The court, the congress and the president: Turning back the clock on the pregnant poor.(Statistical Data Included)

"Well, as you know, there are many things in life that are not fair, that wealthy people can afford and poor people can't." President Jimmy Garter, press conference, July 12, 1977.

Safe, legal abortions are apparently to be added to the list of "luxuries" such as "faceliftings, hair transplants, expensive cars and tickets to the Kennedy Center" (1) that "wealthy people can afford and poor people can't" as the result of actions taken and policy decisions enunciated during and just preceding the summer by the President of the United States, his Secretary of Health, Education, and Welfare, the U.S. Supreme Court, the Congress and numerous state legislatures and officials.

The long hot summer began early for poor pregnant women when the House of Representatives on June 17 voted 201-155 to pass the so-called Hyde Amendment to the DHEW-Labor appropriations bill. That amendment prohibits the use of federal funds after October 1 "to pay for abortions or to promote or encourage abortions." (2) Three days later, the U.S. Supreme Court, in 6-3 decisions, ruled that states need not pay for "nontherapeutic" abortions even though they pay for childbirth, and that public hospitals need not perform such abortions, although they provide other pregnancy-related services. (3) On June 29, the Senate voted. (56-39) to bar the use of federal funds for abortion except to save the life of the pregnant woman if the fetus were carried to term "or where medically necessary, or for the treatment of rape or incest." (4)

The same day, the Supreme Court vacated a ruling by New York District Court Judge John F. Dooling, Jr., that had enjoined enforcement of the previous year's version of the Hyde Amendment, passed by both houses of Congress, which banned federal funding for abortions unless the pregnant woman's life was endangered; (5) on August 4, the 1976 Hyde Amendment went into effect when Judge Dooling lifted a temporary restraining order that had prevented enforcement. (6) Lest there be any misinterpretation of the extent of the ban, Attorney General Griffin B. Bell informed DHEW, on request, that it applied to all abortions "except where the victim's life is endangered," despite exceptions that had been written into the Senate-House conference report accompanying the ban.

Earlier, on July 12, President Carter had indicated at a news conference that he believed the federal government should not finance abortions "except when the woman's life is threatened or when pregnancy is the result of rape or incest." HEW Secretary Joseph Califano previously had indicated his support for congressional enactment of legislation barring the expenditure of federal funds for abortions except when performed to save a woman's life.

Encouraged by the actions of Congress, the nation's chief executive and its high court, officials from more than two dozen states announced that their states would no longer pay for abortions unless the pregnant woman's life were threatened; (*) and officials from numerous other states indicated that they would only fund "medically necessary," or "therapeutic," abortions--variously defined. Although most state legislatures were in recess during the summer, many legislators, courting the favor of right-to-life constituents, rushed to the media to announce that they would file bills to stop state payments for abortions. Bills actually were filed in five states, (+) and one, Illinois, became the first to pass such a measure following the Supreme Court's June decisions. (7) As of this writing, however, support for continued Medicaid reimbursement has come from the governors of three of these states (Massachusetts, Michigan and New York) as well as from the governors of California, Maryland, Vermont and Washingto n. (#) (More than half of Medicaid-funded abortions were performed in these seven states in 1976.) Nevertheless, it is considered unlikely that many states will continue to provide Medicaid reimbursement for long after federal aid is cut off, since four-fifths of public funds for abortion have come from the federal government.

Thus, the denial of federal funds for abortions is likely, as predicted by Rep. Louis Stokes (D.-Ohio) during the congressional debate over the Hyde Amendment, to be "tantamount to . . . outlawing abortion for the poor." (8)