Court Opinion

ID: 9734272
Source: CourtListenerOpinion
Date Created: 2023-08-26 17:30:40.739263+00
Date Added: 2024-06-11T18:26:47.522895
License: Public Domain

Mallett, J.
(dissenting). Under § 109a of the Social Welfare Act,1 an indigent woman will receive no reimbursement for medical expenses if she chooses to have a medically indicated abortion. The majority concludes that § 109a does not exceed the limits of the equal protection guarantee of the Michigan Constitution. I respectfully dissent.
I
The plaintiffs Jane and Nancy Doe argue that § 109a violates the Equal Protection Clause of the Michigan Constitution by creating an intolerable classificatory scheme. I agree. Indigent pregnant women requiring medical care for childbirth may receive Medicaid benefits. However, indigent pregnant women who seek an abortion, even when medically necessary to preserve their health, are denied reimbursement through Medicaid unless the abortion is necessary to save their lives. 187 Mich App 493, 523; 468 NW2d 862 (1991). I find that § 109a is an unduly burdensome interference with a woman’s fundamental right to privacy that includes the right to choose to terminate her *698pregnancy. See Roe v Wade, 410 US 113; 93 S Ct 705; 35 L Ed 2d 147 (1973), reh den 410 US 959 (1973).
Relying almost exclusively on United States Supreme Court decisions, the majority concludes that Michigan’s denial of Medicaid funding for indigent pregnant women who seek a medically indicated abortion that is not required to save their lives does not impinge upon their fundamental right to privacy. Beal v Doe, 432 US 438; 97 S Ct 2366; 53 L Ed 2d 464 (1977); Maher v Roe, 432 US 464; 97 S Ct 2376; 53 L Ed 2d 484 (1977); Harris v McRae, 448 US 297; 100 S Ct 2671; 65 L Ed 2d 784 (1980), reh den 448 US 917 (1980); Regan v Taxation with Representation, 461 US 540; 103 S Ct 1997; 76 L Ed 2d 129 (1983). I find the United States Supreme Court analysis in these decisions flawed, and, thus, the majority’s reliance on these cases misplaced. Judicial review of § 109a under the "rationality” analysis is equally defective.
This Court is hardly precluded from independently interpreting Michigan’s Equal Protection Clause and may reject United States Supreme Court analysis. City of Mesquite v Aladdin’s Castle, Inc, 455 US 283, 293; 102 S Ct 1070; 71 L Ed 2d 152 (1982) (a state court is entirely free to read its own constitution more broadly than this Court reads the federal constitution, or to reject the mode of analysis used by this Court in favor of a different analysis of its corresponding constitutional guaranty). Moreover, Michigan courts have rejected United States Supreme Court analysis on previous occasions. See People v Jackson, 391 Mich 323; 217 NW2d 22 (1974) (extended rights of defendants to be represented by counsel at corporeal or photographic identification procedures independent of federal constitutional ruling); People v *699Sundling, 153 Mich App 277; 395 NW2d 308 (1986) (rejected adoption of "good faith” exception to the exclusionary rule where search is improper).
In concluding that § 109a is unconstitutional, I need not find that Michigan’s Equal Protection Clause offers greater protection than its federal counterpart.2 Nor do I need to conclude that a woman’s fundamental right to privacy is broader under Michigan’s Constitution than the federal right established in Roe v Wade. Section 109a impinges upon the fundamental privacy right of an indigent woman who chooses abortion as a medical treatment for her pregnancy and, therefore, is unconstitutional.
The plaintiffs do not contend that the right to choose a medically indicated abortion includes a right that the government pay for it. Ante, p 666. The majority’s assertion in this regard goes beyond the scope of the case before this Court. As Justice Brennan clarifies in Harris, supra, Roe does not stand for the proposition that "the State is under an affirmative obligation to ensure access to abortions for all who may desire them.” 448 US 330 (Brennan, J., dissenting.) Roe does require, however, that the state "refrain from wielding its enormous power and influence in a manner that might burden the pregnant woman’s freedom to choose whether to have an abortion.” Id.
Concluding that § 109a is constitutional, the majority cites Maher, supra, for the proposition that " '[(t)he right recognized in Roe] implies no limitation on the authority of a State to make a *700value judgment favoring childbirth over abortion, and to implement that judgment by the allocation of public funds.’ ” Ante, p 667. The majority fails to acknowledge the fact that, notwithstanding this conclusion, the Maher Court held that the government cannot unduly interfere "with [a woman’s] freedom to decide whether to terminate her pregnancy.” 432 US 474. See also Bellotti v Baird, 428 US 132, 147; 96 S Ct 2857; 49 L Ed 2d 844 (1976) (a state requirement that unduly burdens the right to seek an abortion is unconstitutional).
Ruling that legislation that prohibits government-funded abortions is not unconstitutional, the United States Supreme Court has reasoned that a woman’s indigency, not the government’s action, makes an abortion inaccessible. See Maher and Harris, supra. The Court held:
[Although government may not place obstacles in the path of a woman’s exercise of her freedom of choice, it need not remove those not of its own creation. Indigency falls in the latter category. The 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. Although [the government] has opted to subsidize medically necessary services generally, but not certain medically necessary abortions, the fact remains that [the denial of government funds for an abortion] 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 costs at all. [Harris, supra, pp 316-317.]
Thus, the United States Supreme Court concluded that the denial of public funds for an abortion does not infringe upon a woman’s fundamental right to *701choose this medical procedure. This examination is commonly referred to as the "obstacles” analysis and has been soundly rejected by members of the United States Supreme Court. See Maher at 482-490 (Brennan, J., dissenting). I, too, reject the "obstacles analysis” because it is illusive and misleading.
The Michigan Medicaid program is a state-administered plan designed to pay the costs of medical care for most welfare recipients and certain other poor individuals. Michigan chose to subsidize the health care costs of its indigent citizens by enacting 1966 PA 321, MCL 400.105 et seq.; MSA 16.490(15) et seq.
Once a woman is found eligible to receive Medicaid assistance, her access to quality medical care is theoretically the same as a person who does not require Medicaid assistance. In other words, Michigan’s enactment of the Medicaid program removes a recipient’s indigent status relating to medical care. With the enactment of § 109a, however, a female recipient may obtain access to the full range of medical treatments provided under this program unless she chooses abortion as a medical treatment. The government’s restriction of Medicaid funds for a medically indicated abortion, in fact, creates the financial "obstacles” that the Medicaid program purposefully eliminated. Such a restriction is clearly an infringement upon a woman’s freedom of choice.
In most instances, services provided under Medicaid represent an indigent woman’s sole access to health care. While the government may restrict its use of public funds, such action is inappropriate here where the effect is that an indigent woman’s freedom of choice is altered to accommodate the government’s agenda. Justice Brennan stated in Harris, supra:
*702The fundamental flaw in the Court’s . . . analysis ... is its failure to acknowledge that the discriminatory distribution of the benefits of governmental largesse can discourage the exercise of fundamental liberties just as effectively as can an outright denial of those rights through criminal and regulatory sanctions. [448 US 334.]
Here, too, the differential distributions of incentives under § 109a have the same effect as an outright prohibition of an indigent woman’s exercise of her fundamental right.
Furthermore, the complex design of welfare in Michigan contributes to the burdensome effect of § 109a. Under the current scheme, if a woman receiving Medicaid or Aid to Dependent Children (adc) benefits fails to report the receipt of other income and assets, she could become disqualified for future benefits. MCL 400.40-400.43; MSA 16.440-16.443. If an indigent woman received funds from an outside source to finance an abortion, her total monthly welfare benefits could be proportionately reduced. Id. Because payments are made directly to the provider and no cash allowance is given for medical assistance, she is not even given the choice of waiving other medical necessities in favor of a medically indicated abortion. Consequently, a woman who chooses to have the abortion must forgo housing or care for her family if she wants this medical treatment. See Corns, The impact of public abortion funding decisions on indigent women: A proposal to reform state statutory and constitutional abortion funding provisions, 24 U Mich J L Ref 371, 388 (1991).
Considered in context with an indigent woman’s entire financial circumstance, the coercive effect of § 109a on a woman’s procreation choice is obvious. Faced with the denial of benefits, an indigent woman is pressured into carrying the fetus to *703term, notwithstanding her choice to have an abortion, and the sometimes substantial impairment to her physiological and psychological health.
II
For these reasons, I find that § 109a unduly burdens a woman’s fundamental right to privacy and thus is subject to judicial review under the "strict scrutiny” analysis.
When examining violations of the Equal Protection Clause where a fundamental right is implicated, this Court has adopted the "strict scrutiny” analysis employed by the United States Supreme Court. San Antonio Independent School Dist v Rodriguez, 411 US 1, 17; 93 S Ct 1278; 36 L Ed 2d 16 (1973), reh den 411 US 959 (1973). If the legislation impinges upon a fundamental right or involves a suspect classification, the government must demonstrate a compelling interest or the legislation fails. See Manistee Bank & Trust Co v McGowan, 394 Mich 655, 668; 232 NW2d 636 (1975). If a fundamental right is not implicated, the legislation must be rationally related to a legitimate government purpose. Id.
In Roe v Wade, supra, the United States Supreme Court identified two governmental interests in procreative choices: (1) a woman’s health, and (2) the potential life of the fetus. However, the government’s interest in the potential life of the fetus does not become compelling until the fetus is viable. Id. at 163-164. Thus, the only compelling government interest in a woman’s procreation choice before the third month is the protection of a woman’s own health. Prohibiting reimbursement for abortions under § 109a in all trimesters does not advance the government’s compelling interest in the health of the woman or the child. In fact, *704such action exceeds the balance between the government’s interest and the constitutional right of the woman to be free from government interference in her procreative decisions. The Michigan Legislature’s decision to deny Medicaid reimbursements to an indigent woman who seeks a medically indicated abortion but provides funding to a woman who chooses childbirth as a medical treatment for her pregnancy cannot survive the strict scrutiny analysis.
III
The exercise of fundamental rights cannot be a vain endeavor. The State of Michigan remains bound by the decision in Roe v Wade that legalized abortion. To argue that a woman has a right to an abortion but that the government need not allow her access to this service renders Roe v Wade meaningless.
But for the United States Supreme Court decisions in Harris, Maher, and Beal, supra, several courts would find Medicaid limitations on abortions unconstitutional. Doe v Rampton, 366 F Supp 189 (D Utah, 1973) (Medicaid funding and the right to choose abortion are inseparable); Coe v Hooker, 406 F Supp 1072 (D NH, 1976) (abortion is an alternative treatment of pregnancy, and the state may not arbitrarily restrict a Medicaid recipient’s choice of treatment); McRae v Mathews, 421 F Supp 533 (ED NY, 1976) (the freedom to choose an abortion is an "unreal” right if indigents cannot receive Medicaid subsidy).3
Similarly, several states have enacted legislation that would provide government-funded abortions where an indigent woman has become pregnant as a result of rape or incest. Preterm, Inc v Dukakis, *705591 F2d 121 (CA 1, 1979), cert den 441 US 952 (1979), app dis 448 US 901 (1980); Doe v Busbee, 471 F Supp 1326, 1329 (ND Ga, 1979). These decisions represent a recognition on the part of legislatures that the choice to become pregnant in the first place does not always rest with a woman and, thus, the state need not penalize her when she is victimized. Section 109a permits no such recognition. Moreover, the inflexibility of § 109a exhibits the Michigan Legislature’s unwillingness to cooperate with the health needs of women requiring Medicaid assistance. Such action is reprehensible.
Contrary to the majority’s assumption, a Medicaid recipient’s access to private funds to finance a medically indicated abortion, or any medical treatment for that matter, is scarcely a reality in the State of Michigan.4 Jane Doe is hardly a prototype of pregnant indigent women, the majority of whom are not as fortuitous to have their situation addressed by the Michigan Supreme Court. Shortly after plaintiff Nancy Doe’s request for medical assistance for a first-trimester abortion for her daughter was denied, plaintiff Jane Doe was presented with private funds for her abortion. However, the availability of private funds for Jane Doe’s abortion can only be attributed to the notoriety of her situation.
As Justice Powell pointed out in Healy v James, 408 US 169, 183; 92 S Ct 2338; 33 L Ed 2d 266 (1972), "[w]e are not free to disregard the practical realities.” Michigan’s equal protection guarantees are based on the premise that laws must not unfairly prejudice similarly situated persons. The Michigan Legislature does not possess unlimited *706authority to enact laws on the basis of popular moralistic objectives that encroach upon constitutionally protected freedoms. See Marbury v Madison, 5 US (1 Cranch) 137; 2 L Ed 60 (1803). When this occurs, "the courts are entrusted with the responsibility to review and the power to nullify legislative acts which are repugnant to the constitution.” Manistee Bank, supra at 666.
The State of Michigan has accepted the responsibility of equitably providing medical services by enacting the Medicaid program. By denying an indigent woman access to a medically accepted and constitutionally protected abortion when medically indicated by her treating physician, the Legislature denies her equal protection under the law of the State of Michigan.
I would affirm the decision of the Court of Appeals that found that § 109a is unconstitutional under Michigan’s Constitution.

 MCL 400.1 et seq.; MSA 16.401 et seq.

 The federal constitution provides: "[no state shall] deny to any person within its jurisdiction the equal protection of the laws.” US Const, Am XIV, § 1. Michigan’s 1963 Constitution, art 1, § 1, provides: "All political power is inherent in the people. Government is instituted for their equal benefit, security and protection.” The 1963 constitution also provides: "No person shall be denied the equal protection of the laws . . . .” Const 1963, art 1, § 2.

 See Corns, supra at 389-391.

 See note, The effect of recent medicaid decisions on a constitutional right: Abortions only for the rich? 6 Fordham Urb L J 687, 710 (1978).