Missouri must provide abortion funds to low-income women who are victims of rape or incest or lose as much as $1.4 billion a year in federal Medicaid subsidies, a U.S. District judge in Kansas City ruled Wednesday.
The order by Senior Judge Scott O. Wright said federal Medicaid directives set by Congress take precedence over a conflicting Missouri law. The state statute allows Medicaid funds for abortion only in cases where the life of the mother is endangered.The ruling is in keeping with other federal court decisions that basically have shot down attempts by some recalcitrant states to defy the new Medicaid rules on abortion.
"This is an important ruling for women in the state of Missouri," said Patty Brous, executive director of Planned Parenthood of Greater Kansas City.
The same federal rules that were relaxed could be tightened up again by the new Republican majorities in Congress. But in the meantime, pro-life activists are disappointed by the court ruling.
"It's another example regarding abortion where judicial fiat is being allowed to trump representative government," said Mary Kay Culp, president of Missouri Right to Life.
The case arose after Congress revised the Hyde Amendment, which since 1976 has restricted Medicaid funding for abortion to cases in which the life of the pregnant woman is in danger. The new language of the 1994 amendment added rape and incest, and the Medicaid Bureau instructed states to comply.
But a dozen states, including Missouri and Utah, balked.
Gov. Mel Carnahan's administration intended to comply with the new federal Medicaid directive but was blocked by the state General Assembly.
The General Assembly added amendments to spending bills for health and social services that made a point of requiring those budgets to comply with state law. And the law bans public funding for abortion except in cases where the mother's life is in danger.
Faced with apparently contradictory instructions, the director of the Missouri Department of Social Services asked for a court ruling.
Planned Parenthood of Kansas City already had submitted claims for Medicaid reimbursement for abortions for two women, one an incest victim and one a rape victim. Those cases have remained pending.