Eric M. Bost, Commissioner of Human Services v. Low-Income Women of Texas

Nature of Case:

A group of Dallas-based physicians and family planning clinics sued the state on the grounds that denying Medicaid funding for abortion services puts low-income women--those with medical conditions that would be aggravated by a pregnancy but that are not life threatening--at risk for more complicated health problems for themselves or their fetuses. Currently, state policy limits Medicaid abortion funding to cases of rape, incest and endangerment to the mother’s life. Once pregnant, women who suffer from legitimate medical conditions such as asthma, epilepsy, cancer, or other pre-existing health conditions face increased health risks which, although not always fatal, can be debilitating for the mother or harmful to the fetus. The physicians argue that denying poor pregnant women certain medically necessary health services while providing all medically necessary health services to men is illegal sex discrimination.

Holding:

In the final ruling for this case, the Texas Supreme Court ruled 8-0 that the state’s refusal to pay for abortions for Medicaid-eligible women whose mental or physical conditions may be aggravated by pregnancy does not violate the Texas Constitution’s Equal Right Amendment and shows a “legitimate governmental interest of favoring childbirth over abortion.” Although the Supreme Court agreed that the policy denies low-income women the same rights as other women seeking abortions, the court said “that in deciding how to spend taxpayer money, the state could endorse policies that discourage abortion.” This ruling reverses the Texas Court of Appeals opinion that if the state chooses to provide medically necessary services to indigent persons, it must not discriminate on the basis of gender.