U.S. Supreme Court
WILLIAMS v. ZBARAZ, 448 U.S. 358 (1980)
448 U.S. 358
WILLIAMS ET AL. v. ZBARAZ ET AL.
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ILLINOIS.
No. 79-4.
Argued April 21, 1980.
Decided June 30, 1980.*
[Footnote *] Together with No. 79-5,
Miller, Acting Director, Department of Public Aid of Illinois, et al. v. Zbaraz
et al., and No. 79-491, United States v. Zbaraz et al., also on appeal from the
same court.
Appellees brought a class action in Federal District Court under 42 U.S.C.
1983 to enjoin, on both federal statutory and constitutional grounds,
enforcement of an Illinois statute prohibiting state medical assistance payments
for all abortions except those necessary to save the life of the woman seeking
the abortion. The District Court, granting injunctive relief, held that Title
XIX of the Social Security Act, which established the Medicaid program, and the
regulations promulgated thereunder require a participating State under such
program to provide funding for all medically necessary abortions, and that the
so-called Hyde Amendment prohibiting the use of federal funds to reimburse the
costs of certain medically necessary abortions does not relieve a State of its
independent obligation under Title XIX to provide Medicaid funding for all
medically necessary abortions. The Court of Appeals reversed, holding that the
Hyde Amendment altered Title XIX in such a way as to allow States to limit
funding to the categories of abortions specified in that Amendment, but that a
participating State may not, consistent with Title XIX, withhold funding of
those medically necessary abortions for which federal reimbursement is available
under the Hyde Amendment, and the case was remanded to the District Court for
modification of its injunction and with directions to consider the
constitutionality of the Hyde Amendment. The District Court then held that both
the Illinois statute and the Hyde Amendment violate the equal protection
guarantee of the Constitution insofar as they deny funding for "medically
necessary abortions prior to the point of fetal viability."
Held:
1. The District Court lacked jurisdiction to consider the
constitutionality of the Hyde Amendment, for the court acted in the absence
of a case or controversy sufficient to permit an exercise of judicial power
under Art. III of the Constitution. None of the parties ever challenged the
validity of the Hyde Amendment, and appellees could have been awarded all
the relief sought entirely on the basis of the District Court's [448 U.S. 358, 359] ruling as to the Illinois statute.
The constitutionality of the Hyde Amendment was interjected as an issue only
by the Court of Appeals' erroneous mandate, which could not create a case or
controversy where none otherwise existed. P. 367.
2. Notwithstanding that the District Court had no jurisdiction to declare
the Hyde Amendment unconstitutional, this Court has jurisdiction under 28
U.S.C. 1252 over the "whole case," and thus may review the other issues
preserved by these appeals. McLucas v. DeChamplain, 421 U.S. 21. Pp.
367-368.
3. A participating State is not obligated under Title XIX to pay for those
medically necessary abortions for which federal reimbursement is unavailable
under the Hyde Amendment. Harris v. McRae, ante, at 306-311. P. 369.
4. The funding restrictions in the Illinois statute, comparable to those in
the Hyde Amendment, do not violate the Equal Protection Clause of the
Fourteenth Amendment. Harris v. McRae, ante, at 324-326. P. 369.
469 F. Supp. 1212, vacated and remanded.
STEWART, J., delivered the opinion of the Court, in which BURGER, C. J., and
WHITE, POWELL, and REHNQUIST, JJ., joined. BRENNAN, J., filed a dissenting
opinion, in which MARSHALL and BLACKMUN, JJ., joined, ante, p. 329. MARSHALL,
J., ante, p. 337, BLACKMUN, J., ante, p. 348, and STEVENS, J., ante, p. 349,
filed dissenting opinions.
Victor G. Rosenblum argued the cause for appellants in No. 79-4. With him on
the briefs were Dennis J. Horan, John D. Gorby, and Patrick A. Trueman. William
A. Wenzel III, Special Assistant Attorney General of Illinois, argued the cause
for appellants in No. 79-5. With him on the briefs were William J. Scott,
Attorney General, and James C. O'Connell and Ellen P. Brewin, Special Assistant
Attorneys General. Solicitor General McCree argued the cause for the United
States in No. 79-491. With him on the briefs were Assistant Attorney General
Daniel and Eloise E. Davies.
Robert W. Bennett argued the cause for appellees in each case. With him on
the brief were Lois J. Lipton, David Goldberger, Aviva Futorian, Robert E.
Lehrer, and James D. Weill.Fn
Fn [448 U.S. 358, 359] Briefs of amici
curiae urging reversal in all cases were filed by Robert
[448 U.S. 358, 360] B. Hansen, Attorney General, Paul M. Tinker,
Assistant Attorney General, and Lynn D. Wardle for the State of Utah; by Bronson
C. La Follette, Attorney General of Wisconsin, F. Joseph Sensenbrenner, Jr.,
Assistant Attorney General, and William J. Brown, Attorney General of Ohio, for
the States of Wisconsin et al.; by George E. Reed and Patrick F. Geary for the
United States Catholic Conference; and by Daniel J. Popeo for the Washington
Legal Foundation. John J. Degnan, Attorney General, Erminie L. Conley, Assistant
Attorney General, and Andrea M. Silkowitz, Deputy Attorney General, filed a
brief for the State of New Jersey as amicus curiae urging reversal in No. 79-5.
James Bopp, Jr., and David D. Haynes filed a brief for the National Right to
Life Committee, Inc., as amicus curiae urging reversal in No. 79-4. Briefs of
amici curiae urging affirmance in all cases were filed by Paul Bender, Thomas
Harvey, and Roland Morris for Jane Roe et al.; and by Margo K. Rogers and Eve W.
Paul for the Planned Parenthood Federation of America, Inc., et al. Briefs of
amici curiae in all cases were filed by Francis X. Bellotti, Attorney General of
Massachusetts, Garrick F. Cole, Assistant Attorney General, John D. Ashcroft,
Attorney General of Missouri, Paul L. Douglas, Attorney General of Nebraska, and
William J. Brown, Attorney General of Ohio, for the Commonwealth of
Massachusetts et al.; by Dorothy T. Lang for the Physicians National Housestaff
Association et al.; and by Francis D. Morrissey for Certain Physicians,
Professors and Fellows of the American College of Obstetrics and Gynecology. [448 U.S. 358, 360]
MR. JUSTICE STEWART delivered the opinion of the Court.
This suit was brought as a class action under 42 U.S.C. 1983 in the District
Court for the Northern District of Illinois to enjoin the enforcement of an
Illinois statute that prohibits state medical assistance payments for all
abortions except those "necessary for the preservation of the life of the woman
seeking such treatment."1 The plaintiffs were [448 U.S.
358, 361] two physicians who perform medically necessary abortions for
indigent women, a welfare rights organization, and Jane Doe, an indigent
pregnant woman who alleged that she desired an abortion that was medically
necessary, but not necessary to save her life. The defendant was the Director of
the Illinois Department of Public Aid, the agency charged with administering the
State's medical assistance programs.2 Two other physicians intervened as defendants.
The plaintiffs challenged the Illinois statute on both federal statutory and
constitutional grounds. They asserted, first, that Title XIX of the Social
Security Act, commonly known as the "Medicaid" Act, 42 U.S.C. 1396 et seq. (1976
ed. and Supp. II), requires Illinois to provide coverage in its Medicaid plan
for all medically necessary abortions, whether or not the life of the pregnant
woman is endangered. Second, the plaintiffs argued that the public funding by
the State of medically necessary services generally, but not of certain
medically necessary abortions, violates the Equal Protection Clause of the
Fourteenth Amendment. [448 U.S. 358, 362]
The District Court initially held that it would abstain from considering the
complaint until the state courts had construed the challenged statute.3 The plaintiffs appealed, and the Court of Appeals for the
Seventh Circuit reversed. Zbaraz v. Quern, 572 F.2d 582. The appellate court
held that abstention was inappropriate under the circumstances, and remanded the
case for further proceedings, including consideration of the plaintiffs' motion
for a preliminary injunction. On remand, the District Court certified two
plaintiff classes: (1) a class of all pregnant women eligible for the Illinois
medical assistance programs who desire medically necessary, but not
life-preserving, abortions, and (2) a class of all Illinois physicians who
perform medically necessary abortions for indigent women and who are certified
to obtain reimbursement under the Illinois medical assistance programs.
Addressing the merits of the complaint, the District Court concluded that
Title XIX and the regulations promulgated thereunder require a participating
State under the Medicaid program to provide funding for all medically necessary
abortions. According to the District Court, the so-called "Hyde Amendment" -
under which Congress has prohibited the use of federal funds to reimburse the
costs of certain medically necessary abortions4
- does not relieve a State of its independent
[448 U.S. 358, 363]
obligation under Title XIX to provide Medicaid funding for all medically
necessary abortions. Thus, the District Court permanently enjoined the
enforcement of the Illinois statute insofar as it denied payments for abortions
that are "medically necessary or medically indicated according to the
professional medical judgment of a licensed physician in Illinois, exercised in
light of all factors affecting a woman's health."
The Court of Appeals again reversed. Zbaraz v. Quern, 596 F.2d 196. Reaching
the same conclusion as had the Court of Appeals for the First Circuit in
Preterm, Inc., v. Dukakis, 591 F.2d 121, the court held that the Hyde Amendment
"alters Title XIX in such a way as to allow states to limit funding to the
categories of abortions specified in that amendment." 596 F.2d, at 199. It
further held, however, that a participating State may not, consistent with Title
XIX, withhold funding for those medically necessary abortions for which federal
reimbursement is available under the Hyde Amendment.5 Accordingly, the case was remanded to the
District [448 U.S. 358, 364] Court with
instructions that the permanent injunction be modified so as to require
continued state funding only "for those abortions fundable under the Hyde
Amendment."6 Id., at 202. The Court of Appeals also
directed the District Court to proceed expeditiously to resolve the
constitutional questions it had not reached. The District Court was specifically
directed to consider "whether the Hyde Amendment, by limiting funding for
abortions to certain circumstances even if such abortions are medically
necessary, violates the Fifth Amendment." Ibid. (footnote omitted).
On the second remand, the District Court notified the Attorney General of the
United States that the constitutionality of an Act of Congress had been drawn
into question, and the United States intervened, pursuant to 28 U.S.C. 2403 (a),
to defend the constitutionality of the Hyde Amendment.7 [448 U.S. 358, 365]
Zbaraz v. Quern, 469 F. Supp. 1212, 1215, n.3. In view of the fact that the
plaintiffs had not challenged the Hyde Amendment, but rather only the Illinois
statute, the District Court expressed misgivings about the propriety of passing
on the constitutionality of the federal law. But noting that the same reasoning
would apply in determining the constitutional validity of both the Illinois
statute and the Hyde Amendment, the District Court observed: "Although we are
not persuaded that the federal and state enactments are inseparable and would
hesitate to inject into the proceeding the issue of the constitutionality of a
law not directly under attack by plaintiffs, we are obviously constrained to
obey the Seventh Circuit's mandate. Therefore, while our discussion of the
constitutional questions will address only the Illinois statute, the same
analysis applies to the Hyde Amendment and the relief granted will encompass
both laws." Ibid.
The District Court then concluded that both the Illinois statute and the Hyde
Amendment are unconstitutional insofar as they deny funding for "medically
necessary abortions prior to the point of fetal viability." Id., at 1221. If the
public funding of abortions were restricted to those covered by the Hyde
Amendment, the District Court thought that the effect would "be to increase
substantially maternal morbidity and mortality among indigent pregnant women."
Id., at 1220. The District Court held that the state and federal funding
restrictions violate the constitutional standard of equal protection because
"a pregnant woman's interest in her health so outweighs any possible state
interest in the life of a non-viable fetus that, for a woman medically in
need of an abortion, the state's interest is not legitimate. At the point of
viability, however, `the relative weights of the respective interests
involved' shift, thereby legitimizing the state's interests. After that
point, therefore, . . . a state may withhold funding for medically necessary
abortions that [448 U.S. 358, 366]
are not life-preserving, even though it funds all other medically necessary
operations." Id., at 1221.
Accordingly, the District Court enjoined the Director of the Illinois
Department of Public Aid from enforcing the Illinois statute to deny payment
under the state medical assistance programs for medically necessary abortions
prior to fetal viability.8 The District Court did not, however, enjoin
any action by the United States.
The intervening-defendant physicians, the Director of the Illinois Department
of Public Aid, and the United States each appealed directly to this Court,
averring jurisdiction under 28 U.S.C. 1252. This Court consolidated the appeals
and postponed further consideration of the question of jurisdiction until the
hearing on the merits. 444 U.S. 962.
I
The asserted basis for this Court's jurisdiction over these
appeals is 28 U.S.C. 1252, which provides in relevant part:
"Any party may appeal to the Supreme Court from an interlocutory or final
judgment, decree or order of any court of the United States . . . holding an
Act of Congress unconstitutional in any civil action, suit, or proceeding to
which the United States or any of its agencies, or any officer or employee
thereof, as such officer or employee, is a party."
It is quite obvious that the literal requirements of 1252 are satisfied in
the present cases, for these appeals were taken from the final judgment of a
federal court declaring unconstitutional an Act of Congress - the Hyde Amendment
- in a [448 U.S. 358, 367] civil action to which the United
States was a party by reason of its intervention pursuant to 28 U.S.C. 2403 (a).
It is equally clear, however, that the appellees and the United States are
correct in asserting that the District Court in fact lacked jurisdiction to
consider the constitutionality of the Hyde Amendment, for the court acted in the
absence of a case or controversy sufficient to permit an exercise of judicial
power under Art. III of the Constitution. None of the parties to these cases
ever challenged the validity of the Hyde Amendment, and the appellees could have
been awarded all the relief they sought entirely on the basis of the District
Court's ruling with regard to the Illinois statute.9 The constitutional validity of the Hyde
Amendment was interjected as an issue in these cases only by the erroneous
mandate of the Court of Appeals. But, even though the District Court was simply
following that mandate, the directive of the Court of Appeals could not create a
case or controversy where none otherwise existed. It is clear, therefore, that
the District Court exceeded its jurisdiction under Art. III in declaring the
Hyde Amendment unconstitutional.
The question thus arises whether the District Court's lack of jurisdiction in
declaring the Hyde Amendment unconstitutional divests this Court of jurisdiction
over these appeals. We think not. As the Court in McLucas v. DeChamplain, 421
U.S. 21, 31-32, observed:
"Our previous cases have recognized that this Court's jurisdiction under
1252 in no way depends on whether the district court had jurisdiction. On
the contrary, an appeal under 1252 brings before us, not only the
constitutional question, but the whole case, including threshold
[448 U.S. 358, 368] issues of subject-matter jurisdiction, and
whether a three-judge court was required." (Citations omitted.)
Thus, in the McLucas case, which involved an appeal under 1252 from a
single-judge District Court, this Court pretermitted the question whether the
single-judge District Court had had jurisdiction to enter the challenged
preliminary injunction, and instead resolved the appeal on the merits. It
follows from McLucas that, notwithstanding the fact that the District Court was
without jurisdiction to declare the Hyde Amendment unconstitutional, this Court
has jurisdiction over these appeals and thus may review the "whole case."10
II
Disposition of the merits of these appeals does not require
extended discussion. Insofar as we have already concluded that the District
Court lacked jurisdiction to declare the Hyde Amendment unconstitutional, that
portion of its judgment must be vacated. See, e. g., United States v. Johnson,
319 U.S. 302; Muskrat v. United States, 219 U.S. 346. The remaining questions
concern the Illinois statute. The appellees argue that (1) Title XIX requires
Illinois to provide coverage in its state Medicaid plan for all medically
necessary abortions, whether or not the life of the pregnant woman is
endangered, and (2) the funding by Illinois of medically necessary services
generally, but not of certain medically necessary
[448 U.S. 358, 369]
abortions, violates the Equal Protection Clause of the Fourteenth Amendment.11 Both arguments are foreclosed by our decision today in Harris
v. McRae, ante, p. 279. As to the appellees' statutory argument, we have
concluded in McRae that a participating State is not obligated under Title XIX
to pay for those medically necessary abortions for which federal reimbursement
is unavailable under the Hyde Amendment. As to their constitutional argument, we
have concluded in McRae that the Hyde Amendment does not violate the equal
protection component of the Fifth Amendment by withholding public funding for
certain medically necessary abortions, while providing funding for other
medically necessary health services. It follows, for the same reasons, that the
comparable funding restrictions in the Illinois statute do not violate the Equal
Protection Clause of the Fourteenth Amendment.
Accordingly, the judgment of the District Court is vacated, [448 U.S. 358, 370] and the cases are remanded to that
court for further proceedings consistent with this opinion.
It is so ordered.
[For dissenting opinion of MR. JUSTICE BRENNAN, see ante, p. 329.]
[For dissenting opinion of MR. JUSTICE MARSHALL, see ante, p. 337.]
[For dissenting opinion of MR. JUSTICE BLACKMUN, see ante, p. 348.]
[For dissenting opinion of MR. JUSTICE STEVENS, see ante, p. 349.]
Footnotes
[Footnote 1] The statute is codified as
Ill. Rev. Stat., ch. 23 (1979). It provides in relevant part: " 5-5. [Medical
services.] The Illinois Department, by rule, shall determine the quantity and
quality of the medical assistance for which payment will be authorized, and the
medical services to be provided, which may include all or part of the following:
[listing 16 categories of medical services], but not including abortions, or
induced miscarriages or premature births, unless, in the opinion of a physician,
such procedures [448 U.S. 358, 361] are necessary for the preservation of
the life of the woman seeking such treatment. . . ." " 6-1. Eligibility
requirements. . . . Nothing in this Article shall be construed to permit the
granting of financial aid where the purpose of such aid is to obtain an
abortion, induced miscarriage or induced premature birth unless, in the opinion
of a physician, such procedures are necessary for the preservation of the life
of the woman seeking such treatment. . . ." " 7-1. Eligibility requirements. Aid
in meeting the costs of necessary medical, dental, hospital, boarding or nursing
care, or burial shall be given under this Article [to eligible persons], except
where such aid is for the purpose of obtaining an abortion, induced miscarriage
or induced premature birth unless, in the opinion of a physician, such
procedures are necessary for the preservation of the life of the woman seeking
such treatment. . . ."
[Footnote 2] The medical assistance
programs at issue here are the Illinois Medicaid plan, which is jointly funded
by the Federal Government and the State of Illinois, and two fully state-funded
programs, the Illinois General Assistance and Local Aid to Medically Indigent
Programs.
[Footnote 3] All opinions of the District
Court other than that now under review are unreported.
[Footnote 4] Since September 1976,
Congress has prohibited - by means of the "Hyde Amendment" to the annual
appropriations for the Department of Health, Education, and Welfare (now divided
into the Department of Health and Human Services and the Department of
Education) - the use of any federal funds to reimburse the cost of abortions
under the Medicaid program except under certain specified circumstances. The
current version of the Hyde Amendment, applicable for fiscal year 1980,
provides: "[N]one of the funds provided by this joint resolution 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
[448 U.S. 358, 363] incest has been reported promptly to a law
enforcement agency or public health service." Pub. L. 96-123, 109, 93 Stat. 926.
See also Pub. L. 96-86, 118, 93 Stat. 662. This version of the Hyde Amendment is
broader than that applicable for fiscal year 1977, which did not include the
"rape or incest" exception, Pub. L. 94-439, 209, 90 Stat. 1434, but narrower
than that applicable for most of fiscal year 1978 and all of fiscal year 1979,
which had an additional exception for "instances where severe and long-lasting
physical health damage to the mother would result if the pregnancy were carried
to term when so determined by two physicians," Pub. L. 95-205, 101, 91 Stat,
1460; Pub. L. 95-480, 210, 92 Stat. 1586. In this opinion, the term "Hyde
Amendment" is used generically to refer to all three versions, except where
indicated otherwise.
[Footnote 5] Neither the Director of the
Illinois Department of Public Aid nor the intervening-physicians sought review
of the judgment of the Court of Appeals. The District Court in the proceedings
now on appeal proceeded on the premise that Title XIX obligates Illinois to fund
all abortions reimbursable under the Hyde Amendment. That issue, therefore, is
not before us on these appeals.
[Footnote 6] Although the medical
assistance programs funded exclusively by the State are not governed directly by
either Title XIX or the Hyde Amendment, the Court of Appeals concluded that the
modified injunction requiring state payments for abortions fundable under the
Hyde Amendment should apply to all three Illinois medical assistance programs,
see n. 2, supra. 596 F.2d, at 202-203. Relying on a statement in the State's
brief, the Court of Appeals held that the challenged Illinois statute was
intended to represent the State's understanding of the congressional purpose
reflected in the original Hyde Amendment. Id., at 203. The Court of Appeals thus
declined to sever the various funding restrictions in the Illinois statute.
[Footnote 7] Section 2403 (a) provides:
"In any action, suit or proceeding in a court of the United States to which the
United States or any agency, officer or employee thereof is not a party, wherein
the constitutionality of any Act of Congress affecting the public interest is
drawn in question, the court shall certify such fact to the Attorney General,
and shall permit the United States to intervene for presentation of evidence, if
evidence is otherwise admissible in the case, and for argument on the question
of constitutionality. The United States shall, subject to the applicable
provisions of law, have all the rights of a party and be subject to all
liabilities of a party as to court costs to the extent necessary for a proper
presentation of the facts and law relating to the question of
constitutionality."
[Footnote 8] The District Court refused to
stay its order, and the Director of the Illinois Department of Public Aid and
the intervening-defendant physicians moved in this Court for a stay pending
appeal. That motion was denied. 442 U.S. 1309 (STEVENS, J., in chambers). A
reapplication by the intervening-defendant physicians also was denied. 442 U.S.
915.
[Footnote 9] Title XIX does not prohibit
"[a] participating State . . . [from] includ[ing] in its Medicaid plan those
medically necessary abortions for which federal reimbursement is unavailable
[under the Hyde Amendment]." Harris v. McRae, ante, at 311, n. 16.
[Footnote 10] Although this Court need
not pass on the remainder of the judgment in a case in which an appeal under
1252 is taken from a court that lacked jurisdiction to declare a federal statute
unconstitutional, see FHA v. The Darlington, Inc., 352 U.S. 977, we are
empowered to do so because "an appeal under 1252 brings before us, not only the
constitutional question, but the whole case." McLucas v. DeChamplain, 421 U.S.,
at 31. Here, there is no reason not to resolve the "whole case" on the merits.
The remainder of the case that is properly before this Court, and which clearly
involves a justiciable controversy, includes both the appellees' federal
statutory and constitutional challenges to the Illinois statute.
[Footnote 11] This case was decided by
the District Court under the version of the Hyde Amendment applicable during
fiscal year 1979, and Congress has since narrowed the ambit of the Hyde
Amendment for fiscal year 1980, see n. 4, supra. The recent statutory revision
does not, however, affect the outcome of either issue now before the Court. The
statutory issue is not affected, because we today conclude in Harris v. McRae,
ante, at 306-311, that Title XIX does not require a participating State to fund
those medically necessary abortions for which federal reimbursement is
unavailable under the Hyde Amendment, including the version of the Hyde
Amendment applicable for fiscal year 1980. The constitutional issue is not
affected, because, regardless of whether the State of Illinois is obligated to
fund all abortions for which federal reimbursement is available under the Hyde
Amendment, we conclude in Harris v. McRae that even the most restrictive version
of the Hyde Amendment - which is similar to the Illinois statute at issue here -
does not violate the equal protection standard of the Constitution. Since the
outcome of these issues is not affected by the recent changes in the Hyde
Amendment, we need not defer review in order to provide the District Court with
an opportunity to evaluate the effects of these changes in the federal law.
[448 U.S. 358, 371]
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