Harris v. McRae, 448 U.S. 297 (1980)

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In 1965 Congress established Medicaid, a program in which it reimbursed states for a portion of the costs of providing medical care to the poor. Many members of Congress disagreed with the Supreme Court’s controversial decision in Roe v. Wade (1973), the case in which the Court recognized that women have a constitutional right under the due process clause of the Fourteenth Amendment to terminate their pregnancies. Beginning in 1976, Congress passed legislation, known as the Hyde Amendment, that denied reimbursement for abortions, even those deemed medically necessary, except those necessary to save the life of the mother. In Harris v. McRae, the Supreme Court found no constitutional barriers to this withholding of federal funds.

Cora McRae, a New York Medicaid recipient in the first trimester of an unwanted pregnancy, filed a suit in U.S. District Court alleging that the Hyde Amendment was unconstitutional. She alleged that it violated the Establishment Clause of the First Amendment because it mirrored the Roman Catholic Church’s teachings that abortion is a sin and that human life begins at conception. Refusal to provide federal funds to support abortion also was inconsistent, she claimed, with the equal protection component of the Fifth Amendment’s due process clause because Medicaid reimbursed medical expenses associated with childbirth. This discrimination in types of reimbursable medical procedures placed an especially heavy burden on indigent, unmarried teenage girls, the category most in need of abortion.

The Court, in a five-to-four decision, upheld the constitutionality of the Hyde Amendment. The majority relied on its earlier decision in Maher v. Roe (1977) in which it sustained Connecticut’s decision, with regard to poor women, to pay for expenses associated with delivery of a baby but not for abortions. The Court reasoned that Roe v. Wade does not prevent a state from making a value judgment favoring childbirth over abortion and implementing that judgment through the allocation of public funds. The Constitution, said the Court, blocks government from placing obstacles in the path of a woman’s right to choose to terminate her pregnancy but it does not mandate that government remove obstacles, such as poverty, that it did not place there. No one is entitled to government funds needed to exercise a constitutional right.

Laws that discriminate against a suspect category of people, such as members of a racial minority, trigger a heightened level of judicial scrutiny. The Court, however, does not view poverty as a suspect classification and, therefore, Congress only has to demonstrate that the withholding of federal funds for abortion serves a legitimate governmental interest. Roe v. Wade recognized the government’s interest in preserving potential human life, an end achieved in the Hyde Amendment by providing incentives to pregnant women to carry their pregnancy to term.

The fact that the ban on use of federal funds to pay for abortion coincides with the tenets of the Catholic Church does not violate the prohibition on governmental establishment of religion. Preferring childbirth over abortion has a secular purpose, as do laws against stealing and murder, concluded the Court.

Most states have followed the federal government’s lead in restricting public funding for abortions. Congress has extended the ban on abortion funding to other federal programs financing health care, including those for federal employees, Peace Corps volunteers, and military personnel and their dependents.


References and Further Reading

  • Boonstra, Heather, and Adam Sonfield, Rights Without Access: Revisiting Public Funding of Abortion for Poor Women, Guttmacher Report on Public Policy, 3 (2000): 2:8–11.
  • Fried, Marlene Gerber. ‘‘The Economics of Abortion Access in the US: Restrictions on Government Funding for Abortion Is the Post-Roe Battleground.’’ Conscience 26, no. 4 (2005): 10–15.
  • Luker, Kristin. Abortion and the Politics of Motherhood. Berkeley: University of California Press, 1985.
  • McDonagh, Eileen L., My Body, My Consent: Securing the Constitutional Right to Abortion Funding, Albany Law Review 62 (1999): 3:1057–118.

Cases and Statutes Cited

  • Maher v. Roe, 432 U.S. 464 (1977)
  • Roe v. Wade, 410 U.S. 113 (1973)

See also Abortion; Due Process of Law (V and XIV); Due Process; Equal Protection of Law (XIV); Establishment Clause Doctrine: Supreme Court Jurisprudence; Roe v. Wade, 410 U.S. 113 (1973)