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Limiting Governmental Support

The most perverse aspect of abortion law in the United States is that it affects only poor women. The Supreme Court has ruled that it is not discriminatory for a governmental agency to refuse to pay for medical care that is otherwise available in the medical marketplace. Most states and the federal government will not allow the use of governmental funds to pay for abortions or abortion referral services. The restrictions on the federal Title X family planning grants are typical:

Because Title X funds are intended only for family planning, once a client served by a Title X project is diagnosed as pregnant, she must be referred for appropriate prenatal and/or social services by furnishing a list of available providers that promote the welfare of mother and unborn child. ... A Title X project may not use prenatal, social service or emergency medical or other referrals as an indirect means of encouraging or promoting abortion as a method of family planning, such as by weighing the list of referrals in favor of health care providers which perform abortions, by including on the list of referral providers health care providers whose principal business is the provision of abortions, by excluding available providers who do not provide abortions, or by "steering" clients to providers who offer abortion as a method of family planning. (42 CFR sec. 59.8)

These restrictions were recently upheld by the U.S. Supreme Court, which found that the regulations did not interfere with physicians' right of free speech. Referring to its previous decisions upholding the right of the government not to fund abortions, the Court reiterated the rule that refusing to fund the exercise of a right is not the same as prohibiting that right. As with other voluntary employment situations, the Court found that the employer has the right to restrict the workplace activities:


The same principles apply to petitioners' claim that the regulations abridge the free speech rights of the grantee's staff. Individuals who are voluntarily employed for a Title X project must perform their duties in accordance with the regulation's restrictions on abortion counseling and referral. The employees remain free, however, to pursue abortion related activities when they are not acting under the auspices of the Title X project. The regulations, which govern solely the scope of the Title X project's activities, do not in any way restrict the activities of those persons acting as private individuals. The employees' freedom of expression is limited during the time that they actually work for the project; but this limitation is a consequence of their decision to accept employment in a project, the scope of which is permissibly restricted by the funding authority.[176]

[176]Rust v. Sullivan. 111 S. Ct. 1759 (1991).


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