Although therapeutic or elective abortions are among the most frequently performed medical procedures for women throughout the world, indigent American women are now denied coverage under the Medicaid program because of the Hyde Amendment, which prohibits the use of federal funds for the termination of pregnancies except in narrowly defined cases. The vast majority of states, left free to choose as to the expenditure of their own funds for abortion coverage, have also denied this type of welfare assistance to economically eligible women. The discriminatory effect of the refusal to subsume abortions as part of the Medicaid mandate has been the subject of various legal actions. The constitutionality of that denial is at issue and now awaits Supreme Court determination.
PIP: Recent Supreme Court and lower court rulings related to induced abortion in the U.S. were reviewed and current issues concerning abortion availability for indigent women were discussed. As a result of the passage of the Hyde Admendment of 1977, limiting Medicaid funding for abortions, indigent women are being denied the freedom to decide whether or not to have an abortion. The Hyde Admendment permits the states to refuse to provide Medicaid funding for abortion except in cases of rape or incest. The Medicaid system was established in 1965 to provide medical care for indigent persons. Middle and upper class women who can afford abortions still have the freedom to decide to have an abortion. Furthermore, most private insurance plans provide abortion coverage. Although economic discrimination is not illegal in the U.S., racial and ethnic discrimination is illegal. Since a disproportionate number of Medicaid patients are members of racial minorities, opponents of the Admindment claim that the legislaton is illegal. Prior to 1977 the Supreme Court rulings reflected a liberal attitude toward abortion. In 1977 the Supreme Court rulings reflected a liberal attitude toward abortion. In 1977 the Supreme Court was expected to affirm the right of indigent women to receive abortion coverage under Medicaid by invoking the 14th Admendment; surprisingly, the Court did not support the rights of these women. Currently there are a number of cases in the lower courts and several are expected to reach the Supreme Court. These cases could change the current situation.