Abortion on demand in a post-Wade context: must the state pay the bills?

The legal issues involved with the application of the United States Supreme Court decisions in Roe v. Wade and Doe v. Bolton (1973) are reveiwed, particularly the question of whether an indigent pregnant woman now has the right to abortion on demand at public expense. The 2 decisions, based on the Fourteenth Amendment, established that a woman, in consultation with her physician, must be free to choose to terminate her pregnancy, at least in the first trimester. State laws are permitted only to regulate abortion procedures in the second trimester and may only regulate or proscribe abortion itself after the fetus becomes viable. The Court did not rule that indigents had a corollary right to the implementation of abortion, and thus free abortions do not appear to be constitutionally required. However, depending on the type of Medicaid coverage in which the individual state is participating, the medically indigent may receive Medicaid benefits for abortions, at least in the first trimester. Since Medicaid is voluntary for the state, it could drop out of the program entirely or the Congress could specifically exclude abortions from Medicaid coverage. Both actions appear unlikely, however, and abortions for medical reasons clearly seem to fall under Medicaid's purpose. Consequently, despite the Wade and Bolton decisions, the right to abortion is limited by the ability of indigents to pay for it. In the light of the serious complications of illegal abortion, it is concluded that legislators should insure the availability of legal abortions. Such a move would not in itself encourage abortions but would properly extend the right to abortion to all citizens.