Beal v. Doe, 432 U.S. 438 (1977)

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Indigents who were eligible for financial assistance under Title XIX of the Social Security Act’s Medicaid program challenged a Pennsylvania statute that denied funding for their desired abortions. The state law limited such support to those abortions that were certified by physicians as medically or psychiatrically necessary.

According to the U.S. Supreme Court in Beal v. Doe, the only question was whether Title XIX required states to fund the cost of all abortions, including those that were elective. In ruling for the state limitation, Justice Powell reasoned that the language of the congressional statute did not specifically mention abortions and did not suggest that participating states were required to fund every medical procedure. States, he said, were only required to meet certain standards for determining eligibility under a plan that was consistent with the overall objectives of Medicaid. Next, he noted that in Roe v. Wade, the Court had expressly recognized the ‘‘important and legitimate interest [of the state] in protecting the potentiality of human life.’’ He also found supporting history in the fact that when Title XIX was passed in 1965, nontherapeutic abortions were illegal in most states. Finally, he deferred to the interpretation of the law by the Department of Health, Education, and Welfare, the federal agency responsible for its administration, which was akin to the Court’s rendition.

Beal was one of three cases that posed direct legislative challenges to the highly controversial abortion case, Roe v. Wade, decided just four years earlier. One of themost direct and effective state and local strategies for curbing the availability of abortions following Roe was simply to deny public funding and/or the use of public hospitals and facilities for the procedure. The leading case, Maher v. Roe, established that although women have a fundamental constitutional right to decide whether to have an abortion, there was no corresponding obligation on the part of state and local governments to provide funding for them. Maher upheld Connecticut’s refusal to reimburse Medicaid recipients for the cost of an abortion unless a doctor certified that it was medically or psychiatrically necessary. In the third case, Poelker v. Doe, the Court voted to sustain the St. Louis, Missouri, policy of denying indigent pregnant women access to nontherapeutic abortions in the city’s public hospitals.

These rulings were later reaffirmed in Harris v. McRae, when the Court upheld congressional restrictions on federal funding for abortions, and in Webster v. Reproductive Health Services, sustaining Missouri’s 1986 ban on the use of public hospitals, facilities, and employees for the elective procedure. After more than a decade in which the Supreme Court legitimated governmental policies denying funding and the use of public hospitals for nontherapeutic abortions, there remained, in 1989, thirteen states with no restrictions on funding. Thirty-one states passed laws denying support for indigent women.


References and Further Reading

  • Baer, Judith A. Historical and Multicultural Encyclopedia of Women’s Reproductive Rights in the United States. Westport, CT: Greenwood, 2001
  • Bond, Jon R., and Charles A. Johnson. ‘‘Implementing a Permissive Policy: Hospital Abortion Services after Roe v. Wade.’’ American Journal of Political Science 26 (1982): 1–24
  • Craig, Barbara Hinkson, and David M.O’Brien.Abortion and American Politics. Chatham, NJ: Chatham House, 1993
  • Hull, N.E.H., and Peter Charles Hoffer. Roe v. Wade: The Abortion Rights Controversy in American History. Lawrence: University Press of Kansas, 2001

Cases and Statutes Cited

  • Harris v. McRae, 448 U.S. 297 (1980) 
  • Maher v. Roe, 432 U.S. 464 (1977) 
  • Poelker v. Doe, 432 U.S. 519 (1977) 
  • Roe v. Wade, 410 U.S. 113 (1973) 
  • Webster v. Reproductive Health Services, 492 U.S. 490 (1989) 

See also Harris v. McRae, 448 U.S. 297 (1980); Maher v. Roe, 432 U.S. 464 (1977); Poelker v. Doe, 432 U.S. 59 (1977); Roe v. Wade, 410 U.S. 113 (1973); Webster v. Reproductive Health Services, 492 U.S. 490 (1989)