women would be able to have abortions, even though the Hyde Amendmenthad not actually made abortions illegal, or even forbidden states to pay forthem.
Doctor's Certification Needed
The Connecticut state welfare regulations also mandated that Medicaid funds could not be used to pay for abortions, unless a doctor certified that an abortion was medically necessary to save the life or health of the mother. In 1974, two Connecticut women decided to challenge that rule.
Mary Poe (a pseudonym used to protect the woman's identity) was a 16-year-oldhigh school junior who had already had an abortion at a Connecticut hospital. The hospital believed that Poe was covered under Medicaid. But when Poe could not get a doctor to certify that her abortion was medically necessary, thehospital could not be reimbursed and pressed Poe to pay the hospital bill of$244.
Susan Roe (also a pseudonym) was an unwed mother of three children. When shegot pregnant with her fourth child, she wanted to get an abortion, but her doctor refused to say that the procedure was medically necessary. Together, thetwo women filed a complaint in district court, saying that the Connecticut regulations had violated their rights to equal protection and due process of law under the Fourteenth Amendment.
The women made three key points: (1) It was unfair for Connecticut's Medicaidprogram to fund childbirth but not abortion. (2) It was unfair for Connecticut's Medicaid program to demand certification that abortion was medically necessary, when such certification was not required for any other medical procedure covered by Medicaid. (3) By denying funding, the Connecticut Medicaid regulation deprived poor women of their constitutional right of privacy to decide for themselves whether they wanted an abortion.
The district court found in favor of the women. The court interpreted the Social Security Act to uphold the claim that each state had to fund abortions for women on Medicaid, even though federal funds had been denied. The Supreme Court, however, did not agree. They ruled that states have the right to fund or not fund abortions as they choose, even if they are also funding childbirth, or if their decisions mean that poor women will not be able to afford abortions.
Not a Protected Class
First, the Court held that the women could not refer to their equal rights aspoor people, because "[f]inancial need alone does not identify a . . . classfor purposes of equal protection analysis." In other words, for people to argue that they are being discriminated against, they have to show that they belong to a group, and that their discrimination results from their membershipin that group. But, said the Court, being poor does not make you a member ofa group that is being discriminated against, at least not for the purposes ofthe law. Second, the Court held that the Connecticut regulation did not violate the women's right to privacy, or the right to choose an abortion as guaranteed by Roe v. Wade. A poor woman was perfectly free to have an abortion. The state was simply not going to help her pay for it.
The Court also ruled that states had the right to establish policies that favored childbirth over abortion. Connecticut's Medicaid regulations had the right to require different rules for abortion than for other medical procedures,because "[other] procedures do not involve the termination of a potential human life."
A Distressing Insensitivity
Justices Brennan, Marshall, and Blackmun dissented from the Court's opinion.Justice Brennan wrote an opinion for the three of them, claiming that "a distressing insensitivity to the plight of impoverished pregnant women is inherent in the Court's analysis."
Indeed, the regulations in Connecticut and in many other states gave welfaremothers with unwanted pregnancies several unpleasant choices. If they went ahead and bore the child, they would receive virtually no more money to take care of it. In 1981, four years after Maher v. Roe, the grant for a fourth person in a welfare household ranged from $24.00 per month in Mississippito $90.00 in California.
Alternately, a woman might try to find a doctor who would perform an abortionfor free, but few doctors were willing to perform such a service. A woman might use her welfare money to pay for an abortion rather than for rent or food. But in Texas, for example, an abortion costs about three months of welfarepayments, while in Mississippi, the procedure cost four months payments. Finally, a woman might try to borrow the money from a friend or relative, payingit back more gradually out of her welfare payments.
Legal Consequences of Maher v. Roe
The Maher case helped make it much easier for state governments to deny funding for abortions. For example, Maher was cited as a precedent in a 1980 case that eventually upheld the Hyde Amendment.
Besides the immediate consequences for poor women who could not get funding for abortions, Maher v. Roe also affected the way the Supreme Court defined "rights" in general. The case, despite the objections of the dissenters,established the precedent that the government is not responsible for helpingcitizens exercise their rights. Moreover, governments are allowed to set policy that support citizens in exercising some rights (having children) while failing to support them in exercising others (having abortions.)
Thus, in a later case known as Selective Service System v. Minnesota Pub.Int. (1984), the Court ruled that college students who were receiving federal educational assistance had to certify that they had registered for the draft as a condition of getting aid. Technically, under the Fifth Amendment, the government cannot require a person to testify against himself or herself.So it would have been unconstitutional to pass a law requiring all students to certify that they had registered for the draft. Students who were dependenton government aid, however, could be required to waive their rights in exchange for receiving the aid. Just as poor women were still theoretically free to have abortions, needy students were still theoretically free to refuse to testify against themselves.
Related Cases
Maher, Connecticut Commissioner of Social Services
Appellees
Mary Poe, Susan Roe
Appellant's Claim
That the Connecticut Welfare Department regulation that limits state Medicaidbenefits for first trimester abortions to those that are "medically necessary" violates the Fourteenth Amendment rights of low-income women to equal protection under the law, since the state did provide Medicaid benefits to coverchildbirth expenses.
Chief Lawyer for Appellant
Lucy V. Katz
Chief Lawyer for Appellees
Edmund C. Walsh, Assistant Attorney General of Connecticut
Justices for the Court
Warren E. Burger, Lewis F. Powell, Jr. (writing for the Court), William H. Rehnquist, John Paul Stevens, Potter Stewart, Byron R. White
Justices Dissenting
Harry A. Blackmun, William J. Brennan, Jr., Thurgood Marshall
Place
Washington, D.C.
Date of Decision
20 June 1977
Decision
That states have a right to favor childbirth over abortion by funding one under Medicaid while refusing to fund the other.
Significance
The decision represented a trend to limit the availability of abortion, particularly to poor women, by denying state and federal funds for abortions.
In 1973, the Supreme Court handed down a landmark decision, Roe v. Wade, certifying that a woman's constitutional right to privacy also guaranteedher right to choose to have an abortion. State laws against abortion had to be struck down in the wake of this decision, which pro-choice advocates hailedas a victory.
But the decision also created a backlash of anti-abortion sentiment. Althoughthe Supreme Court had made it impossible to outlaw abortion outright, thosewho believed abortion was wrong tried to stop women from having this procedure in many other ways.
For example, Congress passed the Hyde Amendment to the Social Security Act, which provided that federal funds could not be used to reimburse states for Medicaid-funded abortions unless the life of the mother was threatened by the pregnancy, or unless the pregnancy was due to rape or incest. Medicaid is a federally funded program administered by the states to help low-income people get medical care. Although the Hyde Amendment left states the option of payingfor women's abortions out of their own funds, most states felt they could not afford that. Thus, cutting off federal funds made it very unlikely that low-income women would be able to have abortions, even though the Hyde Amendmenthad not actually made abortions illegal, or even forbidden states to pay forthem.
Doctor's Certification Needed
The Connecticut state welfare regulations also mandated that Medicaid funds could not be used to pay for abortions, unless a doctor certified that an abortion was medically necessary to save the life or health of the mother. In 1974, two Connecticut women decided to challenge that rule.
Mary Poe (a pseudonym used to protect the woman's identity) was a 16-year-oldhigh school junior who had already had an abortion at a Connecticut hospital. The hospital believed that Poe was covered under Medicaid. But when Poe could not get a doctor to certify that her abortion was medically necessary, thehospital could not be reimbursed and pressed Poe to pay the hospital bill of$244.
Susan Roe (also a pseudonym) was an unwed mother of three children. When shegot pregnant with her fourth child, she wanted to get an abortion, but her doctor refused to say that the procedure was medically necessary. Together, thetwo women filed a complaint in district court, saying that the Connecticut regulations had violated their rights to equal protection and due process of law under the Fourteenth Amendment.
The women made three key points: (1) It was unfair for Connecticut's Medicaidprogram to fund childbirth but not abortion. (2) It was unfair for Connecticut's Medicaid program to demand certification that abortion was medically necessary, when such certification was not required for any other medical procedure covered by Medicaid. (3) By denying funding, the Connecticut Medicaid regulation deprived poor women of their constitutional right of privacy to decide for themselves whether they wanted an abortion.
The district court found in favor of the women. The court interpreted the Social Security Act to uphold the claim that each state had to fund abortions for women on Medicaid, even though federal funds had been denied. The Supreme Court, however, did not agree. They ruled that states have the right to fund or not fund abortions as they choose, even if they are also funding childbirth, or if their decisions mean that poor women will not be able to afford abortions.
Not a Protected Class
First, the Court held that the women could not refer to their equal rights aspoor people, because "[f]inancial need alone does not identify a . . . classfor purposes of equal protection analysis." In other words, for people to argue that they are being discriminated against, they have to show that they belong to a group, and that their discrimination results from their membershipin that group. But, said the Court, being poor does not make you a member ofa group that is being discriminated against, at least not for the purposes ofthe law. Second, the Court held that the Connecticut regulation did not violate the women's right to privacy, or the right to choose an abortion as guaranteed by Roe v. Wade. A poor woman was perfectly free to have an abortion. The state was simply not going to help her pay for it.
The Court also ruled that states had the right to establish policies that favored childbirth over abortion. Connecticut's Medicaid regulations had the right to require different rules for abortion than for other medical procedures,because "[other] procedures do not involve the termination of a potential human life."
A Distressing Insensitivity
Justices Brennan, Marshall, and Blackmun dissented from the Court's opinion.Justice Brennan wrote an opinion for the three of them, claiming that "a distressing insensitivity to the plight of impoverished pregnant women is inherent in the Court's analysis."
The Connecticut scheme clearly impinges upon . . . [women's] privacy by bringing financial pressures on indigent women that force them to bear children they would not otherwise have . . . We have repeatedly found that infringements of fundamental rights are not limitedto outright denials of those rights . . . but also to restraints that make exercise of those rights more difficult.
Indeed, the regulations in Connecticut and in many other states gave welfaremothers with unwanted pregnancies several unpleasant choices. If they went ahead and bore the child, they would receive virtually no more money to take care of it. In 1981, four years after Maher v. Roe, the grant for a fourth person in a welfare household ranged from $24.00 per month in Mississippito $90.00 in California.
Alternately, a woman might try to find a doctor who would perform an abortionfor free, but few doctors were willing to perform such a service. A woman might use her welfare money to pay for an abortion rather than for rent or food. But in Texas, for example, an abortion costs about three months of welfarepayments, while in Mississippi, the procedure cost four months payments. Finally, a woman might try to borrow the money from a friend or relative, payingit back more gradually out of her welfare payments.
Legal Consequences of Maher v. Roe
The Maher case helped make it much easier for state governments to deny funding for abortions. For example, Maher was cited as a precedent in a 1980 case that eventually upheld the Hyde Amendment.
Besides the immediate consequences for poor women who could not get funding for abortions, Maher v. Roe also affected the way the Supreme Court defined "rights" in general. The case, despite the objections of the dissenters,established the precedent that the government is not responsible for helpingcitizens exercise their rights. Moreover, governments are allowed to set policy that support citizens in exercising some rights (having children) while failing to support them in exercising others (having abortions.)
Thus, in a later case known as Selective Service System v. Minnesota Pub.Int. (1984), the Court ruled that college students who were receiving federal educational assistance had to certify that they had registered for the draft as a condition of getting aid. Technically, under the Fifth Amendment, the government cannot require a person to testify against himself or herself.So it would have been unconstitutional to pass a law requiring all students to certify that they had registered for the draft. Students who were dependenton government aid, however, could be required to waive their rights in exchange for receiving the aid. Just as poor women were still theoretically free to have abortions, needy students were still theoretically free to refuse to testify against themselves.
Related Cases
- Roe v. Wade, 410 U.S. 113 (1973).
- Akron v. Akron Center for Reproductive Health, 462 U.S. 416 (1983).
- Planned Parenthood Association of Kansas City v. Ashcroft, 462 U.S. 476 (1983).
- Selective Service System v. Minnesota Pub. Int., 468 U.S. 841 (1984).
- Thornburgh v. American College of Obstetricians and Gynecologists,476 U.S. 747 (1986).
- Webster v. Reproductive Health Services, 492 U.S. 490 (1989).
- Hodgson v. Minnesota, 497 U.S. 417 (1990).
- Ohio v. Akron Center for Reproductive Health, 497 U.S. 502 (1990).
- Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S.833 (1992).
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