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Poor women in Florida have the right to seek an abortion, but they should not expect the government to pay for it, the Florida Supreme Court ruled Thursday. The court’s decision is a major defeat for abortion rights advocates who sought to ensure that poor women had easier access to abortions through public financial assistance. “Women who have a medical need for abortions will be, in many cases, coerced by the state to either forgo an abortion all together or delay it until later in their pregnancy when they can come up with the money,” said Bonnie Scott Jones, an attorney for the Center for Reproductive Law & Policy in New York who argued the case before the court. The ruling involved a class action suit filed in March 1993 against the Agency for Health Care Administration on behalf of Medicaid-eligible women in Florida, as well as abortion clinics, doctors and a nonprofit agency that provides abortion funding. They all claimed that rules which exclude medically necessary abortions from being paid for by the state — except in cases where the pregnancy endangers the life of the mother or is the result of rape or incest — violate the privacy clause of the Florida Constitution. Medicaid is a federal-state program designed to provide medical care to the poor. The name plaintiffs included Barbara Hunter, who suffered from Graves Disease, which required she undergo radio-iodine treatments that would hurt her fetus. She had to stop the treatment during her pregnancy. Another woman, identified only as Renee B., said her pregnancy caused her to hemorrhage and have high blood sugar. Plaintiffs also cited causes of other potential medically necessary abortions that are not covered, including HIV, AIDS, diabetes and sickle cell anemia. All of the named plaintiffs eventually received abortions using nonstate funds. The plaintiffs argued that, except for abortion, Florida does not require a patient’s medical condition to be life-threatening or caused by a crime in order for it to be reimbursed by Medicaid. The health care agency, which administers the Medicaid program, argued that Medicaid doesn’t pay for all medically necessary procedures, citing certain organ transplants as examples. During arguments in March, Bill Roberts, deputy general counsel for AHCA, noted that the question of whether Medicaid should pay for abortion deals with poverty and not constitutional rights. “The plaintiffs were not being denied constitutional rights, it was an aspect of their poverty that they can’t afford an abortion. Poverty was not created by the state,” Roberts said in an interview Thursday. “It’s clear that no right was being infringed.” The Florida Supreme Court noted that the right of privacy in the Florida Constitution protects a woman’s right to choose an abortion … but “does not create an entitlement to the financial resources to avail herself to this choice.” The case originated in 1993 in Palm Beach, where it was certified as a class action. Last year, the 1st District Court of Appeal in Tallahassee upheld the state’s rules restricting Medicaid abortions. The trial court noted: “The plaintiffs’ argument, in effect, says to the government: Leave me alone, stay out of my private affairs, and let me choose what it is I want to do concerning my reproduction, except that I want you to finance my choice.” Jones of the reproductive center said she was disappointed that the court declined to take up the plaintiffs’ second argument that ACHA’s rules discriminated according to gender. The plaintiffs asserted that Medicaid pays for a full range of health services, including reproductive services, to eligible men, as long as they are medically necessary. “It imposes two different standards on men and women, which I think is improper in terms of sex discrimination,” Jones said. “In the meantime, women have barriers to health care that men don’t.”

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