Maher v. Roe

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-old high 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, the hospital 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 she got pregnant with her fourth child, she wanted to get an abortion, but her doctor refused to say that the procedure was medically necessary. Together, the two 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 Medicaid program 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.