June 30, 1980
5-4 Decision
Majority: Stewart, White, Rehnquist, Powell, Burger
Dissent: Brennan, Marshall, Blackmun, Stevens

In Harris v. McRae, the Court upheld the Hyde Amendment, which limited Medicaid funding for abortion to circumstances in which the mother’s life was endangered, even though the program generally paid for other "medically necessary," services. The Court ruled that the funding restriction did not impinge on the right to seek abortion recognized in Roe, writing, "[a]though the liberty protected by the Due Process Clause affords protection against unwarranted government interference with freedom of choice . . . it does not confer an entitlement to such funds as may be necessary to realize all the advantages of that freedom." The Court also determined that the Hyde Amendment did not violate the Equal Protection clause because it "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 cost at all."

The majority determined that the Hyde Amendment did not violate a woman’s constitutional privacy right to seek an abortion because the government’s refusal to subsidize abortions does not create "a government obstacle in the path of a woman who chooses to terminate her pregnancy." The majority upheld the provision, therefore, because the government has no "affirmative funding obligation" and the Hyde Amendment does not restrict a women’s right to terminate her pregnancy.

The majority also rejected the claim that exclusion of medically necessary abortions from Medicaid coverage violated the Equal Protection clause, stating that "[t]he financial constraints that restrict an indigent woman’s ability to enjoy the full range of constitutionally protected freedom of choice are the product not of governmental restrictions on access to abortions, but rather of her indigency." The majority further found that the principle impact of the Hyde Amendment "falls on the indigent," a class not entitled to heightened protection under the Equal Protection clause. As a result, the majority upheld the Hyde Amendment, concluding that its goal of encouraging childbirth by subsidizing the costs for indigent women who carry their pregnancies to term was "rationally related to the legitimate governmental objective of protecting potential life."

All four dissenting justices filed separate opinions. Justice Brennan’s dissent criticized the Court for failing to recognize that the government’s "denial of public funds for medically necessary abortions . . . serves to coerce indigent pregnant women to bear children that they would otherwise elect not to have," and therefore to "achieve indirectly what Roe v. Wade said it could not do directly." Justice Marshall explained that for poor woman the "denial of Medicaid-funded abortion is equivalent to denial of legal abortion altogether."