Hope v. Perales

150 Misc. 2d 985, 571 N.Y.S.2d 972, 1991 N.Y. Misc. LEXIS 351
New York Supreme Court·Decided April 15, 1991·Published·Cited by 8 cases

Opinion

OPINION OF THE COURT

C. Beauchamp Ciparick, J.

This is an action challenging the constitutionality of the Prenatal Care Assistance Program (Public Health Law § 2520 et seq.) (PCAP), a medical assistance program for pregnant women with incomes at or below 100 and 185% of the Federal poverty line, offering services designed to promote a healthy pregnancy, delivery and recovery.

Plaintiffs, 2 women with incomes between 100% and 185% of the Federal poverty line; 4 physicians who practice as obstetricians and gynecologists; 1 nurse-midwife affiliated with a New York City hospital; 7 health care clinics that serve women in the PCAP income bracket; 4 advocacy organizations whose memberships include women in this income category; and 2 members of the clergy who offer women in the stated income category guidance, move for (1) an injunction enjoining enforcement of Laws of 1989 (ch 584), effective January 1, 1990 (amending Public Health Law §§ 2521, 2522, 2529), and the regulations promulgated thereunder, to the extent that such enactments fail to provide reimbursement to health care providers who perform medically necessary abortions on women otherwise eligible for medical care under PCAP estab[987]*987lished by chapter 584; and (2) a declaration that the plaintiff class of women are entitled to funding of medically necessary abortions.

Defendants Cesar Perales, Commissioner of the New York State Department of Social Services, and David Axelrod, M.D., Commissioner of the New York State Department of Health, both directors of the State agencies charged with administering PCAP, cross-move for summary judgment declaring that PCAP is constitutional.

At a hearing on September 24, 1990, plaintiffs’ motion for a temporary restraining order enjoining enforcement of chapter 584 was denied without prejudice to further proceedings. Plaintiff Jane Hope at that time was over 21 weeks pregnant. Under the relevant criteria, it is alleged that Hope would be eligible for prenatal medical care under PCAP. As a carrier of sickle cell anemia, Hope was advised to terminate her pregnancy by abortion, a procedure specifically excluded from funding under PCAP.1

Therefore, Hope and Jane Moe, on behalf of all pregnant women who might require a therapeutic abortion, joined by [988]*988physicians who provide obstetrical and gynecological care to women who would be eligible for PCAP, a certified nurse-midwife, family planning and medical clinics who service women eligible for PCAP and advocacy organizations who represent and include as members women eligible for PCAP, instituted the instant action challenging the constitutionality of PCAP.

Plaintiffs maintain that chapter 584 violates provisions of the New York State Constitution including the Free Exercise of Religion Clause (NY Const, art I, §3), the Due Process Clause (NY Const, art I, § 6), the Equal Protection Clause (NY Const, art I, § 11), the clause pledging aid, care and support of the needy (NY Const, art XVII, § 1), and the clause pledging protection and promotion of the health of the inhabitants of the State (NY Const, art XVII, § 3) by excluding funds for medically necessary abortions to the class of women with incomes between 100 and 185% of the Federal poverty line ("eligible women”) who would otherwise be eligible for medical assistance under PCAP. Plaintiffs label the funding scheme of PCAP discriminatory against this class of women on the ground that it "burdens the exercise of the right of reproductive choice” and improperly pressures these women toward childbirth.

By stipulation dated and so ordered December 14, 1990, the parties agreed that if an eligible woman elects to have an abortion, she cannot be denied coverage for all other services provided in Public Health Law § 2522 (1) including, inter alla, transportation to all covered services, in-patient care, specialty physician and clinic services necessary following pregnancy or abortion to ensure a healthy recovery and mental health and related social services. Defendant New York State Department of Social Services agreed to send notices clarifying this to all Medicaid providers. It was further stipulated that the second and fifth causes of action were withdrawn with the exception of those allegations relating to transportation to and from an abortion and without prejudice to separate lawsuits by eligible women denied coverage for the services enumerated in Public Health Law § 2522 (1).

[The court’s discussion of the plaintiffs’ standing has been omitted for purposes of publication.]

BACKGROUND

Plaintiffs do not seek to halt the prenatal and postpartum [989]*989services currently being provided under PCAP. Indeed, it is uncontroverted that PCAP serves a laudatory purpose and none of the parties or amici to this proceeding would have this court void chapter 584 on the grounds of unconstitutionality effectively terminating all prenatal and obstetric assistance now extended under PCAP. Rather the instant dispute involves the scope of services funded under PCAP.

It is plaintiffs’ position that PCAP is underinclusive in its blanket exclusion of funds for all abortions without exception, for example, to preserve the life of the mother. Plaintiffs’ objective in this proceeding is to expand the breadth of chapter 584 to include financing for abortions in the case of medical necessity by way of an injunction prohibiting denial of such funding.

Plaintiffs insist that in the wake of Webster v Reproductive Health Servs. (492 US 490), Hodgson v Minnesota (497 US —, 110 S Ct 2926), and Ohio v Akron Center for Reproductive Health (497 US —, 110 S Ct 2972), the Federal right to privacy is tenuous and in this case New York is given the opportunity to reaffirm the fundamental nature of the right to an abortion under the New York State Constitution where, as here, the State lacks the compelling interest needed to justify impairment of such right by legislative decree.

While plaintiffs acknowledge that the State is not required to finance the exercise of fundamental constitutional rights (Harris v McRae, 448 US 297), they nevertheless maintain that the State cannot wield its economic power to dictate the choice it prefers, in this instance, childbirth.

Defendants counter that New York has an important and substantial interest in providing access to prenatal and obstetric care to women with incomes between 100 and 185% of the Federal poverty line who otherwise might not have sought such care or postponed it until the late stages of pregnancy. To address this interest the Legislature enacted chapter 584 as "one step” toward ameliorating this serious problem. PCAP is intended to expand an existing medical assistance program; there is no constitutional requirement that it be all encompassing. Defendants contend that the legislative decision to promote the health of newborns through a specifically tailored medical assistance program does not deprive this group of women of their right to obtain an abortion simply because the State is not supplying the funds. Indeed, the State assumes these women can raise the funds necessary to obtain an [990]*990abortion as they are above the poverty line and presumably have resources to draw upon. Therefore, defendants declare that PCAP places no obstacles in an eligible woman’s path to obtain an abortion and does not impinge on the exercise of her right to choose an abortion.

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Hope v. Perales, 150 Misc. 2d 985, 571 N.Y.S.2d 972, 1991 N.Y. Misc. LEXIS 351 (N.Y. Super. Ct. 1991).

150 Misc. 2d 985 (Hope v. Perales) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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