Maryland Gov. Harry Hughes will ask the legislature this week to make it easier for poor women to receive Medicaid-financed abortions, according to Statehouse sources.
Hughes, strongly "pro-choice" on abortion, decided to seek removal of restrictive budget language the legislature approved two years ago after he got reports from the state Department of Health and Mental Hygiene of a 50 percent decrease in Medicaid-financed abortions for poor women.
The dramatic decrease--from 6,500 abortions in fiscal 1980 to 3,200 in fiscal 1982, according to the health department--has been tied directly to the language that was included, after much controversy, in the 1980 budget.
The language, which anti-abortion legislators tacked on to close a "mental health loophole" that allowed abortion on demand, limits the circumstances in which Medicaid can be used to pay for abortions.
Hughes' decision is certain to reignite an extremely emotional issue in the General Assembly, one that also caused the first rift between Hughes and the outgoing lieutenant governor, Samuel Bogley, who is strongly anti-abortion.
"We'll fight that. That's just wrong," said Del. Timothy F. Maloney (D-Prince George's), a leader of the anti-abortion forces that obtained the stricter language.
"For the past two years we've had a stalemate that no one's been completely happy with," he said. "Now the governor's broken the stalemate with an extremist position. Why did he wait till after the election last November if he felt this way?"
Del. Lorraine Sheehan (D-Prince George's), a leader of the pro-choice groups in past sessions, said Planned Parenthood and other advocacy groups had been pressing Hughes for the change. She said the groups believe the new General Assembly, which began its four-year term last week, is likelier than last year's to support less restrictive language. Hughes must submit his budget to the General Assembly for adoption.
In addition to a dramatic drop in Medicaid abortions, state officials said the current language had "scared off" some doctors and many clinics.
It was not clear what financial impact Hughes' proposal would have.
John Folkemer, chief of the state division of program review and planning for Medicaid, said the cost to the state of all Medicaid-financed abortions had not dropped from around $1.5 million a year--despite the decrease in actual numbers of operations performed--because many lower-priced clinics are no longer involved.
Instead, much of the Medicaid work is now done in hospitals, which cost substantially more, he said. The average Medicaid reimbursement for an abortion is $400, he said.
Despite the restrictions included in budgets since 1981, Maryland is considered relatively liberal on abortion financing. Folkemer said that many states allow Medicaid payment for abortions only when the mother's life is in danger.
The circumstances under which abortions qualify for Medicaid in the current law are when the mother's life is in jeopardy; in instances of rape or incest; or when there is "certification in writing by the physician or surgeon that . . . there exists medical evidence that continuation of the pregnancy is creating a serious effect on the woman's present mental health or, if carried to term, there is substantial risk of a serious or long-lasting effect on the woman's future mental health."
The requirement of doctor certification and proof that the mother's present and future mental health would be affected are what pro-choice groups and others have said caused the dramatic drop in Medicaid abortions performed in Maryland.
These are the requirements Hughes has apparently decided to drop in favor of less restrictive wording included in the 1979 and 1980 budgets.
In those years Medicaid abortions could be performed in life-threatening circumstances, in cases of rape and incest, and "where, within a reasonable degree of certainty the continuation of pregnancy could have a severe and adverse affect on the woman's present or future mental health."
According to an administration aide, Hughes decided to change the language "to carry out the expressed intent of those who feel there should be no distinction in services available between wealthy women and poor women.Also , he had been advised that some doctors were reluctant to perform the operation even when it was acceptable under the current language."
During his reelection campaign last year, Hughes repeatedly said that it was a woman's right to choose abortion and that the operation should be available to all women regardless of whether they could pay.