Abstract

PIP: Despite the ascent of Bill Clinton to Presidential power in the US and his early successful repeals of bans on abortion counseling at federally funded clinics, abortions in military hospitals, and fetal tissue research, the controversy and debate over a woman's right to abortion continues in the US. The Hyde Amendment, named after Representative Henry Hyde, Republican from Illinois, has been in effect since 1976 barring Medicaid from funding abortions except to save the life of the pregnant woman. Congress in 1993, however, eased the amendment to allow states to use Medicaid funds to pay for abortions for low-income women in the cases of rape or incest. Anti-abortion lawmakers were assured by the provision's sponsors that the Clinton Administration would not force states to comply. The Department of Health and Human Services (HHS) instead sent a letter to state Medicaid directors on December 28, 1993, ordering them to use Medicaid funds to pay for abortions for low-income women who were the victims of rape or incest. President Clinton subsequently complained that HHS had bypassed his office in issuing the directive, state Medicaid directors protested that the directive had been imposed without the usual notice and allowance of time for public comment, and states claimed that the order clashes with existing state laws which ban the public funding of abortions not required to save the life of the mother. Officials from Arkansas, Colorado, North Dakota, Pennsylvania, and Utah have stated that they may fight the directive, while the HHS will most likely not move to rescind or change its directive. The issue will probably be resolved in the courts. The authors note that this state/federal battle over Medicaid-funded abortions is only part of a larger war scheduled to take place in Congress over whether pregnancy-related services, including abortion, will be covered in the Administration's Health Security Act.