D----R---- v. Mitchell

Decision Date30 June 1978
Docket NumberNo. 77-0156.,77-0156.
Citation456 F. Supp. 609
PartiesD---- R----, on behalf of herself and all other persons similarly situated, Plaintiff, v. Anthony MITCHELL, Individually and in his capacity as Director of the Department of Social Services of the State of Utah, Scott M. Matheson, Individually and in his capacity as Governor of the State of Utah, Robert B. Hansen, Individually and in his capacity as Attorney General of the State of Utah, and Rob Muilenburg, Individually and in his capacity as the Administrator of the University of Utah Medical Center, Defendants.
CourtU.S. District Court — District of Utah

David S. Dolowitz, of Parsons, Behle & Latimer, Salt Lake City, Utah, for plaintiff.

Robert B. Hansen, Atty. Gen., Paul M. Tinker, Asst. Atty. Gen., Salt Lake City, Utah, for defendants.

MEMORANDUM OPINION AND ORDER

ALDON J. ANDERSON, Chief Judge.

The narrow issue presently before the court is whether the State of Utah may lawfully limit the funding of abortions provided to Medicaid recipients to those cases where the life of the mother would be endangered if an abortion is not performed.

The undisputed facts of this case show that at the time the abortion giving rise to this action was sought, plaintiff was a nineteen year old unmarried female and the mother of one child. Plaintiff is a recipient of Aid to Families with Dependent Children program (AFDC), 42 U.S.C. §§ 601 et seq., a welfare program established by the Social Security Act of 1935 and jointly administered by the United States and the State of Utah. As part of her AFDC assistance, plaintiff receives medical care under Title XIX of the Social Security Act, commonly known as the Medicaid program, 42 U.S.C. §§ 1396a et seq. (1970).

After she became pregnant, plaintiff consulted with and was examined by her physician, and determined that her desire to secure an abortion was appropriate medical treatment for her condition in the best medical judgment of her physician. Plaintiff's physician attempted to have plaintiff admitted to the University of Utah Medical Center for an abortion, but plaintiff was denied admission for treatment at the Medical Center on the ground that the Center would not be paid for the services rendered to plaintiff in light of certain provisions that had recently been enacted by the Utah State Legislature. Those provisions, House Bill 447 and a portion of Item 175 of House Bill 462, are the subject of this lawsuit and provide respectively:

The Utah State Department of Social Services shall not provide any public assistance for medical, hospital or other medical expenditures or medical services to otherwise eligible persons where the purpose of such assistance is for the performance of an abortion, unless the life of the mother would be endangered if an abortion is not performed.
It is the intent of the Legislature to concur in the Hyde Amendment passed by Congress to the effect that none of the funds contained in this Act shall be used to perform abortions except where the life of the mother or health of the fetus would be endangered if the fetus were carried to full term or in cases of rape and incest. This statement will hold unless overturned by the United States Supreme Court. If H.B. 447 should pass and become law this intent statement is to be deleted.

(Emphasis added). Since House Bill 447 did pass and become law, the legislative intent provision was deleted from the codification of House Bill 447. The codification of House Bill 447, Utah Code Ann. § 55-15a-3 (1953), reads identically to the first above-quoted paragraph. By this action, plaintiff seeks injunctive and declaratory relief from these provisions pursuant to 42 U.S.C. § 1983 (1970) and 28 U.S.C. §§ 1331, 1343, 2201 and 2202 (1970).

At the time this action was filed, the United States Supreme Court had pending before it the cases of Beal v. Doe, 432 U.S. 438, 97 S.Ct. 2366, 53 L.Ed.2d 464 (1977), Maher v. Roe, 97 S.Ct. 2376, 53 L.Ed.2d 484, 432 U.S. 464 (1977), and Poelker v. Doe, 432 U.S. 519, 97 S.Ct. 2391, 53 L.Ed.2d 528 (1977). The concern of these cases was various state limitations upon the funding of elective, nontherapeutic abortions in the Medicaid context. Because the major abortion decisions of the Supreme Court and the various lower court decisions from which appeal was taken in the above cases were in favor of those seeking abortions and against those attempting to restrict abortions, the defendants in this action entered into a stipulation whereby the defendants were enjoined and prohibited from enforcing the above state provisions during the pendency of this litigation, until the Supreme Court rendered its decisions in the above named cases or until further order of this court. On June 20, 1977, the Supreme Court issued its opinions in Beal, Maher and Poelker, reversing the lower courts and remanding the causes for further action. In Maher the Court dealt with the constitutional questions presented by the state restrictions, and in Beal the Court addressed the statutory issues under the Medicaid Act. Thereafter, the present defendants filed a motion to vacate the restraining order entered against them on the basis of the stipulation and a motion to dismiss the present action with prejudice. The grounds stated in support of the motion are that the decisions of the Court in Beal, Maher and Poelker are "substantially dispositive of the issues raised in this action" and require the entry of judgment in defendants' favor. Similarly, plaintiff filed a motion for summary judgment in her favor, basing the motion on the pleadings and memoranda on file herein.

On September 13 and September 30, 1977, the court heard arguments on the above motions, and on the latter date the restraining order was vacated. In effect, this permitted defendants to enforce the challenged state provisions. The court observed in its vacating order that although the recent Supreme Court decisions did not decide the precise issue before this court, they "clearly shifted support to a position more favorable to defendants." Order Vacating Temporary Restraining Order, filed October 14, 1977 at 2. The issues raised by the motions to dismiss and for summary judgment were taken under advisement by the court. Subsequently, plaintiff filed a motion to modify the court's order vacating the restraining order by taking into consideration the recently enacted Labor-HEW Appropriations Act of 1978 requiring the funding not only of abortions where a pregnancy or childbirth would endanger the life of the mother, but also abortions desired where the pregnancy is the result of rape or incest or where the pregnancy would result in severe and long-lasting physical damage to the health of the mother. Arguments on this motion were had before the court and the matter again was taken under advisement. Since the matter was last argued and up through May 31, 1978, counsel for the parties have filed supplemental memoranda and correspondence with the court regarding the issues under advisement.

The positions of the parties may be stated as follows. Plaintiff contends that even though states participating in the Medicaid program are not obliged to provide funding for elective or nontherapeutic abortions (as the Supreme Court made clear in Beal and Maher), the states are required by the Medicaid statutes and regulations and the Constitution of the United States to supply such funding where a Medicaid recipient and her physician determine that an abortion is "medically necessary." Because plaintiff's abortion was "medically indicated" and thus felt to be "medically necessary," plaintiff claims that the State of Utah's refusal to provide funding of the abortion deprived her of: (1) the equal protection of the law guaranteed by the Fourteenth Amendment to the Constitution of the United States; (2) due process of law guaranteed by the Fourteenth Amendment to the Constitution; and (3) a benefit to which she was statutorily entitled under the Medicaid statutes and regulations. Defendants argue, however, that neither the Medicaid provisions nor the Constitution requires states to provide funding for medically indicated or necessary abortions. Defendants strongly urge that states may decide for themselves the extent to which they will provide funding for abortions, and that since plaintiff's abortion was sought and obtained for reasons other than that plaintiff's life would be endangered by continuing with her pregnancy, the State of Utah was and is under no obligation to bear the cost of plaintiff's abortion. Having fully and carefully considered the matters presented by the motions of the parties, the court is prepared to enter its ruling.

The Constitutionality of Utah's Abortion Funding Statute

Plaintiff attacks Utah's abortion restrictions on both due process and equal protection grounds. With regard to the claim of violation of due process rights, plaintiff argues that the Utah provisions are constitutionally infirm "in that they prohibit payment for medically necessary abortions, thus effectuating an unconstitutional infringement upon the exercise of a constitutionally protected fundamental right." Plaintiff's Memorandum in Opposition to Motion to Dismiss at 5. As to the equal protection claim, plaintiff contends that the State of Utah discriminates between therapeutic and nontherapeutic abortions and the "exclusion of payment for therapeutic abortions is an impermissible limitation upon the exercise of a constitutionally protected right." Id. at 6. In plaintiff's complaint it was alleged that the claimed constitutional right of plaintiff could not be infringed unless in protection of a compelling state interest. Complaint ¶¶ 15 and 17. In her recent memoranda, however, plaintiff makes no more mention of the necessity of such a compelling state interest, but she does continue to refer to a fundamental constitutional right to which she is entitled. Because of the overtones and the ambiguity in the...

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11 cases
  • Reproductive Health Services v. Freeman
    • United States
    • U.S. Court of Appeals — Eighth Circuit
    • January 9, 1980
    ...of defendants' proposition that Title XIX also permits a state to withhold subsidies for therapeutic abortions, D. R. v. Mitchell, 456 F.Supp. 609, 622 (D.Utah 1978) we do not find defendants' argument persuasive. First, Beal expressly did not contemplate Title XIX's requirements concerning......
  • McRae v. Califano
    • United States
    • U.S. District Court — Eastern District of New York
    • January 15, 1980
    ...compelling. If this is correct, no other governmental interest could qualify as compelling." The earlier case of D.R. v. Mitchell, D.Utah 1978, 456 F.Supp. 609 upheld, against constitutional and Title XIX arguments, the Utah statute limiting funding to the cases in which the mother's life w......
  • Hodgson v. Board of County Com'rs, Hennepin County
    • United States
    • U.S. Court of Appeals — Eighth Circuit
    • February 8, 1980
    ...Right to Choose v. Byrne, 165 N.J.Super. 443, 398 A.2d 587 (1979). Apparently only one case has held to the contrary. D. R. v. Mitchell, 456 F.Supp. 609 (D.Utah 1978) (state medicaid statute subsidizing only life-sustaining abortions not inconsistent with requirements of Title The district ......
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    ...restraining order preventing state from refusing to reimburse providers for medically necessary abortions); D. R. v. Mitchell, 456 F.Supp. 609 (D.Utah June 30, 1978) (court granted state's motion for summary judgment and held that Medicaid Act does not require funding of all medically neces......
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