Kindley v. Governor of Maryland

• Decision Date: 10 March 1981
• Docket Number: No. 155,155
• Citation: 426 A.2d 908,289 Md. 620
• Parties: Lola Alice KINDLEY et al. v. GOVERNOR OF MARYLAND et al.
• Court: Maryland Court of Appeals

Page 620

289 Md. 620

426 A.2d 908

Lola Alice KINDLEY et al. v. GOVERNOR OF MARYLAND et al.

No. 155.

Court of Appeals of Maryland.

March 10, 1981.

John T. Enoch, Baltimore (Goodman, Meagher & Enoch, Baltimore, on brief), for appellants.

Randall M. Lutz, Asst. Atty. Gen., Baltimore (Stephen H. Sachs, Atty. Gen., Baltimore, on brief), for Governor of Maryland et al.

Eileen Franch, Baltimore, for Doe et al.

Argued before MURPHY, C. J., and SMITH, DIGGES, ELDRIDGE, COLE, DAVIDSON and RODOWSKY, JJ.

COLE, Judge.

This case represents an attack on the right of the State of Maryland to provide funds for abortions performed on indigent and medically indigent women.

Appellants, residents and taxpayers of Montgomery and Baltimore Counties, filed a bill in equity against various state officials, including the Governor, State Treasurer, Comptroller, and Secretary of Health and Mental Hygiene, seeking declaratory and injunctive relief to prevent the funding of abortions and to declare illegal the payment of funds for abortions for indigents for the fiscal year 1978 (July 1, 1977 June 30, 1978).

Both appellants and appellees filed motions for summary judgment. In a decision rendered on October 29, 1979, the Circuit Court for Anne Arundel County (Turk, J.) ruled that:

1) Maryland Code (1957, 1971 Repl.Vol., 1977 Cum.Supp.), Art. 43, § 42(a)(1), authorizing the Secretary of Health and Mental Hygiene to administer "a program of comprehensive medical and other care in the State for indigent and medically indigent persons", permits the funding of all abortions.

2) The provision in the Budget Bill for Fiscal Year 1978 entitled "Medical Assistance Provider Reimbursements" was sufficient to permit the funding of all abortions for indigent persons.

3) The provision in the Budget Bill for Fiscal Year 1978 entitled "Medical Assistance Provider Reimbursements" was not a "lump sum" appropriation within the ambit of the Maryland Code (1957, 1976 Repl.Vol.), Art. 15A, § 12, requiring review of such appropriations by the Board of Public Works.

4) Past and present regulations, adopted by the Department of Health and Mental Hygiene, were and are adequate to support State funding of abortions for indigents.

Appellants noted an appeal to the Court of Special Appeals. Prior to consideration by that court, this Court granted appellants' request for a writ of certiorari.

The primary issue we must consider is whether and, if so, to what extent Art. 43, § 42(a)(1) of the Maryland Code ¹ authorizes the appropriation of public funds for abortions. The appellants ask us to read § 42(a)(1) in light of the criminal abortion statute still intact at the time the section was enacted. They contend that even if § 42 can be read as permitting some abortions, only those abortions which were legal in 1967 belong to the permitted class. Appellants also maintain that whatever else the term "comprehensive medical and other care" may be read to include, it should not be read to permit what appellants term nontherapeutic abortions.

The current version of Art. 43, § 42, was enacted as Chapter 688, Laws of Maryland, 1967. The precursor to the present statute was enacted in 1945 as Chapter 91 of the Laws of Maryland. The 1945 version provided that the "Bureau of Medical Services, under the direction of the Director of Health, shall (1) administer a program of medical care in the State of Maryland for indigent and medically indigent persons...." In 1967 Maryland elected to participate in the federal Medicaid Program and broadened the language of § 42 to be consistent with the scope of that program.

The Medicaid Program was established by Congress in 1965 as Title XIX of the Social Security Act, a co-operative federal-state effort to provide a broad range of health care services to the indigent and medically indigent. Among others, preventive, rehabilitative, and screening services were originally provided; now family planning services are included as well. 42 U.S.C.A. §§ 1396-1396k (1974, 1980 Supp.). Accordingly, the General Assembly amended § 42, providing in part, that "The State Board of Health ² shall (1) administer a program of comprehensive medical and other care in the State of Maryland for indigent and medically indigent persons ..." (emphasis supplied).

At the time of the 1967 amendments to § 42, any abortion, even by a licensed physician, was a criminal offense, except where the fetus was dead or the physician, after consultation with one or more physicians, was "satisfied ... that no other method (would) secure the safety of the mother." Maryland Code (1957, 1967 Repl.Vol.), Art. 27, § 3 (repealed by Chapter 470, Laws of Maryland, 1968).

Appellants have requested that we define the term "safety of the mother" in the criminal statute and limit the abortions which may be funded under § 42 to those which were legal under criminal law as it existed in 1967. The appellants contend that only those abortions, if any, could have been intended to be covered by the General Assembly when it enacted § 42. We find appellants' contention to be without merit. First we note that § 42 mentions neither abortions nor any other specific medical procedure. It is phrased in broad and general terms clearly designed to permit indigent persons to receive the advantages of whatever health care may be presently accepted as appropriate in the medical community. To accept appellants' contention would require the absurd result of precluding from coverage any medical procedure which may not yet have been developed, in general use, or legal as of 1967. Thus indigent persons would be denied the benefits of latest technological advances as well as medicines which may have been in existence in 1967 but were then illegal because their safety or the propriety of their use had not yet been determined.

It is true that in endeavoring to ascertain legislative intent we may consider the circumstances existing and events occurring at the time of the statute's passage, Mackie v. Town of Elkton, 265 Md. 410, 415, 290 A.2d 500 (1972); however, we must consider also that our laws are addressed to the future. Where, as here, a statute is phrased in broad general terms, it suggests that the legislature intended the provision to be capable of encompassing circumstances and situations which did not exist at the time of its enactment. 2A A. Sutherland, Statutes and Statutory Construction § 49.01 (4th ed. C. D. Sands 1973) (hereinafter cited as Sutherland).

In addition, we have said that a construction of a statute which is "unreasonable, illogical or inconsistent with common sense should be avoided." Comptroller v. John C. Louis Co., 285 Md. 527, 539, 404 A.2d 1045 (1979); accord, State v. Berry, 287 Md. 491, 413 A.2d 557 (1980); Board v. Stephans, 286 Md. 384, 408 A.2d 1017 (1979); Harbor Island Marina v. Calvert Co., 286 Md. 303, 407 A.2d 738 (1979). To freeze the scope of funded health care under § 42 to that available in 1967 would lead to just such a result. It would require that we indulge a presumption that the legislature intended to provide indigents with a system of second rate care. ³

Having concluded that the meaning of "medical and other care" cannot be interpreted solely in light of treatment available in 1967, we turn to the more difficult task of ascertaining the proper construction. Appellants maintain that whatever else may be within the ambit of "medical and other care", so-called nontherapeutic or elective abortions must be excluded.

The phrase "medical and other care" does not on its face suggest such a limitation in intended coverage. Our research has revealed neither committee reports nor any other legislative history which would allow us to discern with certainty the intent of the legislature. In such a situation the correct approach is to presume a reasonable intent on the part of the legislature. 2A Sutherland at § 45.12. Sutherland also lays down the guiding principle for determining what is a reasonable construction of legislation for relief of the poor:

"The care of the state for its dependent classes is considered by all enlightened people as a measure of its civilization, and provisions for the proper care and treatment at public expense of the indigent sick, and of those who for other reasons are unable to take care of themselves, is said to be among the unquestioned objects of public duty." Therefore, statutes enacted in fulfillment of this recognized public obligation should at all times be liberally interpreted so that the undesirable social effect resulting from the neglect of the poor may be eliminated. (3 Sutherland at § 71.08, quoting Jones v. Cooney, 81 Mont. 340, 263 P. 429, 430 (1928).)

In our view § 42 was enacted to alleviate some of the hardships of poverty by providing medical care to those who could not afford it. See Maher v. Roe, 432 U.S. 464, 469-70, 97 S.Ct. 2376, 2380, 53 L.Ed.2d 484 (1977). These hardships include not only the discomfort of heightened severity or duration of an untreated condition, but the sociological and economic problems which flow directly from inadequate medical care. In addition, the legislature may well regard medical care of a preventive and planning nature as important as providing curative treatment for existing illness. The importance of such services was explicitly recognized by Congress when it amended the Medicaid program to include "family planning services" among the types of care which the participating states are now required to fund. 42 U.S.C.A. 1396d(a)(4) (C). Apparently Congress recognized that health care which is not medically necessary to treat a clinically diagnosable illness may still be deemed not only socially desirable but necessary to the well being of the patient, his family and society. In sum, defining medical care narrowly is inconsistent with reasonable statutory construction.

It is in this light that we consider the extent to which § 42 permits the appropriation of...