Those working to end abortion in the United States have a multilevel strategy that, at its apex, would overturn Roe v. Wade, the seminal case ensuring a woman’s right to an abortion. Further down the ladder, though, is where the fight over access gets messier, and abortion opponents have been steadily working to limit that access, bit by bit. In denying certiorari for an appeal against a lower court’s ruling against an Indiana law that prohibits clinics that perform abortion from receiving Medicaid funds, the U.S. Supreme Court issued a reminder that eroding access is not acceptable.
The argument that proponents of the Indiana law – and a similar one pending in Arizona – make is that in providing Medicaid funds for organizations that perform abortions, the government is indirectly funding the procedure by freeing up other money that the clinics otherwise would have to use. Because federal law does not allow for direct public funding of abortions, these laws test the bounds of just how far that limitation stretches. The Supreme Court, in denying review of the case, says not as far as Indiana and Arizona would like.
For clinics such as Planned Parenthood, which was at the heart of the Indiana case, the state and federal Medicaid money they receive is essential for providing a long list of critical health services completely unrelated to abortion. Cancer screenings, annual medical exams and birth control are key among these, and limiting their availability simply because the provider also performs politically charged procedures is the wrong way of going about changing abortion politics. What happens in the fallout of such a punitive approach is that women who cannot afford health care elsewhere would be without options for the basic health services that so many clinics provide – along with abortions.
The Supreme Court made clear with its refusal to consider the appeal that holding basic health services hostage to demands that abortion not be performed is going a bit far in the bid to end the practice. If the right to such services is guaranteed by the U.S. Constitution, which it is, then attempting work-arounds such as Indiana’s is unacceptable. These tests are continual, though, and as courts at all levels consider them, abortion policy across the country and state by state evolves according to the political, religious, moral and legal values of the given local, state or national community. State ballot initiatives that attempt to define personhood at conception, for example, continually have failed in Colorado and elsewhere, but the conversation continues. With the umbrella protection of Roe still intact, there are limits to that evolution and conversation that informs it.
That is, like it or not, the essence of the U.S. policymaking process and the interplay between the three branches of government.
