September 1993 Term
___________
Nos. 21924, 21925, 21926
___________
| WOMEN'S HEALTH CENTER OF WEST VIRGINIA, INC., WOMEN'S HEALTH
SERVICES, INC., AND WEST VIRGINIA FREE, ON BEHALF OF THEMSELVES AND ALL
MEDICAID-ELIGIBLE WOMEN IN WEST VIRGINIA, PLAINTIFFS BELOW, APPELLANTS,
AND THE WEST VIRGINIA CHAPTER OF THE NATIONAL ORGANIZATION FOR WOMEN,
INTERVENING PLAINTIFF, APPELLEE, AND KAREN A. CROSS, REBECCA A. ROMERO, CHARLOTTE S. SNEAD, DIANNE FOWLER, REV. WAYNE SWISHER, JAY GOULD, DR. RIC DAY, LINDA DAY, PHYLLIS MARTIN, KIM HALE, KAREN AUSTIN, LEONARD ANDERSON, KEITH WAGNER, DONNA BOLEY, ODELL HUFFMAN, BARBARA WARNER, BEN VEST, STEVE HARRISON, DICK HENDERSON, DANNY ELLIS, LARRY HENDRICKS, JOHN PINO, LARRY BORDER, TOM LOUISOS, JAY NESBITT, FARRELL JOHNSON, RON WALTERS, KENNETH ADKINS AND RANDY SCHOONOVER, TAXPAYERS AND CITIZENS OF THE STATE OF WEST VIRGINIA, AND WEST VIRGINIANS FOR LIFE, INC., A WEST VIRGINIA CORPORATION, INTERVENING DEFENDANTS BELOW, APPELLEES; WOMEN'S HEALTH CENTER OF WEST VIRGINIA, INC., WOMEN'S HEALTH SERVICES, INC., AND WEST VIRGINIA FREE, ON BEHALF OF THEMSELVES AND ALL MEDICAID-ELIGIBLE WOMEN IN WEST VIRGINIA, PLAINTIFFS BELOW, APPELLEES, AND THE WEST VIRGINIA CHAPTER OF THE NATIONAL ORGANIZATION FOR WOMEN, INTERVENING PLAINTIFF, APPELLANT, V. RUTH ANN PANEPINTO, PH.D., SECRETARY, WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES; AND NANCY J. TOLLIVER, COMMISSIONER, BUREAU OF ADMINISTRATION AND FINANCE, DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEFENDANTS BELOW, APPELLEES AND KAREN A. CROSS, REBECCA A. ROMERO, CHARLOTTE S. SNEAD, DIANNE FOWLER, REV. WAYNE SWISHER, JAY GOULD, DR. RIC DAY, LINDA DAY, PHYLLIS MARTIN, KIM HALE, KAREN AUSTIN, LEONARD ANDERSON, KEITH WAGNER, DONNA BOLEY, ODELL HUFFMAN, BARBARA WARNER, BEN VEST, STEVE HARRISON, DICK HENDERSON, DANNY ELLIS, LARRY HENDRICKS, JOHN PINO, LARRY BORDER, TOM LOUISOS, JAY NESBITT, FARRELL JOHNSON, RON WALTERS, KENNETH ADKINS AND RANDY SCHOONOVER, TAXPAYERS AND CITIZENS OF THE STATE OF WEST VIRGINIA, AND WEST VIRGINIANS FOR LIFE, INC., A WEST VIRGINIA CORPORATION, INTERVENING DEFENDANTS BELOW, APPELLEES; WOMEN'S HEALTH CENTER OF WEST VIRGINIA, INC., WOMEN'S HEALTH SERVICES, INC., AND WEST VIRGINIA FREE, ON BEHALF OF THEMSELVES AND ALL MEDICAID-ELIGIBLE WOMEN IN WEST VIRGINIA, PLAINTIFFS BELOW, APPELLEES, AND THE WEST VIRGINIA CHAPTER OF THE NATIONAL ORGANIZATION FOR WOMEN, INTERVENING PLAINTIFF, APPELLEE, V. RUTH ANN PANEPINTO, PH.D., SECRETARY, WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES; AND NANCY J. TOLLIVER, COMMISSIONER, BUREAU OF ADMINISTRATION AND FINANCE, DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEFENDANTS BELOW, APPELLEES AND KAREN A.
CROSS, REBECCA A. ROMERO, CHARLOTTE S. SNEAD, DIANNE FOWLER, REV. WAYNE
SWISHER, JAY GOULD, DR. RIC DAY, LINDA DAY, PHYLLIS MARTIN, KIM HALE,
KAREN AUSTIN, LEONARD ANDERSON, KEITH WAGNER, DONNA BOLEY, ODELL HUFFMAN,
BARBARA WARNER, BEN VEST, STEVE HARRISON, DICK HENDERSON, DANNY ELLIS,
LARRY HENDRICKS, JOHN PINO, LARRY BORDER, TOM LOUISOS, JAY NESBITT,
FARRELL JOHNSON, RON WALTERS, KENNETH ADKINS AND RANDY SCHOONOVER,
TAXPAYERS AND CITIZENS OF THE STATE OF WEST VIRGINIA, AND WEST VIRGINIANS
FOR LIFE, INC., A WEST VIRGINIA CORPORATION, INTERVENING DEFENDANTS BELOW,
APPELLANTS |
|
Appeal from the Circuit Court of Kanawha County. |
| For Women's Health Center: Roger Forman Forman & Crane Charleston, West Virginia Kathryn Kolbert Eve C. Gartner The Center for Reproductive Law & Policy New York, New York. |
| For Now: John M. Hedges Charleston, West Virginia Barbara Fleischauer Morgantown, West Virginia. |
| For Health & Human Resources: Thomas W. Woodward Deputy Attorney General Charleston, West Virginia. |
| For Cross, et al.: John Andrew Smith Stephen A. Weber Geoffry A. Haddad Kay, Casto, Chaney, Love & Wise Charleston, West Virginia. |
| Chief Justice Workman delivered the Opinion of the Court. Justice Brotherton Dissents and reserves the right to file a Dissenting opinion. Justice McHugh Dissents and reserves the right to file a Dissenting opinion. |
| The opinion of the court was delivered by: Chief Justice Workman |
|
SYLLABUS BY THE COURT |
| 1. "'The provisions of the Constitution of the State of West Virginia
may, in certain instances, require higher standards of protection than
afforded by the Federal Constitution.' Syllabus Point 2, Pauley v. Kelly,
162 W.Va. 672, 255 S.E.2d 859 (1979)." Syl. Pt. 1, State v. Bonham, 173
W.Va. 416, 317 S.E.2d 501 (1984). |
| 2. Under the rationale announced by this Court in United Mine Workers
v. Parsons, 172 W.Va. 386, 305 S.E.2d 343 (1983), we hold that when state
government seeks to act "for the common benefit, protection and security
of the people" in providing medical care for the poor, it has an
obligation to do so in a neutral manner so as not to infringe upon the
constitutional rights of our citizens. |
| 3. Given West Virginia's enhanced constitutional protections, we
conclude that the provisions of West Virginia Code § 9-2-11 (1993)
constitute undue government interference in violation of the state's
obligation to act neutrally with regard to the exercise of the federally
protected right to terminate a pregnancy. |
| 4. "Where there is an adequate procedural remedy which prevents a
statute from being unconstitutionally applied, the Court will, under the
doctrine of least obtrusive remedy, adopt such procedure to avoid
declaring a statute unconstitutional." Syl. Pt. 6, Waite v. Civil Serv.
Comm'n, 161 W.Va. 154, 241 S.E.2d 164 (1978). |
| Workman, Chief Justice: |
| Appellants challenge the August 25, 1993, order of the Circuit Court
of Kanawha County upholding the constitutionality of West Virginia §
9-2-11 (Supp. 1993), *fn1
which bans the use of state medicaid *fn2
funds for abortions except in limited circumstances. Those individuals and
organizations, to whom we collectively refer as Appellants, *fn3
claim that to deny those abortions which are determined to be "medically
necessary," *fn4
violates the West Virginia Constitution. After extensive consideration of
the submitted record, numerous briefs, and the arguments of counsel, we
conclude that West Virginia Code § 9-2-11 constitutes a discriminatory
funding scheme which violates an indigent woman's constitutional
rights. |
| Senate Bill 2, in essence a medicaid tax reform bill, was introduced
and passed by the Legislature during a second special session in May 1993.
Also contained within the provisions of Senate Bill 2 was the text of West
Virginia Code § 9-2-11. *fn5
A change in federal law prohibiting West Virginia from relying on the
fund-raising sources previously used to raise its share of medicaid funds
necessitated the drafting of Senate Bill 2. During the regular legislative
session, there was no public Discussion of adding any abortion-restrictive
riders to the medicaid tax reform bill. This language, the text of West
Virginia Code § 9-2-11, was added during the final hours of the second
extraordinary legislative session. Although Governor Caperton signed the
bill into law on June 4, 1993, he publicly stated his reservations
concerning the constitutionality of the abortion-funding restrictions
included in Senate Bill 2. *fn6 |
| On July 9, 1993, the Women's Health Center of West Virginia, Inc.,
Women's Health Services, Inc., and West Virginia Free, on behalf of
themselves and all medicaid-eligible women in West Virginia filed a
complaint in the Circuit Court of Kanawha County, seeking to have that
portion of Senate Bill 2, which became West Virginia Code § 9-2-11,
declared unconstitutional. Following a trial on this matter on August 11
and 12, the circuit court entered its ruling on August 25, 1993, declaring
the challenged portion of Senate Bill 2 constitutional. The circuit court
ordered Secretary Panepinto and Commissioner Tolliver to immediately
implement the subject provisions of Senate Bill 2 and West Virginia Code §
9-2-11, and denied Appellants' motion for a stay pending appeal absent the
posting of a $350,000 bond, which they were unable to post. On September
7, 1993, Appellees filed a motion with this Court requesting a stay
pending appeal, which we granted on that same date. *fn7 |
| In preface to the Discussion to follow, we borrow the opening comments
of another tribunal faced with similar issues: |
| At the outset, to dispel certain misconceptions that have appeared in
this case, we must clarify the precise, narrow legal issue before this
court. First, this case does not turn on the morality or immorality of
abortion, and most decidedly does not concern the personal views of the
individual Justices as to the wisdom of the legislation itself or the
ethical considerations involved in a woman's individual decision whether
or not to bear a child. Indeed, although in this instance the Legislature
has adopted restrictions which discriminate against women who choose to
have an abortion, similar constitutional issues would arise if the
Legislature--as a population control measure, for example--funded
[medicaid] . . . abortions but refused to provide comparable medical care
for poor women who choose childbirth. Thus, the constitutional question
before us does not involve a weighing of the value of abortion as against
childbirth, but instead concerns the protection of either procreative
choice from discriminatory governmental treatment. |
| Committee to Defend Reprod. Rights v. Myers, 29 Cal.3d 252, 256, 625
P.2d 779, 780, 172 Cal. Rptr. 866, 867 (1981) (emphasis
supplied). |
| Contrary to Appellees' representation, the question before this Court
is not whether the state is obligated to subsidize the exercise of a
woman's right to have an abortion. Rather, the issue presented is whether,
once the state undertakes funding of medical care for the poor, which
includes funding for childbirth, can the state deny funding for medically
necessary abortion services? More specifically, does the limitation of
funds to certain legislatively-specified reproductive services violate the
constitutional protections afforded the indigent female citizens of this
state? |
| We begin our analysis by addressing Appellees' contention that the
decision of the United States Supreme Court in Harris v. McRae, 448 U.S.
297, 65 L. Ed. 2d 784, 100 S. Ct. 2671 (1980), which upheld the funding
restrictions imposed by the Hyde Amendment, *fn8
should control the outcome of this case. At issue in Harris, was whether
the denial of public funding via the Medicaid program for certain
medically necessary abortions violated the liberty or equal protection
guarantees of the Due Process Clause of the Fifth Amendment or either of
the religion clauses of the First Amendment. 448 U.S. at 301. Recognizing
that a woman's decision whether to terminate her pregnancy falls within
the liberty protection of the Due Process Clause, the Court in Harris
ruled that: |
| it simply does not follow that a woman's freedom of choice carries
with it a constitutional entitlement to the financial resources to avail
herself of the full range of protected choices. The reason was explained
in Maher [v. Roe, 432 U.S. 464, 53 L. Ed. 2d 484, 97 S. Ct. 2376 (1977)]:
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 fact remains
that the Hyde Amendment 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. We are thus not persuaded that the Hyde
Amendment impinges on the constitutionally protected freedom of choice
recognized in [Roe v.] Wade [410 U.S. 113 (1973)]. |
| Id. at 317. The Court also rejected claims based on equal protection
and religion. Id. at 319-326. Appellees suggest that we adopt the
reasoning used in Harris and conclude that notwithstanding a woman's
fundamental right to have an abortion, the state is not required to
provide funding to enable the exercise of that right. |
| Conversely, Appellants maintain that this Court is not bound by the
Harris decision under the rationale that because the West Virginia
Constitution provides more expansive protections to its citizens than the
federal constitution, this state's constitutional protections prevail. See
Doe v. Maher, 40 Conn. Supp. 394, , 515 A.2d 134, 147 (1986) ("federal
decisional law is not a lid on the protections guaranteed under our state
constitution"). As support for this proposition, Appellants cite decisions
in seven states which have relied on the greater protections of their
respective state constitutions to find abortion-restrictive language in
entitlement programs unconstitutional. See Committee to Defend Reprod.
Rights v. Myers, 29 Cal.3d 252, 625 P.2d 779, 172 Cal. Rptr. 866; Maher,
40 Conn. Supp. 394, 515 A.2d 134; Moe v. Secretary of Admin. & Fin.,
382 Mass. 629, 417 N.E.2d 387 (1981); Right to Choose v. Byrne, 91 N.J.
287, 450 A.2d 925 (1982); Hope v. Perales, 189 A.D.2d 287, 595 N.Y.S.2d
948 (1993); Planned Parenthood Ass'n, Inc. v. Department of Human
Resources, 63 Ore. App. 41, 663 P.2d 1247 (1983), aff'd, 297 Or. 562, 687
P.2d 785 (1984); Doe v. Celani, No. S81-84CnC, (Vt. Super. Ct. May 26,
1986). |
| Those protections unique to our state constitution as contrasted to
the federal constitution are found in sections one, three, and ten of
article III. Section one of article III reads: |
| All men are, by nature, equally free and independent, and have certain
inherent rights, of which, when they enter into a state of society, they
cannot, by any compact, deprive or divest their posterity, namely: the
enjoyment of life and liberty, with the means of aquiring and possessing
property, and of pursuing and obtaining happiness and
safety. |
| W.Va. Const. art. III, § 1 (emphasis supplied). Nowhere in the United
States Constitution are the terms "equally free and independent" or
"safety" or comparable rights guaranteed. similarly, section three of
article III provides that: "Government is instituted for the common
benefit, protection and security of the people, nation or community."
W.Va. Const. art. III, § 3 (emphasis supplied). The federal constitution
is devoid of any language stating that the federal government is
instituted for the "common benefit" and "security" of its citizens.
Although our due process clause does not significantly differ in terms of
its language from the Fifth and Fourteenth Amendments to the federal
constitution, *fn9
this Court has determined repeatedly that the West Virginia Constitution's
due process clause is more protective of individual rights than its
federal counterpart. See State v. Bonham, 173 W.Va. 416, 317 S.E.2d 501
(1984). |
| In Bonham, this Court noted that, "the United States Supreme Court has
. . . recognized that a state supreme court may set its own constitutional
protections at a higher level than that accorded by the federal
constitution." 173 W.Va. at 418, 317 S.E.2d at 503 (citing, inter alia,
Connecticut v. Johnson, 460 U.S. 73, 81 n.9, 74 L. Ed. 2d 823, 103 S. Ct.
969 (1983)). Based on the principle that "'the provisions of the
Constitution of the State of West Virginia may, in certain instances,
require higher standards of protection than afforded by the Federal
Constitution[,]' Syllabus Point 2, Pauley v. Kelly, 162 W.Va. 672, 255
S.E.2d 859 (1979)," we ruled in Bonham, that this state's due process
clause affords a criminal defendant greater protections than the federal
counterpart. 173 W.Va. at 418-19, 317 S.E.2d at 503-04 and Syl. Pt. 1
(holding that imposition of more severe sentence following trial de novo
does violate defendant's due process rights); see also West Virginia
Citizens Action Group v. Daley, 174 W.Va. 299, 324 S.E.2d 713 (1984)
(state constitution compels striking limitation on soliciting after sunset
even if federal constitution does not); Woodruff v. Board of Trustees of
Cabell Huntington Hospital, 173 W.Va. 604, 611, 319 S.E.2d 372, 379 (1984)
(Article III, § 1 "more stringent in its limitation on waiver [of
fundamental rights] than is the federal constitution"); Pushinsky v. West
Virginia Board of Law Examiners, 164 W.Va. 736, 266 S.E.2d 444 (1980)
(recognizing that state constitution imposes more stringent limitations on
power of state to inquire into lawful associations and speech than those
imposed by federal constitution); Pauley v. Kelly, 162 W.Va. 672, 707, 255
S.E.2d 859, 878 (1979) (ruling that education is a "fundamental
constitutional right"); see generally Justice Thomas B. Miller, The New
Federalism in West Virginia, 90 W.Va. L. Rev. 51 (1987-88). |
| The provision of enhanced guarantees for "the enjoyment of life and
liberty . . . and safety" by our state constitution both permits and
requires us to interpret those guarantees independent from federal
precedent. W.Va. Const. art. III, § 1. Accordingly, we are not bound by
federal precedent in interpreting issues of constitutional law arising
from these enhanced guarantees. See Bonham, 173 W.Va. at 418, 317 S.E.2d
at 503. Furthermore, because we are permitted to elevate our
constitutional protections, we are similarly free to reject federal
precedent such as Harris. See 448 U.S. 297. We do just that
today. |
| Under Roe v. Wade, 410 U.S. 113, 35 L. Ed. 2d 147, 93 S. Ct. 705
(1973), the constitutional basis for granting a woman choice with regard
to pregnancy termination is grounded in the "Fourteenth Amendment's
concept of personal liberty and restrictions upon state action." Id. at
153. In the most recent United States Supreme Court decision on the issue,
the Court reiterated the central premise of Roe--that women may, for some
time period, make independent decisions to obtain abortions based on the
right to privacy. Planned Parenthood v. Casey, 120 L. Ed. 2d 674, 112
S.Ct. 2791, 2811-12 (1992). Appellees claim, however, that West Virginia
has not recognized a parallel fundamental right to privacy under our state
constitution similar to that recognized in Roe. See 410 U.S. at 152-53.
Because there is a federally-created right of privacy that we are required
to enforce in a non-discriminatory manner, it is inconsequential that no
prior decision of this Court expressly determines the existence of an
analogous right. |
| Appellants note that if an indigent woman who is receiving Aid to
Families with Dependent Children (AFDC) benefits, receives a gift or
donation, earns additional income, or borrows funds to pay for an
abortion, that money is required to be reported to the Department of Human
Resources ("DHS") and may render the woman inelegible to receive continued
benefits. As attested to by John A. Boles, Jr., the Director of the Office
of Income Maintenance within the DHS, even a gift, donation, loan, or
extra income in the amount of $333 "would, in most cases, disqualify a
recipient for at least one month, and could possibly disqualify the
recipient for several months." *fn10
Thus, indigent women who are forced to secure funds to pay for an abortion
are, in effect, penalized for the exercise of a constitutional right.
Moreover, the penalty is realized not only by the women, but also by their
families through the loss of funds which would have been received if not
for the exercise of a constitutional right. |
| Furthermore, Appellants point out that the provisions of West Virginia
Code § 9-2-11 necessarily impinge on the health and safety of poor women.
To illustrate how the denial of funding for medically necessary abortions
impacts negatively on the safety of indigent women, Appellants identify
those types of health concerns that may warrant an abortion which are not
covered by West Virginia Code § 9-2-11. Specific examples of medical
conditions which may necessitate performing an abortion are hypertension
which places pregnant women at higher risk for strokes, premature placenta
separation, and a severe bleeding disorder. Other medical conditions which
may place the mother's health in jeopardy if she continues the pregnancy
include gestational diabetes, epilepsy, and phlebitis. In certain
instances, as in the case of phlebitis, the drugs used to prevent blood
clotting in the lungs are dangerous to the fetus and cannot be
administered if the woman is pregnant. In the case of malignant breast
tumors, pregnancy may actually accelerate the growth of the tumors.
According to the submitted record, many of these problems occur with
greater frequency among low-income women. *fn11 |
| Given that the term safety, by definition, conveys protection from
harm, it stands to reason that the denial of funding for abortions that
are determined to be medically necessary both can and most likely will
affect the health and safety of indigent women in this state. To deny this
Conclusion requires that we similarly deny the reality of being poor. The
question then becomes whether this arguable impingement on safety
resulting from the provisions of West Virginia Code § 9-2-11 rises to the
level of impermissible state action. |
| The United States Supreme Court explained in Maher, |
| The Constitution imposes no obligation on the States to pay the
pregnancy-related medical expenses of indigent women, or indeed to pay any
of the medical expenses of indigents. But when a State decides to
alleviate some of the hardships of poverty by providing medical care, the
manner in which it dispenses benefits is subject to constitutional
limitations. |
| 432 U.S. at 469-70 (emphasis supplied and footnote omitted). The Court
ruled in Maher that Connecticut regulations which excluded funding for
nontherapeutic abortions did not violate the Equal Protection Clause of
the Fourteenth Amendment. Id. at 479-80. The oft-quoted reasoning of the
Court in Maher was that: |
| The Connecticut regulation places no obstacles--absolute or
otherwise--in the pregnant woman's path to an abortion. An indigent woman
who desires an abortion suffers no disadvantage as a consequence of
Connecticut's decision to fund childbirth; she continues as before to be
dependent on private sources for the service she desires. The State may
have made childbirth a more attractive alternative, thereby influencing
the woman's decision, but it has imposed no restriction on access to
abortions that was not already there. The indigency that may make it
difficult--and in some cases, perhaps impossible--for some women to have
abortions is neither created nor in any way affected by the Connecticut
regulation. |
| Id. at 474. Perhaps just as frequently-quoted is Justice Brennan's
response to this reasoning: |
| As a practical matter, many indigent women will feel they have no
choice but to carry their pregnancies to term because the State will pay
for the associated medical services, even though they would have chosen to
have abortions if the State had also provided funds for that procedure, or
indeed if the State had provided funds for neither procedure. This
disparity in funding by the State clearly operates to coerce indigent
pregnant women to bear children they would not otherwise choose to have,
and just as clearly, this coercion can only operate upon the poor, who are
uniquely the victims of this form of financial pressure. |
| Maher, 432 U.S. at 483 (Brennan, J., Dissenting). As noted above, the
potential denial of AFDC benefits upon borrowing, earning, or receiving
funds to pay for an abortion is yet another illustration of how indigent
women are coerced by the State to have children which they might otherwise
choose not to bear. |
| Appellees strenuously argue that the state is not obligated to pay for
the exercise of constitutional rights. While this proposition is true as
stated, it is equally true that once a government chooses to dispense
funds, it must do so in a non-discriminatory fashion, and it certainly
cannot withdraw benefits for no reason other than that a woman chooses to
avail herself of a federally-granted constitutional right. See Maher, 432
U.S. at 469-70; accord Moe, 382 Mass. at , 417 N.E.2d at 402; Byrne, 91
N.J. at 306-07, 450 A.2d at 935. As noted in Moe, |
| the Legislature need not subsidize any of the costs associated with
child bearing, or with health care generally. However, once it chooses to
enter the constitutionally protected area of choice, it must do so with
genuine indifference. It may not weigh the options open to the pregnant
woman by its allocation of public funds; in this area, government is not
free to 'achieve with carrots what [it] is forbidden to achieve with
sticks.' |
| 382 Mass. at , 417 N.E.2d at 402 (quoting Lawrence Tribe, American
Constitutional Law, § 15-10 at 933 n.77 (1978)). |
| The concept invoked by selective governmental funding is the issue of
government neutrality. We have previously determined that the common
benefit clause of article III, section 3 of the West Virginia Constitution
imposes an "obligation upon state government . . . to preserve its
neutrality when it provides a vehicle" for the exercise of constitutional
rights. United Mine Workers v. Parsons, 172 W.Va. 386, 398, 305 S.E.2d
343, 354 (1983). We characterized article III, section 3 as an "equal
protection clause" that serves the goal of "fundamental fairness." Id.
Under this rationale, we ruled that while there was no constitutional
mandate to sell air time to anyone, once West Virginia University sold
broadcast time to the coal industry for the presentation of "a politically
controversial issue of public concern," the University was required to
sell equal air time to the coal miners' union to permit contrasting
viewpoints. Id. Furthermore, we noted in Parsons, that the obligation of
the government to act for the "common benefit, protection, and security"
of its citizens is "as applicable in the [arena of free speech] . . . as
it is in any other context." Id. |
| In reliance on Parsons, Appellants argue that strict neutrality is
mandated whenever state government operates to assist
constitutionally-protected decisions. In resolving this same issue of
neutrality, the Massachusetts Supreme Court looked to the views Justice
Brennan expressed in his Dissent to Harris: |
| 'In every pregnancy, [either medical procedures for its termination,
or medical procedures to bring the pregnancy to term are] medically
necessary, and the poverty-stricken woman depends on the Medicaid Act to
pay for the expenses associated with [those] procedure[s]. But under [this
restriction], the Government will fund only those procedures incidental to
childbirth. By thus injecting coercive financial incentives favoring
childbirth into a decision that is constitutionally guaranteed to be free
from governmental intrusion, [this restriction] deprives the indigent
woman of her freedom to choose abortion over maternity, thereby impinging
on the due process liberty right recognized in Roe v. Wade.
' |
| Moe, 417 N.E.2d at 402 (quoting Harris, 448 U.S. at 333, Brennan, J.
Dissenting). |
| Appellants urge this Court to accept the reasoning articulated by
Justice Brennan and others that by denying funding for medically necessary
abortions while funding childbirth, the state impermissibly pressures
women towards a state-approved reproductive choice. The effect of such
restrictions is inherently coercive where a woman is too poor to afford
appropriate medical care: |
| From a realistic perspective, we cannot characterize the statutory
scheme as merely providing a public benefit which the individual recipient
is free to accept or refuse without any impairment of her constitutional
rights. On the contrary, the state is utilizing its resources to ensure
that women who are too poor to obtain medical care on their own will
exercise their right of procreative choice only in the manner approved by
the state. |
| Meyers, 29 Cal.3d at 276, 625 P.2d at 793, 172 Cal. Rptr. at 880.
Appellants suggest and we agree that for an indigent woman, the state's
offer of subsidies for one reproductive option and the imposition of a
penalty for the other necessarily influences her federally-protected
choice. Under the rationale announced by this Court in Parsons, we hold
that when state government seeks to act "for the common benefit,
protection and security of the people" in providing medical care for the
poor, it has an obligation to do so in a neutral manner so as not to
infringe upon the constitutional rights of our citizens. See 172 W.Va. at
398, 305 S.E.2d at 354. |
| While Appellees prefer to characterize this case as one involving
guarantees of state funding to carry out a protected right, what is really
at issue here is "the right of the individual . . . [to be] free from
undue government interference, not an assurance of government funding."
Byrne, 91 N.J. at 307, 450 A.2d at 935 n.5. Given West Virginia's enhanced
constitutional protections, we cannot but conclude that the provisions of
West Virginia Code § 9-2-11 constitute undue government interference with
the exercise of the federally-protected right to terminate a pregnancy. As
we have discussed above, were it not for this state's undertaking to
provide medically necessary care to the poor through entitlement
programming such as medicaid, it would not be operating in violation of
its obligation to act neutrally for the common benefit of its citizens by
enacting legislation such as West Virginia Code § 9-2-11, the effect of
which is forced compliance with legislated reproductive
policy. |
| Having concluded that the provisions of West Virginia are
unconstitutional, all that remains is to fashion a remedy. In syllabus
point six of Waite v. Civil Service Commission, 161 W.Va. 154, 241 S.E.2d
164 (1978) we held that: "where there is an adequate procedural remedy
which prevents a statute from being unconstitutionally applied, the Court
will, under the doctrine of least obtrusive remedy, adopt such procedure
to avoid declaring a statute unconstitutional." Accord, State ex rel.
Harris v. Calendine, 160 W.Va. 172, 177, 233 S.E.2d 318, 323 (1977); Syl.
Pt. 4, State ex rel. Alsop v. McCartney, 159 W.Va. 829, 228 S.E.2d 278
(1976). Accordingly, we conclude that that portion of Senate Bill 2 which
is West Virginia Code § 9-2-11 is severable from the remainder of Senate
Bill 2 under the general severability clause applicable to all statutes,
West Virginia Code § 2-2-10(cc) (1990), because there is no provision in
any section of chapter nine of the Code which prohibits severability and
because the remaining parts of Senate Bill 2 are complete and capable of
standing alone. |
| Based on the foregoing, we hereby reverse and remand the decision of
the Circuit Court of Kanawha County for entry of an order reflecting the
rulings herein. |
| Reversed and remanded. |
|
|
| Opinion Footnotes |
|
|
| *fn1
West Virginia Code § 9-2-11 imposes the following limitations on the use
of medicaid funds: |
| (a) No funds from the medicaid program accounts may be used to pay for
the performance of an abortion by surgical or chemical means
unless: |
| (1) On the basis of the physician's best clinical judgment, there
is: |
| (i) A medical emergency that so complicates a pregnancy as to
necessitate an immediate abortion to avert the death of the mother or for
which a delay will create grave peril of irreversible loss of major bodily
function or an equivalent injury to the mother: Provided, That an
independent physician concurs with the physician's clinical judgment;
or |
| (ii) Clear clinical medical evidence that the fetus has severe
congenital defects or terminal disease or is not expected to be delivered;
or |
| (2) The individual is a victim of incest or the individual is a victim
of rape when the rape is reported to a law-enforcement
agency. |
| (b) The Legislature intends that the state's medicaid program not
provide coverage for abortion on demand and that abortion services be
provided only as expressly provided for in this section. |
| *fn2
Medicaid is a joint federal-state entitlement program that provides
funding for various medical services to the poor. See 42 U.S.C.A. § 1396b
(West 1992 & Supp. 1993). |
| *fn3
The Appellants include the following groups and individuals: Women's
Health Center of West Virginia, Inc., Women's Health Services, Inc., West
Virginia Free, on behalf of themselves and all medicaid-eligible women in
West Virginia, the West Virginia Chapter of N.O.W., Ruth Ann Panepinto,
Secretary, West Virginia Department of Health and Human Services, and
Nancy J. Tolliver, Commissioner, Bureau of Administration and Finance,
Department of Health and Human Resources. |
| *fn4
Under federal law and regulations, all medical services must be "medically
necessary." See 42 U.S.C.A. §§ 1396, 1396a(a)(10)(A), 1396d(a) (West 1992
& Supp. 1993). For determining whether a submitted medical expense
qualifies as medically necessary, the West Virginia Department of Health
and Human Services has adopted Policy No. MA-85-4, which provides that the
Department: "makes rebursement for pregnancy termination when it is
determined to be medically advisable by the attending physician in light
of physical, emotional, psychological, familial, or age factors (or a
combination thereof) relevant to the well-being of the
patient." |
| *fn5
During oral argument, counsel for N.O.W. advised the Court that the same
language of West Virginia Code § 9-2-11, which passed when tacked on to
the medicaid tax reform bill, had previously been submitted as a separate
bill on twenty-three separate occasions and failed each
time. |
| *fn6
In fact, the Governor instituted a civil action in the Circuit Court of
Kanawha County on June 7, 1993, against the Secretary of the West Virginia
Department of Health and Human Services for the purpose of having the
abortion-restrictive language contained in Senate Bill 2 declared
unconstitutional. This action was dismissed pursuant to defendant's Rule
12(b)(6) motion for lack of justiciable controversy and because the
Governor had waived his right to bring the action, having signed and not
vetoed the legislation. See W.Va. R. Civ. P. 12(b)(6). |
| *fn7
The Appellants similarly filed a motion seeking a stay pending appeal with
this Court. Having already granted the stay motion filed by Appellees, we
denied Appellants' stay motion as moot. |
| *fn8
The Hyde Amendment, the federal counterpart to West Virginia Code §
9-2-11, which was in effect at the time of the Harris decision
provided: |
| 'None of the funds provided by this joint resolution [Medicaid
funding] shall be used to perform abortions except where the life of the
mother would be endangered if the fetus were carried to term; or except
for such medical procedures necessary for the victims of rape or incest
when such rape or incest has been reported promptly to a law enforcement
agency or public health service.' |
| Harris, 448 U.S. at 302 (quoting from the version of the Hyde
amendment in effect for fiscal year 1980, Pub. L. No. 96-123, § 109, 93
Stat. 926). The current Hyde Amendment reads: |
| None of of the funds contained in this Act shall be used to perform
abortions except where the life of the mother would be endangered if the
fetus were carried to term. |
| Pub. L. No. 102-170, § 203, 105 Stat. 1126 (1992). |
| *fn9
The due process clause provides: "No person shall be deprived of life,
liberty, or property, without due process of law . . . ." W.Va. Const.
art. III, § 10. |
| *fn10
"In order to qualify for AFDC, income and assets are compared to maximum
limits which include $1,000 in assets (excluding their home furnishings
and $1,500 in equity value in a motor vehicle), and an income less than 26
percent of the Federal Poverty Level." Affidavit of John A. Boles,
Jr. |
| *fn11
See affidavit of Ward W. Maxson, M.D. |