Harris v. McRae (1980)
Congress enacted the Hyde Amendment which restricted the use of
federal Medicaid funds for abortions except in the cases in which a
pregnancy jeopardized the life of the woman or the pregnancy was a
result of rape or incest. Cora McRae, a Medicaid recipient, sought
Medicaid funds for an abortion that did not meet these
exceptions. She brought suit on her behalf and on
behalf of other women similarly situated. The New York City Health
and Hospitals Corporation, a hospital system that serves Medicaid
recipients, was also a plaintiff. They brought suit in a federal
district court in New York against Patricia Harris, then the
Secretary of Health and Human Services (HHS). The sponsor of the
funding restriction, Congressman Henry Hyde, and Senators James
Buckley and Jesse Helms, intervened as defendants. The
district court entered a preliminary injunction against enforcement
of the funding restriction. Harris appealed to the Supreme Court.
The Court vacated the injunction and ordered the district court to
further consider the issues in light of recent Supreme Court case
law. The district court allowed additional plaintiffs to
intervene: four Medicaid recipients, several doctors who perform
abortions, the Women's Division of the Board of Global Ministries
of the United Methodist Church and two members of that division.
Following a trial, the district court invalidated the Hyde
Amendment, ordering Harris not to implement the amendment to the
extent that it prohibited federal funds for "medically necessary"
Harris again appealed to the Supreme Court.
The Statute under Review
Since 1976, Congress has prohibited use of federal funds to pay
for abortions under the Medicaid program except in certain
specified circumstances. This funding restriction, passed as
an amendment to the annual HHS appropriations bill or by a joint
resolution, is known as the Hyde Amendment, after its original
sponsor. Initially the Hyde Amendment permitted federal funds
to pay for abortions only when continued pregnancy would
jeopardize the mother's life. Subsequent versions of the Hyde
Amendment sometimes permitted abortion funding under additional
circumstances, such as in cases of rape or incest.
The Court's Holding
The Court held that under the Medicaid program states are not
obligated to fund abortions for which no federal funds are
available, and that the Hyde Amendment was constitutional.
The opinion was authored by Justice Stewart and joined by Chief
Justice Burger and Justices White, Powell and Rehnquist.
Justice White wrote a concurring opinion. Justices Brennan,
Marshall, Blackmun and Stevens wrote dissents.
The Court's Reasoning
The Court first addressed the question of whether the Medicaid
statute required the states to fund abortions that the federal
government declined to fund. The Court concluded that the statute
created a cooperative funding scheme and that if the federal
government declined payment then the state did not have to provide
The Court then turned to various constitutional challenges to
the Hyde Amendment.
Due Process. The Court held that the Hyde Amendment
did not violate the Due Process Clause. Roe v. Wade
created a limitation on the government's power to interfere with a
woman's decision whether to have an abortion. The government
does not interfere with the abortion decision simply by refusing to
pay for it. Put another way, Roe created no right to
a government-funded abortion. Thus, it is permissible, the
Court said, for the government to use its funding powers to show a
preference for childbirth over abortion.
First Amendment. Plaintiffs made two claims
under the Religion Clauses of the First Amendment. First,
they claimed that the Hyde Amendment violated the Establishment
Clause by embodying Catholic views about the sanctity of human
life. The Court rejected the claim. The fact that a law
"happens to coincide or harmonize with the tenets of some or all
religions," it wrote, does not create an Establishment Clause
violation. For example, a law that forbids stealing is not
unconstitutional simply because stealing happens to violate certain
religious precepts. The plaintiffs also claimed that the Hyde
Amendment violated the Free Exercise Clause. The Court
concluded that the plaintiffs lacked standing to make this claim
because none of them had alleged, let alone proved, that they had
sought an abortion for religious reasons.
Equal Protection. Last, the Court addressed an
argument that the Hyde Amendment violated the Equal Protection
Clause by distinguishing between medically necessary health care
services and abortions. The Court rejected the invitation to
apply a higher level of scrutiny to the Hyde Amendment and upheld
the distinction as one reasonably related to the government's
interest in protecting unborn life.
Justice White. Justice White reiterated that
Roe forbade government interference with the abortion
decision, but did not require the government to pay for
abortions. The government's legitimate interest in protecting
unborn life, he said, justified its refusal to pay for abortions
while paying for other procedures.
Justice Brennan (joined by Justices Marshall and
Blackmun). Justice Brennan dissented from the Court's
opinion, saying that the denial of funding under the Hyde Amendment
was tantamount to governmental coercion because it discouraged poor
women from exercising the abortion right granted by
Justice Marshall. In his dissent, Justice Marshall
said that denial of funding for abortions for the poor was
"equivalent" to a denial of legal abortion. Justice Marshall
also says that he would strike down the amendment under the Equal
Protection Clause. His own test for determining whether there
has been a violation of the Equal Protection Clause would take into
account "the governmental benefits denied, the character of the
class [affected by the challenged law], and the asserted state
interests." He said in this case the governmental benefit in the
form of funding is vital because the woman would either seek an
illegal abortion or carry to term a child and lose control over the
direction of her life. He said the class of poor women affected by
the Hyde Amendment included many minorities and he said the
governmental interest at issue -- the protection of potential life
-- did not measure up to the rights of the women at issue. He
predicted that decision would have a "devastating" impact on the
lives and health of poor women.
Justice Blackmun. Justice Blackmun authored a
dissent in which he largely quoted from prior dissents he authored
in Beal v. Doe, Maher v. Roe and Poelker v.
Doe. He suggested that the Court was not being sensitive
to the plight of the poor.
Justice Stevens. In his dissent, Justice Stevens
said that the denial of payment for abortions was "tantamount to
severe punishment." He also made a fiscal argument saying that the
cost to the government of funding childbirth instead of abortions
was greater. And, as a result, he said there would be less funds
available for all of the beneficiaries of Medicaid. He said that
once the government provides benefits it must be neutral in its
distribution of them. The government, he concluded, cannot
attach greater importance to the interest in protecting potential
life than to the interest in protecting maternal health.
 Then known as the Department of Health,
Education, and Welfare.