Women's Health Services, Inc. v. Maher

514 F. Supp. 265, 1981 U.S. Dist. LEXIS 12021
CourtDistrict Court, D. Connecticut
DecidedMay 6, 1981
DocketCiv. H-79-405
StatusPublished
Cited by11 cases

This text of 514 F. Supp. 265 (Women's Health Services, Inc. v. Maher) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Women's Health Services, Inc. v. Maher, 514 F. Supp. 265, 1981 U.S. Dist. LEXIS 12021 (D. Conn. 1981).

Opinion

RULING ON DEFENDANTS’ AND THIRD-PARTY DEFENDANTS’ MOTIONS TO DISMISS

BLUMENFELD, District Judge.

On January 7, 1980, this court ordered the Connecticut Department of Social Services to extend Medicaid benefits to eligible women requiring medically necessary abortions. Women’s Health Services v. Maher, 482 F.Supp. 725, 735-36 (D.Conn.), vacated and remanded, 636 F.2d 23 (2d Cir. 1980). The court held that a Connecticut regulation (“section 275”) allowing Medicaid reimbursement for abortion services only when “on the basis of his professional judgment, the attending physician has certified in writing that the abortion is necessary because the life of the mother would be endangered if the fetus were carried to term,” 3 Medical Assistance Program Manual, ch. III § 275 (Sept. 1, 1977) [hereinafter section 275], violated the equal protection clause of the fourteenth amendment. Women’s Health Services, 482 F.Supp. at 730-35. The court did not rule on a third-party complaint by the state defendants against the United States Department of Health, Education and Welfare seeking reimbursement for any expenditures ordered by the court.

On June 30, 1980, the United States Supreme Court sustained the “Hyde Amendment,” Pub.L. No. 96-123, § 109, 93 Stat. 926, which limited federal funding for abortions to cases in which “the life of the mother would be endangered if the fetus were carried to term,” against constitutional attack. Harris v. McRae, 448 U.S. 297, 325 n.27, 100 S.Ct. 2671, 2692, 65 L.Ed.2d 784 (1980). The Second Circuit accordingly vacated this court’s order with instructions to consider the effect of Harris v. McRae and rule on issues arising out of the third-party complaint. Women’s Health Services, Inc. v. Maher, 636 F.2d at 26 (2d Cir. 1980). This court thereafter denied the plaintiffs’ petition for a temporary restraining order against enforcement of section 275 on December 16, 1980, because, in light of the Supreme Court’s decision in Harris v. McRae, the plaintiffs were found no longer to raise a serious issue going to the merits which presented a fair ground for litigation. Women’s Health Services, Inc. v. Maher, Ruling on Petition for Temporary Restraining Order, Civil No. H-79-405, at 5-12 (D.Conn. Dec. 16, 1980). The case is now. before the court on the state and third-party defendants’ motions to dismiss for failure to state a cause of action.

I. THE STATE’S MOTION TO DISMISS

The original complaint claimed that section 275 violated the equal protection and due process clauses of the fourteenth amendment. Whether the complaint states a claim upon which relief could be granted now depends on application of the holding and reasoning of Harris v. McRae.

*268 In McRae, the Supreme Court rejected substantive due process and equal protection challenges to a congressional ban on the expenditure of federal funds for abortions “except where the life of the mother would be endangered if the fetus were carried to term.” Harris v. McRae, 448 U.S. 297, 325 n.27, 100 S.Ct. at 2692 (1980). The restriction did not impinge on a pregnant woman’s right to decide whether to terminate her pregnancy because “the Hyde Amendment leaves an indigent woman with at least the same range of choice in deciding whether to obtain a medically necessary abortion as she would have had if Congress had chosen to subsidize no health care costs at ail.” Id. at 317,100 S.Ct. at 2688. If the unavailability of Medicaid funds to pay for abortions discouraged a woman from exercising her right to choose abortion, that disincentive was constitutionally irrelevant. See id. In addition, the Court stated that there is no independent due process right to funding: “Although the liberty protected by the Due Process Clause affords protection against unwarranted government interference with freedom of choice in the context of certain personal decisions, it does not confer an entitlement to such funds as may be necessary to realize all the advantages of that freedom.” Id. at 317, 100 S.Ct. 2688.

The Court also rejected an equal protection challenge, applying the most minimal level of scrutiny — whether “ ‘the classification rests on grounds wholly irrelevant to the achievement of [any legitimate governmental] objective.’ ” Id. at 322, 100 S.Ct. 2691 (quoting McGowan v. Maryland, 366 U.S. 420, 425, 81 S.Ct. 1101, 1104, 6 L.Ed.2d 393 (1961) (bracketed insert added by Supreme Court)). The Court denied that the Hyde Amendment’s distinction between abortions not necessary to save the life of the mother and other medical services was based on a fundamental right or discriminated against a suspect class. Id. Applying the rational basis test, the Court held that the Hyde Amendment is valid because “it bears a direct relationship to the legitimate congressional interest in protecting potential life.” Id. at 325, 100 S.Ct. at 2692.

The plaintiffs argue that Harris v. McRae should be distinguished from the present case because McRae upheld action by Congress while the plaintiffs here challenge action by a state commissioner. They invoke the notion of “structural justice” advanced by Professor Tribe, see generally, L. Tribe, American Constitutional Law §§ 17-1 to 17-3 (1978), to support their view. The theory of structural justice is offered, in part, to explain the Supreme Court’s consideration, in the development of substantive doctrines, of the genesis of a decision in a particular governmental structure. When considering the validity of actions by administrative agencies, for example, the Court will consider whether the agency had been properly delegated the power to act and whether the action was based on factors within the agency’s presumed competence to evaluate. See id. § 17-2 at 1141-43. I will now consider, therefore, the various constitutional theories pressed by the plaintiffs in light of both McRae and the possible significance of administrative as opposed to legislative action.

A. Equal Protection

The equal protection issue must be controlled by the McRae decision unless the promulgation of section 275 by the Commissioner rather than by the state legislature requires application of a level of scrutiny higher than the rational basis test imposed by the Supreme Court. The plaintiffs argue that the regulation may not be sustained unless the record establishes that the state in fact promulgated the regulation in order to protect a legitimate interest such as the potential life of the unborn. Even if an after-the-fact justification by counsel was sufficient in the case of a legislative action, they argue, it should not be sufficient in the case of an administration action. This is especially so when the administrator has not been expressly delegated authority to evaluate and act upon the interests alleged to support his regulation.

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514 F. Supp. 265, 1981 U.S. Dist. LEXIS 12021, Counsel Stack Legal Research, https://law.counselstack.com/opinion/womens-health-services-inc-v-maher-ctd-1981.