States that participated in Medicaid were not required to fund medically necessary abortions for which federal reimbursement was unavailable as a result of the Hyde Amendment. The funding restrictions of the Hyde Amendment did not violate either the Fifth Amendment or the Establishment Clause of the First Amendment.
U.S. Congress amended Title XIX of the Social Security Act to create Medicaid, a voluntary program to provide federal funds to states that choose to provide reimbursement for certain medical expenses for the indigent.[2]
In September 1976, Congress began to ban the use of federal funds to reimburse the cost of abortions under Medicaid.[3] Initially, the only exception was if the life of the mother would be endangered by the fetus being carried to term. The restrictions became known as the Hyde Amendment, after the measure's original sponsor, Illinois Representative Henry Hyde. The language of the 1980 Hyde Amendment provided:
[None] of the funds provided by this joint resolution shall be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term; or except for such medical procedures necessary for the victims of rape or incest when such rape or incest has been reported promptly to a law enforcement agency or public health service.[4]
In 1976, after the passage of the original Hyde Amendment, an action was brought in the United States District Court for the Eastern District of New York that sought to enjoin enforcement of its restrictions.[5] The plaintiffs were Cora McRae, a New York Medicaid recipient who was in the first trimester of a pregnancy that she wished to abort; the New York City Health and Hospitals Corp., which operated hospitals providing abortion services; officers of the Women's Division of the Board of Global Ministries of the United Methodist Church; and the Women's Division itself.[6] McRae sought to bring the action as a class action on behalf of other similarly situated women.[6] The District Court granted the class certification motion and permitted US Senators James L. Buckley and Jesse Helms as well as Hyde to intervene as defendants.[6]
The district court granted the injunction on January 15, 1980, and found that the Hyde Amendment violated the Fifth Amendment's Due Process Clause and the First Amendment's Establishment Clause.[7]
The Court held that states participating in the Medicaid program were not obligated to fund medically necessary abortions under Title XIX. The Court found that a woman's freedom of choice does not carry with it "a constitutional entitlement to the financial resources to avail herself of the full range of protected choices." The Court ruled that because the
