Harris v. McRae

However, the Supreme Court ruled in favor of the government. After noting that a state does not have to pay for even medically necessary abortions, Justice Stewart turned to the constitutionality of the amendment itself. Referring to Maher v. Roe, one of the two 1977 cases in which a state's lack of funding for nontherapeutic abortions had been upheld, he wrote:

Regardless of whether the freedom of a woman to choose to terminate her pregnancy for health reasons lies at the core or the periphery of the due process liberty recognized in Wade, it simply does not follow that a woman's freedom of choice carries with it a constitutional entitlement to the financial resources to avail herself of the full range of protected choices.

The reason why was explained in Maher: although government may not place obstacles in the path of a woman's freedom of choice, it need not remove those not of its own creation. Indigency falls in the later category.

Turning to the religious issues in the case, Stewart dealt first with McRae's claim that the Hyde Amendment violated the "Establishment Clause because it incorporates into law the doctrines of the Roman Catholic Church . . . " Noting that the government was free to pass laws against larceny, even though "the Judaeo-Christian religions oppose stealing," Stewart wrote that "we are convinced that the fact that the funding restrictions in the Hyde Amendment may coincide with the religious tenants of the Roman Catholic Church does not, without more, contravene the Establishment Clause."

The issue of what level of scrutiny ought to be applied was the last addressed. After finding that the "rational relationship" test was sufficient, Stewart concluded:

The Hyde Amendment, by encouraging childbirth except in the most urgent circumstances, is rationally related to the legitimate governmental objective of protecting potential life. By subsidizing the medical expenses of indigent women who carry their pregnancies to term while not subsidizing abortions (except those whose lives are threatened), Congress has established incentives that make childbirth a more attractive alternative than abortion for persons eligible for Medicaid . . . Nor is it irrational that Congress has authorized federal reimbursement for medically necessary services generally, but not for certain medically necessary abortions. Abortion is inherently different from other medical procedures, because no other procedure involves the purposeful termination of a potential life.

The Hyde Amendment has been passed, in one version or another, in every subsequent year. The versions passed in 1993, and since, have reinstated funding for abortions requested by victims of incest or rape.