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    "ocrText": "FOIA Number: 2011-0587-F\nFOIA\nMARKER\nThis is not a textual record. This is used as an\nadministrative marker by the William J. Clinton\nPresidential Library Staff.\nCollection/Record Group:\nClinton Presidential Records\nSubgroup/Office of Origin:\nPress Secretary\nSeries/Staff Member:\nDee Dee Myers\nSubseries:\nOA/ID Number:\n4484\nFolderID:\nFolder Title:\nAbortion [2]\nStack:\nRow:\nSection:\nShelf:\nPosition:\nS\n94\n3\n4\n3\nABORTION\nCLINTON ON ABORTION\nDate/Source\nAbortion/Roe V.\nFunding\nWade\n7/11/80; ltr added\nThe S.C. has\nI believe public\nto FLAG survey\noutlined generally\nfunds should be\nthose abortions\nrestricted to cases\nwhich the State can\nof medical\nno longer prohibit\nnecessity.\nor impose criminal\nsanctions for. The\nremaining question\nis whether the\ngovt. should make\nlegal abortions\navailable to all on\nequal terms\nI\ndo not support that\nposition.\n4/15/82; FLAG\nI am personally\nqstre.\nopposed to\nabortion, but have\nnot seen a so-\ncalled Human Life\nConstitutional\nAmendment that I\ncould support.\n4/21/82; Moral\n(Do you believe\n(Should abortion be\nMajority qstre.\nabortion on demand\ngovt. subsidized?)\nshould be legal\nOnly in cases of\nwhen life of the\ngenuine medical\nmother is not in\nemergency.\ndanger?) Only\nunder limited\ncircumstances. The\nSupreme Court's\nguidelines control\nthis and the state\ngovt is not\nempowered to limit\nthem.\n5/1/84; FLAG\n(Do you support the\n(Tax money?) Only\nqustre.\nproposed Unborn\nin cases of genuine\nChild Amendment?)\nmedical emergency.\nI am personally\nopposed to abortion\nand the state does\nnot fund abortions.\nI have been advised\nby my legal counsel\nthat the \"Unborn\nChild Amend. II may\nbe in conflict with\nthe USSC decisions\non abortion.\nDoes not support\nabortion on demand.\n1/6/85;\nI certainly would\nRussellville\nbe open to a bill\nCourier Democrat\nwhichwould be\nprotective of\nchildren that are\ncapable of living\noutside the\nmother's womb\nwithout support.\n2/6/85; Ark.\nSaid pleased W.\nDemocrat\namendment on Senate\nbill; amendment\nstated a fetus\nwould not be\nconsidered viable\nuntil after the\nsixth month of\npregnancy (Hardin's\nbill said after\n23rd week)\n3/7/85; Ark.\nSigned bill (Act\nGazette\n268) prohibiting\nabortions after\n25th week except\nfor minors\nimpregnanted as\nresult or rape or\nincest or when\nmother's health or\nlife in danger;\nsaid it was\n\"appropriate\" for\nstate to make laws\nconcerning\nabortions late in\npregnancy.\n9/25/86; Ark.\n(Questioned re\nDemocrat\nAmend 657 banning\nstate funds except\nto save mother's\nlife; and making it\nstate policy to\nprotect health,\nsafety and welfare\nof every unborn\nchild from\nconception until\nbirth). Hadn't\ndecided how he\nwould vote. Would\nlike to see debate\non implications.\nNo state funds\nspent now; if\ninmate rec'd.\nabortion shouldn't\nhave & won't again.\nHe \"had noproblem\nW.. stated purpose\"\nof Am. 65 (AETNs\ntranscript says \"I\nsupport what is the\nstated purpose of\nthe amendment\n\"My personal\nposition is that\nbec so many people\nbelieveabortion is\nwrong, we shouldn't\nspend state funds\non abortion. \"\n9/26/86; [ltr_to]\nI am opposed to\nand to govt\nEarlene Windsor\nabortion.\nfunding of\n(Ark. Right to\nabortions. We\nLife)\nshould not spend\nstate funds on\nabortions bec. so\nmany people believe\nabortion is wrong.\nI do support the\nconcept of the\nproposed Ark. Con.\nAm. 65 and agree\nwith its stated\npurpose I am\nconcerned that some\nquestions about the\namend's impact\nappear to remain\nunanswered.\n9/25/86; Ark.\n\"My personal\nDemocrat\nposition is that\nbecause so many\npeople believe\nabort. is wrong we\nshouldn t spend\nstate funds\nabortion. Hasn't\ndecided how he'll\nvote. Does not\nhave a problem W.\nstate hospital\ndispensing morning-\nafter pills.\n10/31/86; Ark.\n(Re Amend. 65) \"I\"m\nGazette\nnot sure we need\nit. \" No state funds\nnow Reiterates\nthat agrees with\npurpose of amend\n,\nbut \"I question\nwhether the amend.\nhas some things in\nit we don't know\nabout that might\ncause some problems\non down the road. \"\n7/8/88; Ark.\n(Re proposed Amend)\nGazette\nPosition same as in\n1986: \"I didn't\nsee why we needed\nit. We don't use\nany state money for\nabortions.\"\n7/14/89; Ark.\n\"I am personally\nI favor both of\nDemocrat\nopposed to\nthese (prohibition\nabortion, except in\non state funds for\ncases of rape,\nabortion and\nincest and to save\nrequired parental\nthe mother's life.\nnotice for most\nHowever, I do not\nminors before\nbelieve the law\nabortion).\nshould make\ncriminal the\nconduct of a woman\nwho decides to have\nan abortion as long\nas the unborn child\ncannot live outside\nthe mother's body.\nMedical technology\nhas advanced\nsignificantly since\nRoe V. Wade and\nthere probably is\nmerit to reviewing\nthe time frame in\nwhich a fetus can\nlive outside the\nmother's womb.\nHowever, this point\nshould not be used\nas a harassment\ntool. \"\n11/28/89; Ltr to\nThough I am\npro-choice writers\npersonally opposed\nto abortion, I do\nnot believe the\ngovt. should\nabsolutely ban or\nmake criminal a\nwoman's decision to\nhave an abortion so\nlong as the unborn\nchild cannot live\noutside the\nmother's womb.\nTherefore, I hope\nthe SC will not\nreverse Roe V.\nWade.\n11/28/89; Ltr to\nThough I am opposed\nI do support a ban\npro-life writers\nto abortion as a\non public funding\nmeans of birth\nfor abortion, and\ncontrol, I do not\nthe law which I\nthink govt. should\nsigned requires\nmake criminals out\nminors to inform\nof women who make a\ntheir parents\ndifferent\nbefore having an\ndecision. Also, I\nabortion.\nfeel that a blanket\nright of abortion\nthrough 24 weeks\ndoes not take into\naccount medical\nchanges which would\npermit unborn\nchildren younger\nthan 24 weeks to\nlive outside the\nmother's womb.\n10/12/89; Gazette\nState shouldn't\nWe have said there\nimpose more\nwon't be public\nrestrictions. \"I\nfunds for\njust think that\ndiscretionary\ngovt's done about\nabortions and we've\nall govt. should do\nrequired parental\non this issue.\nnotification in\nWe've protected the\ncases of minors.\nlife of the child\nthat can live\noutside the\nmother's womb. I\ndon't basically\nthink we should\nhave a wholesale\nstatute that turns\nwomen who decide to\n(have abort's) into\ncriminals That\ndecision still\nneeds to be made\nbetween a woman and\nher doctor and the\nfamily members\ninvolved.\n3/23/90;Family\n(Favor or oppose\nOpposes Tax funded\n(Council_qstre.\nposition that human\nabortion_on demand\nlife begins at\nfor_low_income\nconception?)\nwomen\n\"\n\"Clearly the\nprocess of life\nbegins at\nconceptions. That\ndoes not answer the\nharder question of\nwhether society\nshould make all\nabortions crimes\nwhen half the\npeople do not\nbelieve abortion is\nmurder esp. when\nthe fetus or unborn\nchild cannot\nsurvive outside the\nmother's womb.\nFavors abortion on\ndemand to save life\nof mother, fetal\ndeformity, rape or\nincest; abortion on\ndemand during first\ntrimester protected\nby Roe V. Wade.\nSupports woman's\nright to abortion\nat any time before\nthe child can live\noutside the womb.\n4/27/90; AR Right\nUnder present Ark.\nI have .supported\nto Life qustre.\nlaw, abortion is\nrestrictions on\nillegal when the\npublic funding and\nunborn child can\nparental\nlive outside it's\nnotification\nmother's womb. I\nrequirement of\nsupport that. The\nminors.\ngovt. should impose\nno further\nrestrictions. I do\nnot favor repeal of\nRoe V. Wade. Until\na fetus can live\noutside the\nmother's womb, I\nbelieve the\ndecision on abort.\nshould be the\nwoman's not the\ngovt's.\n8/90; Citizenship\nHave not read the\nSupport parental\nQstre.\nAmendment\nnotice and\nPreventing State\nrestrictions on\nIntervention in\npublic funding.\nReproductive\nChoices.\n8/90; Family\n\"For legal purposes\nOpposes state\nCouncil qstre. NOTE:\nI favor the Fetal\nfunding of abort's\ni'M NOT SURE THIS\nViability test,\nexcept to save\nONE WAS RETURNED;\nbec. of the\nmother's life;\nOR WHEN\ndifferences among\nwould also cover\nmedical and\n\"first trimester\nreligious\nrape, incest\".\nauthorities on\nthis. I have heard\nministers argue\nlife begins at\nconception, while\nothers say the\nBiblical Greek\nmakes it clear that\nlife begins at\nbirth, when the\nchild is\nbreathing.\"\nWoman's choice\nduring first\ntrimester; opposes\nabortion on demand\nat any time during\npregnancy.\n9/90; AP Qustre.\nUnder present Ark.\nWhile I have also\nlaw, abort. is\nsupported\nillegal when the\nrestrictions on\nunborn child can\npublic funding and\nlive outside its\na parental\nmother's womb. I\nnotification\nsupport that .\nrequirement for\nUntil the fetus\nminors, I think the\ncan live outside\ngovt. should impose\nthe mother's womb,\nno further\nI believe the\nrestrictions.\ndecision on abort.\nshould be the\nwoman's not the\ngovt.\n10/90; AAUW qstre.\nSame as above, but\nSame as above but\nadds. \"I do not\nadds: \"Public\nfavor repeal of Roe\nfunding of\nV. Wade. \"\nabortions has been\nlimited by popular\nvote. I support\nfamily planning.\"\n10/10/90; Ark.\nIn an interview W.\nGazette (cited in\na Gazette\n7/17/91 Gazette\ncolumnist, Clinton\npiece).\nused the phrase\n\"pro-choice\" to\ndescribe his\nposition.\n5/22/91; cited in\n\"I don't believe\n7/17/91 Gazette\nthat all abortion\npiece) ; speaking to\nshould be criminal\ngroup of students.\n.\nI don't believe\nin it personally,\nand I think it\nshould be avoided\nwherever possible.\nBut I think to make\nall the people who\ndecide to do it\ncriminals is not\nthe way to deal\nwith it.\"\n6/19/91; Ark.\n\"Based on what I\nGazette\nknow, I don't\nbelieve we need any\nfurther abort.\nrestrictions in\nArk. II\n7/91; speech to\nSays he pushed for\nMade no mention in\nNWPC; reported in\nBush to support\nDC speech of\nArk. Gazette\nchoice; after talk\nsupport for\n7/17/91\nsaid he opposed\nparental notice for\noverturning Roe V.\nminors or\nWade\nrestrictions on\npublic funding.\n7/17/91; Ark.\nBC says \"amazed\" by\nAccording to 3/9/92\nGazette\npress coverage of\nArk. Democrat,\nNWPC speech; \"When\n\"After he spoke to\nasked about how I\nthe NWPC in July\nfelt about it, I\n1991, Clinton said\nsaid what I have\nhe would vote to\nsaid in all my\nrepeal Amend. 68.\nletters to the\n\"I thought the\nsupporters &\namendment was over-\nopponents for\nbroad when it was\nthe last several\neneacted, \" he said\nyears. I've had a\nin 1991. \"We don't\nletter that I've\nspend Medicaid\nsent out to people\nfunds for\nwhich says that I\nabortions. I think\nthink it would be\nif the issue were\nunwise to repeal\non the ballot, I\nRoe V. Wade.\nwould vote to\nrepeal it.\"\n(However, article\nnotes, week before\nthe 1988 vote BC\nwas quoted in the\nArk. Dem. as saying\n\"I agree W. the\nstated premise of\nthe amendment.\"\n3/9/92; article in\nAll Dem. cand's\n\"Although I have\nArk. Dem. on\nsupport Roe V.\nsupported certain\nabortion. in\nWade; support\nlimited\narticle on\nFreedom of Choice\nrestrictions upon\nabortion.\nAct; oppose \"gag\ngovt. funding for\nrule. II Reports\nabortion, I would\nthat during debate\nnot veto any bill\nin Denver, all said\nrequiring Medicaid\nwould appoint SC\nfunding that passed\njustices who favor\nCongress.\" Article\nprivacy rights.\nalso notes that\nGoes on to quote\nClinton's health-\nfrom NARAL survey:\ncare proposal would\ninclude federal\nfinancing for\npregnancy-related\nmedical procedures,\nincluding\nabortions.\"\n1/92; NARAL State\nThe govt. simply\nAlthough I have\nby State Review,\nhas no right to\nsupported certain\n1992; quotes\ninterfere W.\nlimited\nClinton\ndecisions that must\nrestrictions upon\nbe made by women of\ngovt. funding for\nAmerica to make the\nabortions, I would\nright choice. A\nnot veto any bill\nClinton Admin. will\nrequiring Medicaid\noppose any attempts\nfunding that passed\nto weaken that\nCongress. I\nfundamental right.\nsigned a parental\nTo ensure that the\nnotice law in Ark.\nprinciples\nbec. I believe,\nestablished in that\nwhenever possible,\ncase (Roe) remain\nparents should help\nthe law of the\ntheir children work\nland, I will\nthrough the\nactively lobby\ndecision on\nCongress to pass\nabortion and its\nthe Freedomof\nconsequences. the\nChoice Act.\nArk. law is a\nnotice, not a\nparental consent\nlaw, and has a\njudicial bypass\nprovision.\nWinter, 1992:\n\"The govt. simply\nNARAL News\nhas no right to\ninterfere with\ndecisions that must\nbe made by women in\nconsultation with\ntheir partners,\ndoctors, friends,\nand clery. I trust\nthe women of\nAmerica to make the\nright choice. A\nClinton\nAdministration will\noppose any attempts\nto weaken that\nfundamental right. \"\nBC Position Paper,\nBC has always been\nHealth care plan\nFebruary, 1992\npro-choice. He has\nwould cover\nnever wavered in\nabortions.\nhis support of Roe\nSupports repeal of\nV. Wade. Lent his\nthe Hyde Amendment\nname to amicus\nwhich prohibits\nbrief in Planned\nfederal funding for\nParenthood V.\nabortion in almost\nCasey. If elected\nall situations\nPres., will sign\nincluding cases of\nthe Freedom of\nrape and incest.\nChoice Act. Will\nOpposes parental\nimmediately issue\nand spousal consent\nan Exec. Order\nlaws as well as\nrepealing the \"gag\"\nfederal parental\nrule. Will stand\nnotification\nup against zealots\nrequirements.\nwho blockade health\nclinics.\n14A\nState\nARKANSAS GAZETTE Friday, October 31, 1986\n'I'm not sure we need it,' Clinton says of abortion measure\nSTATETTE OCT 31 1986\nsaid the governor should have\nClinton briefly described each\nabout the amendment itself. He\nthat's something the legislature\nwith Lasater would have been a\nBy Maria Henson\nstopped the state from doing busi-\nof the four proposed amendments,\ntold students he had asked propo-\ncan work out\"\ndecision for the Arkansas Devel-\nTOS 26. ST\nGAZETTE STAFF\nness with the now-defunct La-\nthen said Amendment 65 is \"dif-\nnents of the amendment whether\nHe told reporters he had tried to\nopment Finance Authority, he\nMCCRORY - Although main-\nsater and Co. investment firm\nferent\" The people who favor it\nit would prevent University Hos-\nmake the point that people change\nsaid. But if he had known about\ntaining silence about how he will\nafter the two women testified.\nacknowledge that no state funds\nthe Constitution because they\nthe women's testimony, he said he\nvote on proposed Amendment 66\nIn a campaign swing that would\nare spent on abortion, \"so we\nneed or want to change it. Amend-\nwould have asked the director of\nto the state Constitution, Gover-\ntake him Thursday and today to\ndon't have to change the Constitu-\nI question whether the\nment 65 \"says all we want to do is\nthe State Police for a recommen-\nnor Bill Clinton made stronger\nWoodruff County and eastern Ar-\ntion to do what they want. We're\namendment has some\nfreeze the status quo,\" he said. \"In\ndation on whether he should ask\nstatements about the proposal\nkansas, Clinton stopped for a\nnot doing that today. Neither is\nessence, I'm not sure we need it.\nthe Authority to stop doing busi-\nThursday, saying. \"I'm not sure\nspeech Thursday morning at Mc-\nthere anything in the Constitution\nthings in it we don't\nI question whether the amend-\nness with the firm. \"But I think\nwe need it\" If something needs to\nCrory High School. where he ad-\nwhich orders as to spend money\nment has some things in it we\nthere's a good chance that the peo-\nbe done about abortion funding,\ndressed students who rose to wel-\non abortions, 30 if we did need\nknow about that might\ndon't know about that might cause\nple doing the investigation would\nthe legislature can do it, he said.\ncome him with loud applause.\nanything to be done, it could be\ncause some problems\nsome problems on down the road.\"\nhave said, \"Don't change anything;\nHe also told reporters he had\nAfter his speech, a student\ndone with an act of the legisla-\nOn White's latest charges, Clin-\nwe don't want anybody tipped off\nnot known about testimony of two\nasked him in a question-and-an-\nture,\" he said.\non down the road.\nton compared them to \"last-min-\nthat we're looking into this.' But if\nwomen in February 1985 alleging\nswer session about his position on\nClinton called Amendment 65\n- Bill Clinton\nute desperation politics.\" He said\nI had known about it, I would have\nthey had seen Dan Lasater use co-\nAmendment 65. The proposed\n\"one amendment on the ballot\nhe had not known about the Feb-\nat least said something.\"\ncaine. Former Governor Frank\namendment, which will be on the\nthat doesn't have to pass for its\npital at Little Rock from giving\nruary 1985 testimony, in which\nThere have been questions\nWhite, Clinton's Republican oppo-\ngeneral election ballot Tuesday,\nobjective to be reached.\"\n\"morning after\" pills to rape vic-\ntwo women testified in a cocaine\nabout when the governor first\nnent in the gubernatorial race,\nwould prohibit direct or indirect\nThe governor reiterated that he\ntims, \"and the answer was, 1\ntrial in federal court that Lasater\nheard about the loan to his\nmade Lasater's alleged cocaine\nstate funding for abortions except\nagrees with the purpose of the\ndon't know.' The pills are used\nused cocaine. According to testi-\nbrother. Thursday, he said, \"I\nuse an issue Wednesday when he\nto save the mother's life.\namendment but has questions\nto prevent pregnancy.\nmony during the same trial, Clin-\nhonestly don't remember, but I'm\nWhen he asked the proponents\nton's brother, Roger, had bor-\nguessing\nthat he told me about\nhow to avoid having a mother suf-\nrowed $8,000 from Lasater for,\nit probably right before he testi-\nfer irreparable damage when it\namong other things, cocaine debts.\nfied in the [February 1985] trial,\ncannot be determined whether she\nRoger Clinton had worked for La-\nor maybe we discussed it after he\nwill die if she has the baby, Clin-\nsater.\ntestified. but it probably would\nton said he was told, \"Well, maybe\nHalting state bond business\nhave been about that time.\"\nJUL 15 192 10:15\nTo: Betsey\nDAY, NOVEMBER 4, 1988\n3B\nDEMOCRAT NOV 4 19\nwright\nClinton questions\nsays he can vote\nfor Amendment 3\nGov. Bill Clinton said\nFrom: Steve\nThursday night he cannot\nvote for the anti-abortion\namendment that will appear\nFOX\non Tuesday's general elec-\ntion ballot\nAmendment 3 would spor\ncifically prohibit state funds\ning of abortions, even\nthough there is no state\nonly page\nfunding of abortions now\nClinton told reporters\nduring an impromptu news\nconference at Midcoast Air\nCenter in Little Rock that\nhe is concerned about two\nquestions relating to the\namendment:\nHow it would affect the\nrape treatment programs at\nUniversity Hospital:\nWould it change state\nlaw so that abortions even\nin cases of rape, Incest or\nthreat to the life of the\nmother are prohibited, if\nthe Supreme Court reverses\nits 1973 ruling in the case of\nRoe VS. Wade that allows\nabortions?\n3411 \"I can vote for it unless\nthose two questions are an--\nswered, and yet I agree with\nthe stated premise of the\namendment,\" the governor\nsaid.\nJUL 15. '92 10:15\nTo: Betsey\nDAY, NOVEMBER 4, 1988\n3B\nDEMOCRAT NOV 4\nwright\nClinton questions\nsays he can't vote\nfor Amendment 3\nGov. Bill Clinton said\nFrom: Steve\nThursday night he cannot\nvote for the anti-abortion\namendment that will appear\nFOX\non Tuesday's general elec\ntion ballot\nAmendment 3 would spe:\ncifically prohibit state funds\nIng of abortions, even\nthough there is no state\nonly page\nfunding of abortions now\nClinton told reporters\nduring an impromptu news\nconference at Midcoast Air\nCenter in Little Rock that\nhe is concerned about two\nquestions relating to the\namendment:\nHow it would affect the\nrape treatment programs at\nUniversity Hospital:\nWould it change state\nlaw so that abortions even\nin cases of rape, Incest or\nthreat to the life of the\nmother are prohibited, if\nthe Supreme Court reverses\nits 1973 ruling in the case of\nRoe VS. Wade that allows\nabortions?\n7411\" can't vote for it unless\nthose two questions are an-\nswered, and yet I agree with\nthe stated premise of the\namendment,\" the governor\nsaid.\nNOV- - 5-9* THU 16:45 NARAL\nP.03\nNational Abortion Rights Action League-PAC\nWho Decides?\nPresidential Candidates' Positions on Choice\n1992\nNOV- 5-9* THU 16:45 NARAL\nP.04\nPresidential Candidates' Positions On Choice\nAs 1992 begins, losing our right to choose is no longer distant and Inconceivable. The U.S. Supreme\nCourt is ready to make abortion illegal again. That will make the President of the United States and the\nCongress the last line of defense in protecting this fundamental right.\nThe only way to secure our right to choose is to establish federal protection by passing national\nlegislation, like the Freedom of Choice Act, and having a pro-choice President sign that legislation into\nlaw.\nPresident George Bush is anti-choice. He opposes Roe v. Wade and supports a Constitutional\namendment outlawing abortion nationwide. In addition, President Bush opposes and would veto the\nFreedom of Choice Act. The Democratic candidates listed all support Roe v. Wade and the Freedom of\nChoice Act, and oppose a Constitutional amendment outlawing abortion.\nThe National Abortion Rights Action League-PAC (NARAL-PAC) has compiled the following\ndocument from information which the candidates recently provided regarding their current position\non choice. President George Bush did not provide information on his position and therefore, the\ninformation contained in this document is based on his public record.\nWith more than half a million members nationwide, NARAL is the political arm of the pro-choice\nmovement and the largest national organization working solely to keep abortion safe, legal, and\naccessible for all women.\nPaid for by National Abortion Rights Action League PAC. 1101 14th Street, NW, Washington, D.C. 20005.\nNot authorized by any candidate or candidate's committee.\nNARAL and NARAL-PAC have not endorsed any candidate, January 1992\nNOV- 5-9* THU 16:45 NARAL\nP.05\nPresident George Bush (R)\n\"After years of sober and serious reflections on this issue, this is what I think. I think the Supreme Court's decision in Roe\nv. Wade was wrong and should be overturned. I think America needs a Human Life Amendment.\"\nOpposes Roe v. Wade\nOpposes the Freedom of Choice Act\nSupports Constitutional Amendment outlawing abortion\nSupports ban of abortions at overseas military facilities\nSupports the \"Gag Rule\": President Bush vetood the FY 1991 Labor/HHS Appropriations Bill which\nwould have overturned the \"Gag Rule\" on abortion counseling.\nOpposes Medicaid funding: President Bush has repeatedly vetoed legislation that would have restored\nfunds for poor women to obtain abortions even in the case of rape and incest.\nSupports mandatory parental notification/consent laws\nFormer Governor Jerry Brown (D)\n\"We know that we will not really be free until the rights of every American are secured-including the right of every woman\nto control their bodies.\"\nSupports Roe U. Wade\nSupports the Freedom of Choice Act\nOpposes Constitutional amendment outlawing abortion\nSupports reversal of edict banning abortions at overseas military facilities\nSupports overturn of the \"Gag Rule\"\nSupports Medicaid funding\nOpposes mandatory parental notification/consent laws\nNOV- 5-9* THU 16:45 NARAL\nP.06\nGovernor Bill Clinton (D)\n\"The government simply has no right to interfere with decisions that must be made by women in consultation with their\npartners, doctors, friends, and clergy. I trust the women of America to make the right choice. A Clinton Administration\nwill oppose any attempts to weaken that fundamental right.\"\nSupports Roe v. Wade\nSupports the Freedom of Choice Act\nOpposes Constitutional amendment outlawing abortion\nSupports reversal of edict banning abortions at overseas military facilities\nSupports overturn of the \"Gag Rule\"\nMedicaid funding: \"It is clear to me that the Hyde Amendment should be repealed to ensure that, at least in the\ncase of rape, incest, or danger to the health of the mother, women will be able to receive federal funding to pay for\nan abortion. Although I have supported certain limited restrictions upon government funding for abortion I\nwould not veto any bill requiring Medicaid funding that passed Congress.\"\nMandatory parental notification/consent: \"I signed a parental notice law in Arkansas because I believe,\nwhenever possible, parents should help their children work through the decision on abortion and its consequences.\nThe Arkansas law is a notice, not a parental consent law, and has a workable judicial bypass provision which is\nessential to any parental notice legislation.\"\nSenator Tom Harkin (D)\n\"The fundamental rights of women are under attack by the Bush Administration. I am a proud cosponsor of the Freedom of\nChoice Act and have led the fight to guarantee a woman's right to choose. As Chair of the Labor, HHS Appropriations\nSubcommittee, I included language to overturn the gag rule; to increase funding for family planning clinics under Title X;\nand to fund Medicaid abortions in the case of rape and incest. I have gone toe-to-toe with George Bush to fight for women's\nrights; as President, I will fight to ensure the right to choose for all women.\"\nSupports Roc U. Wade\nSupports the Freedom of Choice Act\nOpposes Constitutional amendment outlawing abortion\nSupports reversal of edict banning abortions at overseas military facilities\nSupports overturn of the \"Gag Rule\"\nSupports Medicaid funding\nMandatory parental notification/consent: \"I oppose mandatory parental consent/notification legislation. I do\nnot believe these laws are a realistic approach for a young woman addressing an unplanned pregnancy... And the\nfact is, it's the young woman who has the most at stake not her parents. If parental consent/notification\nlegislation were to be passed then / would insist it contain u bypass that would take into consideration the physical\nand mental welfare of the young women. This bypass would allow for adult counseling.\"\n'NOV'- 5-9* THU 16:45 NARAL\nP.07\nSenator Bob Kerrey (D)\n\"Although a minority of Americans want this legal precedent I Roc U. Wadel overturned, a majority does not. It comes as\nclose as is possible to expressing the will of the American people on an extremely difficult moral issue.\"\nJ\nSupports Roe v. Wade\n7\nSupports the Freedom of Choice Act\nOpposes Constitutional amendment outlawing abortion\nSupports reversal of edict banning abortions at overscas military facilities\nSupports overturn of the \"Gag Rule\"\nMedicaid funding: \"I have proposed a comprehensive national health care plan, Health USA (Senate Bill 1446),\nwhich will reform the way we finance our nation's health care As a result, Health USA will provide access to all legal\nmedical services for all women, regardless of income.\"\n7\nMandatory parental notification/consent: \"I believe that young women should be encouraged to communicate\nwith their families. I have concerns, however, about a parental notification law. It is an idea that sounds great\nbut in practice it is awful. I support parental notification only if bypass provisions are included.\"\nFormer Senator Paul Tsongas (D)\n\"I have consistently supported the broad range of reproductive rights since before entering Congress in 1974. 1 believed\nthen and believe now, that a woman's right to choose is a fundamental right. Decisions about abortion should be made by\nwomen themselves, based on their own beliefs and the medical advice of their physicians-and not imposed by government at\nany level.\"\nJ\nSupports Roe v. Wade\nSupports the Freedom of Choice Act\nOpposes Constitutional amendment outlawing abortion\nSupports reversal of edict banning abortions at overscas military facilities\nSupports overturn of the \"Gag Rule\"\n7\nSupports Medicaid funding\nOpposes mandatory parental notification/consent laws\nNOV- 5-9* THU 16:45 NARAL\nP.08\nISSUES IN BRIEF\nROE U. WADE- In 1973, The U.S. Supreme Court ruled in Roe v. Wade that the right of a woman to\ndecide whether or not to have an abortion based upon her own moral, religious, and personal beliefs\nis so basic to individual dignity and personal privacy that this decision is protected as a fundamental\nright by our Constitution. NARAL opposes any move to restrict that right as defined in Roc.\nFREEDOM OF CHOICE ACT - The Freedom of Choice Act codifics the principles of Roc v. Wade into\nfederal law, protecting women from state government interference in their decision whether or not to\nhave an abortion prior to viability. NARAL supports codification of these principles in federal\nlegislation.\nCONSTITUTIONAL AMENDMENT OUTLAWING ABORTION- Proposals, such as the \"Human\nLife Amendment,\" would amend the U.S. Constitution to provide that life begins at conception and\nresult in the outlawing of abortions nationwide. NARAL opposes any Constitutional amendment that\nwould restrict the right to choose abortion as defined in Roe.\nMEDICAID FUNDING - Since 1977, Congress has prevented poor women from obtaining abortions\nwith funds from the federal Medicaid program, and in 1981, Congress eliminated federal funding of\nabortions for poor women who are victims of rape or incest. NARAL supports restoration of public\nfunds for abortion services for poor women who depend upon the Medicaid program for their health\ncare.\nMANDATORY PARENTAL NOTIFICATION/CONSENT LAWS - The majority of young women\nturn to their parents for guidance when confronted with a crisis pregnancy. The government cannot\nmandate healthy family communication where it docs not already exist. Laws that force young\nwomen to obtain parental consent, notify their parents, or obtain a court order actually endanger\nyoung women and their families. NARAL opposes any legislation that would restrict young women's\naccess to abortion.\nOVERSEAS MILITARY FACILITIES - In 1988, without Congressional approval, the Department of\nDefense issued an edict prohibiting access to abortion services at overseas U.S. military hospitals, even\nfor women who pay for the procedure with private funds. In many countries where U.S. troops are\nstationed, the U.S. military base facility provides the only safe, competent health care available.\nNARAL supports the repeal of this regulation.\ngag RULE- In 1988, the Department of Health and Human Services promulgated federal regulations\nprohibiting any mention of abortion as a legal option at health care facilities receiving any portion of\ntheir funding through the Title X federal family planning program. In May 1991, the U.S. Supreme\nCourt upheld these regulations in the Rust v. Sullivan case. NARAL supports federal legislation to\novertum the gag rule.\nARAL\nNews Release\nFOR IMMEDIATE RELEASE\nCONTACT: Sara Pines\nJanuary 21, 1992\nLoretta Ucelli\n202/408-4615\n\"DAYS or SAYS. LEGAL ABORTION ARE NOW NUMBERED.\" MICHELMAN SAYS\nNARAL Launches Major 1992 Campaign, Releasing Four New TV Ads\nAnd Creating National Commission on America Without Roe\nWASHINGTON, D.C. -- \"Wo are on the edge of at legal precipice,\nfacing & future without the right to choose,\" National Abortion\nRights Action League (MARAL) Executive Director Kate Michelman\nsaid today after the U.S. Supreme Court announced it would hear\nthe Pennsylvania abortion case this term. \"The Pennsylvania case\nis literally a matter of life and death for American women, a\ndirect challenge to legal abortion being heard by a Court that\nhas been reshaped by two anti-choice Presidents. There is no\ndoubt where President Bush is leading America: Back to the days\nof back alley abortion for women facing crisis pregnancies. For\nthe first time in history, Americans are losing a fundamental\nconstitutional right -- and we have only the Bush and Reagan\nadministrations to blame.\"\nCalling 1992 a \"critical election year for women and\nfamilies,\" Michelman said NARAL is launching \"a major political\naction campaign -- the most aggressive, sophisticated campaign in\nour history.\" The Campaign includes four new television spots\nthat will begin airing next week, and the creation of a National\nCommission on America Without Roe. NARAL also released findings\nfrom a nationwide poll of 800 registered voters taken in late\nNational December 14th Street, N.W., 5th Floor\nmore\nAbortion Rights\nWashington, D.C. 20005\nAction League\n202-406-4800\nAdd one\nAccording to the poll, conducted by Kickman-Brown Public\nOpinion Research:\n&\nThe public overwhelmingly opposes what the Bush Supreme\nCourt is about to do -- overturn Roe V. wade. Just 35% of\nrespondents favor an overturn and 62% say that believe Roe\n\"was a good decision to begin with, and the Court\" would be\nmaking \"a bad change in the law\" by overturning it;\n*\nWhen asked about the probable consequences of an\noverturn, more than half of respondents think it is \"very\nlikely\" that women will be \"forced to get illegal, back\nalley abortions again\"; and\n*\nMore Americans would attribute an overturn of Roe more\nto the conservative direction of the Court than to +\nconservative direction in the country.\nThe new television spots, paid for by MARAL and the NARAL\nFoundation, will begin airing next week. Michelman called them\n\"some of the most powerful spots we have ever made.\" one\nfeatures a retired marine whose mother died because of an illegal\nabortion. He says, \"I was four when By mother died. I was a\nyoung man when I found out what killed her -- an illegal\nabortion. ... Remember, when abortion is illegal, women like my\nmother die.\" Another ad features a woman talking about her back\nalley abortion. A third spot says, \"The Bush supreme Court is\ngetting ready to make abortion illegal again. President Bush,\nAmerica is pro-choice and in America, it's the people, not the\npoliticians who decide.\" Michelman said the ads will run\nnationally on Cable News Network and locally in Washington D.C.\nand in other selected markets,\nmore\nAN MEDIA TEL : 202-338-7457\nJan\n21'92\n14:05 No 004 P.04\nAdd Two\nKichelman also announced that NARAL has convened the\nNATIONAL COMMISSION ON AMERICA WITHOUT ROB, a blue-ribbon\nbipartisan Commission of prominent individuals that will devise a\nnational plan for what lies ahead. The Commission will meet in\nwashington D.C. tomorrow, January 22nd, on the 19th anniversary\nof the Roe V. Wade decision. Michelman said the Commission will\nexplore the consequences for women and families of the loss of\nthe fundamental right to choose, consider strategies to guarantee\nthe right to legal, safe and accessible abortion for all women in\nan America without Roe, and recommend policies that address the\nsocial conditions that foster unintended crisis pregnancies and\nforce millions of American women to face the abortion decision\neach year.\n\"It is merely a matter of months until We all suffer the\nterrible consequences of the Bush/Reagan anti-choice\nappointments,\" Michelman said, \"until women facing crisis\npregnancies are forced to choose between two grim alternatives --\ncompulsory pregnancy and childbirth, or illegal, unsafe back\nalley abortions. But it also is merely a matter of time until\nopponents of choice hear the pro-choice majority's message: In\nAmerica, it's the people, not the politicians who decide.\"\n- 30 --\nTHE WHITE HOUSE\nWASHINGTON\nBReDee Meyer / Don steenberg-\nState Dept. notifred Congress\ntoday on re-funding of\ninternational population\ngroups; raises China/\npopulation control issue.\nsttached is brief memo\nand Q+A's on contingency\nfasis.\nSandy\n9316378\nUSAID\nABORTION\nU.S. AGENCY FOR\nINTERNATIONAL\nDEVELOPMENT\nMEMORANDUM FOR ANTHONY LAKE\nTHE WHITE HOUSE\nSUBJECT: Funding of UNFPA, IPPF, WHO/HRP\nIn fulfilling the President's commitment to refund\ninternational population organizations, the State Department\nand A.I.D. have undertaken the following:\nWe will notify Congress on July 15 of our intention to\nprovide FY 1993 funding for the United Nations Population\nFund (UNFPA), the International Planned Parenthood\nFederation (IPPF), and the World Health Organization/Human\nReproduction Programme (WHO/HRP). All three of these\norganizations support population activities around the\nworld, as well as in China. As a result, there are\npolitical and legal (Kemp-Kasten Amendment to the FAA)\nimplications to the proposed action.\nConsultations were held with staff of the chairmen and\nranking Republicans of each of the principal oversight\ncommittees for A.I.D. In response to these consultations,\nwe will have specific provisions governing A.I.D. renewal of\nfunding for these organizations. These provisions are\noutlined below:\nA.I.D. funding must be kept in a separate,\nsegregated account.\nNo A.I.D. funds will be used in China.\nUNFPA and IPPF will report on where U.S. funds are\nused and provide adequate documentation to\ndescribe and support the stated expenditures of\nU.S. funds.\nUNFPA has indicated that they have no intention of\nincreasing the amount of funds going to the present China\nprogram above the Governing Council approved level of $57\nmillion over six years. In addition, UNFPA will not use\nmore for the China program than the planned contribution of\n$9.7 million in FY 1993.\n320 TWENTY-FIRST STREET, N.W., WASHINGTON, D.C. 20523\n-AVE\n2\nA technical notification on the level of funding for\nUNFPA (FY 1993 funding level of $20 million) and full\nnotifications on IPPF ($12 million in FY 1993) and WHO/HRP\n($2.5 million in FY 1993) must be sent to Congress before\nthe transfer of funds for UNFPA and WHO/HRP can be made and\nbefore the grant to IPPF can be signed.\nWe are not considering any official press announcement\nwhile the notifications are pending on the Hill. Our\nrespective press offices are prepared to answer any\nquestions. (Press guidance is attached.)\nOur missions in New York and Geneva and our Embassy in\nBeijing will be notified as well as interested members of\nCongress and non-governmental organizations interested in\npopulation activities.\nmunfids\nfor Marc Grossman\nNorma Aaron Williams\nExecutive Secretary\nExecutive Secretary\nDepartment of State\nAgency for International\nDevelopment\nAttachment: a/s\n1460120890\nPAGE\nRESUMPTION OF FUNDING FOR UNFPA, IPPF AND WHO/HRP\nPRESS GUIDANCE\nFunding level:\nUNFPA: For FY 1993 which ends September 30, the U.S.\ncontribution will be $20 million. The request level for FY\n1994 for UNFPA is $50 million. At this level, the U.S. will\nbe one the top two donors to UNFPA.\nIPPF: In FY 1993, the U.S. contribution will be $12 million\nto IPPF/London. This amount will increase gradually,\ntotaling $75 million over a five year period.\nWHO/HRP: FY 1993 funding level is $2.5 million.\nRestrictions on assistance:\nThe U.S. is very opposed to coercive policies and practices\nin family planning programs, and we are extremely dismayed\nby reports of continuing abuses in the Chinese family\nplanning program. Therefore, the following conditions will\nbe included in the exchange of letters with UNFPA and\nWHO/HRP and in the grant agreement with IPPF:\nU.S. funding must be kept in a separate, segregated\naccount.\nNo U.S. funds will be used in China.\nUNFPA and IPPF will report on where U.S. funds are\nused and provide adequate documentation to describe\nand support the stated expenditures of U.S. funds.\nFor WHO/HRP the segregation of accounts will ensure\nthat no U.S. funds are used for abortion.\nUNFPA has indicated that they have no intention of\nincreasing the amount of funds going to its present China\nprogram above the Governing Council approved level of $57\nmillion over six years. UNFPA will not use more for the\nChina program than the planned contribution of $9.7 million\nin 1993.\nUNFPA and IPPF have assured A.I.D. that they will\ncontinuously review their activities annually, and assess\nthe progress they have made toward voluntarism. The U.S.\nand other donors will have the opportunity to make their own\nassessments during the UNDP Governing Council meeting and\nthe IPPF donors meeting. UNFPA and IPPF have confirmed that\nthey will seek to disassociate themselves from any national\nprogram that deviates from the principles of voluntarism.\n1\nKemp-Kasten amendment: Application to UNFPA:\nThe Kemp-Kasten amendment to the foreign assistance\nappropriations act prohibits funding for an organization or\nprogram which, as determined by the President, supports or\nparticipates in the management of a program of coercive\nabortion or involuntary sterilization.\nAlthough UNFPA did not finance coercive abortion or\ninvoluntary sterilization anywhere, in 1985 the A.I.D.\nAdministrator interpreted the statute broadly and concluded\nthat the restriction applied to UNFPA as a result of its\nactivity in China. Since the Kemp-Kasten amendment is\nambiguous, it is appropriate for a new administration to\nreview whether a less sweeping interpretation of the words\nof the statute is reasonable and would permit the\nadministration to achieve its policy objectives in a manner\nthat complies with law.\nImportance of assistance:\nResumption of funding is an important indication of the\nClinton Administration's strong commitment to international\npopulation assistance.\nUNFPA: UNFPA is the largest multilateral donor in\npopulation, with programs in over 130 countries. Virtually\nevery other donor nation contributes to UNFPA.\nA.I.D. and UNFPA together account for the vast majority of\npopulation assistance -- in 1990, the two together accounted\nfor 76% of all population donor expenditures.\nSupport to UNFPA will complement A.I.D.'s ongoing program\ngeographically, as UNFPA can work in some countries the U.S.\ncannot. UNFPA's assistance tends to flow more toward\nsmaller countries than does A.I.D.'s assistance.\nProgrammatically, UNFPA tends to be more involved in some\nactivities, such as census support and population education,\nwhere A.I.D. has fewer activities. UNFPA and A.I.D. can\nalso complement one another in areas where both are\nworking, such as contraceptive procurement.\nIPPF: IPPF is the largest international private voluntary\nfamily planning organization in the world, and is a global\nfederation of over 130 autonomous national family planning\nassociations working in over 160 countries. IPPF receives\nfunding from 30 other government donors and over 20 private\norganizations.\n2\nIPPF's member Associations make a vital contribution in\ntheir countries by working to promote and provide family\nplanning services, to improve the health of women and their\nfamilies, and to support sustainable development policies.\nIPPF affiliates are often the most important national\nproviders of family planning services.\nSupport to IPPF will be an important complement to A.I.D.'s\non-going programs. IPPF plays an important role in the\nprivate non-governmental sector of many countries. IPPF has\na long history of improving women's reproductive health,\nincluding treatment of sexually transmitted diseases,\nreduction of unsafe abortions, and improvement in women's\nstatus.\nWHO/HRP: The Human Reproduction Programme (HRP) of the\nWorld Health Organization (WHO) is the lead inter-\ngovernmental agency working on evaluating and improving\nexisting methods of fertility regulation as well as\ndeveloping entirely new methods.\nAs the lead inter-governmental agency in health, WHO's\nresearch results, and its recommendations, carry great\ncredibility worldwide. Results of HRP-supported research\nwere largely responsible for getting the U.S. Food and Drug\nAdministration (FDA) to approve the injectable contraceptive\nDepo-Provera (DMPA) and for obtaining FDA approval to extend\nthe effective lifespan of the CuT-380 IUD from four to eight\nyears.\n3\n01/05/94\n12:03\n202 690 5673\nHHS-PUBLIC AFFAI\n006\nDEPARTMENT OF HEALTH & HUMAN SERVICES\nChief of Staff\n/\nWashington, DC 20201\nDEC 23 1993\nMEMORANDUM\nFile: abortion\nTO:\nCarol Rasco\nAssistant to the President\nfor Domestic Policy\nFROM:\nKevin Thurm K-sh The\nSUBJECT: Implementation of the new Hyde Amendment\nI write to inform you of the Department's plan for implementing\nthe new Hyde Amendment.\nIn enacting this year's appropriations bill for HHS, Congress\nchanged the scope of the Hyde Amendment. That provision now\nstates:\nNone of the funds appropriated under this Act shall be\nexpended for any abortion except when it is made known\nto the Federal entity or official to which funds are\nappropriated under this Act that such procedure is\nnecessary to save the life of the mother or that the\npregnancy is the result of an act of rape or incest.\nThe change with the greatest political significance is the\naddition of pregnancies that are \"the result of an act of rape or\nincest\" to the excepted category. The Department must now issue\nguidance to the States as to how this new language will be\nimplemented and interpreted. Attached is a copy of the letter\nthe Department proposes to send.\nAs you can see from the dates referenced in the draft letter,\ntime is of the essence. A number of States will need to submit\namendments to their existing state plans by December 31 in order\nto secure reimbursement for abortions performed during the first\nquarter of FY 1994. HCFA staff have begun informally reminding\nstates by telephone of this deadline, but we still need to issue\na letter before the 31st.\nThe decision by Congress to add coverage for abortions where the\npregnancy results from rape or incest raises two questions\nanswered by the attached letter:\n01/05/94\n12:03\n202 690 5673\nHHS-PUBLIC AFFAI\n007\n2\nFirst, how does the category of rape and incest relate to\nthe general principle under Medicaid that state coverage of\nphysician services is mandatory only where those services\nare medically necessary?\nWe believe that Congress intended by its language to make\nall abortions of pregnancies resulting from rape and incest\nmedically necessary in light of psychological as well as\nphysical factors. This is evident from the text of the Hyde\nAmendment, which lists these abortions immediately following\nthe category of \"necessary to save the life of the mother, \"\na category as to which medical necessity is obvious. The\nhistory of Congressional debate also indicates concerns that\nwomen who are the victims of rape or incest suffer or may\nsuffer serious psychological harm from that experience, harm\nthat would be considerably exacerbated if they were forced\nto carry a resulting pregnancy to term. Thus, the\nDepartment interprets this category of excepted abortions in\nthe same way as the first category and treats them as\nsatisfying the general requirement of medically necessary.\nO\nSecond, to what extent, if any, may States require victims\nof rape and incest report those crimes to law enforcement or\nother agencies as a condition for Medicaid reimbursement?\nSeveral versions of the Hyde Amendment from the late 1970s\nincluded requirements that a victim report rape or incest\nwithin a certain amount of time to certain designated\nauthorities, usually law enforcement agencies. This year's\nversion of the Hyde Amendment, the first to include a rape\nor incest exception since the 1970s, does not include any\nform of a reporting requirement. In the intervening years,\nhowever, several states have elected to cover abortions of\npregnancies resulting from rape or incest with their own\nfunds, and some have imposed their own reporting\nrequirements. These state-level requirements vary in their\ndetails from state to state.\nThe Department has elected to allow, but not require, States\nto impose reasonable reporting or documentation\nrequirements, in order to assure that the exception for rape\nand incest abortions is not abused. Where such requirements\nexist or should a State now elect to impose such\nrequirements, however, the letter requires that States allow\nreimbursement if the treating physician certifies that the\nwoman was unable for physical or psychological health\nreasons to comply with the requirement. This approach\nstrikes a balance that will permit States that have such\nrequirements to retain them and will not place the\n01/05/94\n12:04\n202 690 5673\nHHS-PUBLIC AFFAI\n008\n3\nDepartment in the position of forcing absolute uniformity\namong all such requirements. However, it also insures that\na reporting requirement cannot be used to bar coverage when\ninsisting on compliance would be contrary to the general\nprinciple of covering medically necessary services.\nAlso attached to this memorandum is the set of questions and\nanswers that DHHS staff will use in responding to any inquiries\nfrom the press or public at the time the letter is distributed.\nIf you have any questions, please do not hestitate to contact me.\nAttachments\nCC:\nChristine Varney\n01/05/94 12:06\n202 690 5673\nHHS-PUBLIC AFFAI\n011\n9.\nQ.\nWhat do you plan to do if a State does not comply with this\npolicy?\nA. The Federal government has general authority In the area of\nState compliance. We will address the use of that authority as\nIt becomes necessary.\n10.\nQ. What makes you think that physicians and\nbeneficiaries won't abuse the fatitude given on\nreporting for victims of rape or Incest?\nA. We are not overturning any requirement that the\nphysician or patient needs to report In accordance\nwith State law. The latitude comes In walving the\ntiming of the report in an emergent situation.\n11. Q. How would you define an emergency In this case?\nA. That is a judgment for the physician to make in\nlight of the individual's mental and physical\ncircumstances. We would not supersede that\njudgment.\n01/05/94\n12:05\n202 690 5673\nHHS-PUBLIC AFFAI\n4\n010\ntheir limitations to the statutory availability of Federal funding\nfor abortions do not have to revise their State plans. For the\nStates which do need to change their State plans, we believe\nthat the number of Medicald abortions performed for victims of\nrape or Incest In any single 3-month period, l.e. October-\nDecember 1993, Is small. These States are likely to make\ntheir decisions on the basis of whether there is any substantial\nFederal funding at stake. We don't believe there will be much\nfunding at Issue for one quarter, but we wanted to be sure that\nthose States were advised they had that opportunity.\n5.\nQ. What methods will you use to ensure that only the cases\ndescribed In the new Hyde Amendment language will be paid\nfor with Federal funds?\nA. HCFA Is asking that the States develop their own methods to\nassure that all claims for Federal funding qualify under the\nHyde Amendment requirements. HCFA will then use its audit\nauthority to the extent necessary to review particular claims for\nFederal matching.\n6. Q. When your letter indicates that States are required to cover\nmedically necessary abortions for victims of rape and incest,\nare you saying that even If State law proscribes payments for\nabortions, the State must pay anyway through its Medicaid\nprogram?\nA. Yes. We believe this is consistent with the requirement of the\nFederal law.\n7. Q. Do you have any estimates of how many additional abortions\nwill be paid for by Medicald as a result of this policy?\nA. That is a very difficult estimate to make. Many States already\npay for all Medicaid beneficiaries' abortions with 100% State\nfunds and do not report those numbers. The States are likely\nto begin submitting these claims for the Federal funding share.\nThis means there is no known number of current abortions\nupon which to base an estimate. An educated guess would\nrange between one and a few thousand.\n8.\nQ. How many more abortions are going to be\nperformed because of this policy?\nA. Again, that's a hard question to answer, but since\nmany States are already paying claims for this\nservice, we don't believe the numbers will be\nsignificant.\n01/05/94\n12:05\n202 690 5673\nHHS-PUBLIC AFFAI\n1\n009\nDRAFT\n12/22/93\n3:30 p.m.\nMEDICAID ABORTION POLICY CONCERNING\nVICTIMS OF RAPE OR INCEST\n1.\nQ. Since the Hyde Amendment has always been viewed as\nlegislation restricting the variety of abortion cases which can\nqualify for Federal funding, why does the Administration\nbelieve that this language now dictates the variety of abortion\ncases which States must pay for?\nA.\nIt Is our Interpretation that the Congressional Intent of the 1993\nHyde Amendment language is to assure that poor women\nwhose lives are endangered or who are victims of rape or\nincest will have the financial support of the Medicaid program\nif they choose to have an abortion.\n2.\nQ. Your letter refers to payment for abortions in the context of\n\"mandatory medical services\" in Medicaid. What specific\nservices are being addressed here?\nA. Inpatient and outpatient hospital services, physician services,\nrural health clinic (RHC) services, and Federally Qualified\nHealth Center (FQHC) services.\n3.\nQ. Are there any circumstances In which States will\nnot be required to pay for abortions for cases of\nrape, incest or life endangerment?\nA. States will be required to pay for all such abortions\nunless the abortion Is billed by the providers as an\noptional Medicaid benefit. For example, abortions\nbilled as clinic services in clinics that are not\ncertified as RHC's or FQHC's would not have to be\npaid for by a State. However, if a State chooses to\npay for such abortions, Federal matching funds\nwould be available.\n4.\nQ. Your letter has been issued quite late in December,\nconsidering that it instructs States to submit approvable State\nplan changes by December 31. Why Is this?\nA.\nFirst, it's important to recognize that only a few States have to\nsubmit State plan changes. Those States with State plans\nwhich are sllent on abortion coverage limitations or which tie\n01/05/94\n12:07\n202 690 5673\nHHS-PUBLIC AFFAI\n012\nt\n\"All the News\nThere FR to Print\"\nThe New York Times\nof\nbe\nM\nDate\n$\n$\n1\nL.CXLIII\nNa 49,358\n- - Rew\nNBW YORK, MONDAY, DECEMBER JP, 1993\nV - - - Move - -\nse CBN\nKerrey Backs New Abortion Rule\nSpecial w The New York fine\nWASHINGTON, Dec. 26 - Senator\nMr. Johnson quoted Senator Kerrey\nBob Kerrey of Nebreska said tonight\nin a letter to Metro Right to Life in\nthat he did not consider the Clinton\nOmaha as saying he had \"received\nAdministration's decision to require\npersonal assurances that tn the ab\nstates to pay for some abortions for\nsence of the Hyde Amendment, states\npoot women to be a violation of assur-\nlike Nebracks, which de not allow state\nances given 10 Congress.\nfunds to be used for abortions, would\nOver the weekend, an abortion appo-\nnot be required to accept Federal funds\nnent, Douglas Johnson, the legislative\nfor such procedures.\"\ndirector of National Right to Life, cited\nBut Senstor Kerrey said tonight in a\na letter by Benator Kerrey M proof that\ntelephone interview that the letter con-\nthe Administration had gone back -\ncerried the amendment's repeal. \"The\nits word that the states would maintain\nquestion was asked whether states\nthe right to keep abortion out of their\nwould be able to impose additional\nMedicaid programs.\nrestrictions,\" he said \"The Adminis-\nIn September, Congress loosened the\ntration and # would not coerge states\nban on Federal financing for abortions\nto pay for abortions in all circum-\nto allow the Government to pay for\nstances.\"\nabortions for Medicaid recipients in\nSenator Kerrey, who supported the\ncases of rape or incest as well M when\nchange in the Hyde amendment but\nthe life of the pregnant women le in\nopposed its repeal, said he favored the\ndanger. The Administration had sought\nnew policy. \"It's in fact in keeping with\nto repeal the ban. the Hyde Amend-\nwhat an awful lot of supporters of the\nmeat, named for Representative Men-\nHyde amendment were actually advo-\nry Hyde of Illinois.\ncating.\" be mid.\nBrues C Viadeck, the official in\ncharge of Medicald and Medicare, seld\non Friday that the Administration was\nBooks of The Times:\npreparing regulations to require states\nto pay for such abortions, which would\nMonday through Friday,\nnumber about I thousand I year.\nThe New York Times\n01/05/94\n11:59\n202 690 5673\nHHS-PUBLIC AFFAI\n002\nFILE: abortion\nTALKING POINTS - MEDICAID COVERAGE OF ABORTION\n1/5/93\nThe HHS directive to state Medicaid directors implements\nlegislation passed by Congress in October. The HHS appropriations\nbill for this year adds abortions for pregnancies resulting from\nrape and incest to the category of medically necessary abortions\nfor which funding is provided. Under existing Medicaid policy,\nmedically necessary services are mandatory on the states; states\ncannot decide at their own discretion whether or not to cover these\nabortions.\nMedicaid is a joint federal-state program. The funds used are\ncontributed partly by the federal government and partly by each\nparticipating state government. A state may elect not to\nparticipate at all in the Medicaid program, but once it elects to\nparticipate, it has no choice but to comply with federal law. And\nunder the Medicaid statute, coverage of certain medically necessary\nservices, such as physician services, is mandatory.\nWhen a state law conflicts with a federal law, the federal law\ntakes precedence. This is the doctrine of pre-emption. When\nCongress changed the Hyde amendment this year, it added rape and\nincest to the category of funding for which Medicaid funds must be\nmade available. If a state law conflicts with this, the state law\nmust give way to the federal law insofar as it applies to the\nMedicaid program. The state law is unaffected in the way that it\nimpacts on programs that use only state funds.\nThe number of newly covered abortions which will be affected by the\npolicy change is small - less than 1,000 by most estimates - and\nthe costs to the states will be minimal.\nMore importantly, the women who will be affected are poor women who\nhave already been traumatized, for whom carrying a baby to term\nwould be a real threat to their mental and physical health. These\nare women who are poor, and who have already been victimized by\nrape or incest. Because of that experience, they have already\nsuffered serious psychological harm - harm that would be greatly\nexacerbated if they were forced to carry a resulting pregnancy to\nterm. Adding coverage in these cases to the existing exemption for\nwomen whose pregnancies are life-threatening is the proper course.\nRay Henley's letter is not representative of the views of all\nstates. Many states already provide funding in cases of rape and\nincest, and the new law will now make federal matching funds\navailable to them - actually decreasing their state costs. Because\nthe policy will provide some states with new funds, and will only\nminimally increase costs in others, it does not represent a new\nunfunded mandate.\n*\nAI,GT,MC -\nMG\nFyI.\nDDM\nJAN-05-1994 04:49 FROM DEP SEC HHS\nTO\n94562878 P.06\nAPWA\nAMERICAN PUBLIC WELFARE ASSOCIATION\nKetin V. Concernon, President\nA Sidney johnana M, Executive Insector\nfile: abortion\nJanuary 5. 1994\nBruce Viadeck\nAdministrator\nHealth Care Financing Administration\n200 Independence Avenue SW\nWashington D.C. 20201\nBy Fax and Mail\nDear Bruce,\nIn light of press reports today, I would like to clarify those subjects on which APWA and\nits affiliate, the State Medicaid Directors Association, have policy positions and those on\nwhich we do not.\nNeither the American Public Welfare Association nor the State Medicaid Directors\nAssociation has adopted a policy with regard to Medicaid funding for abortions in the\nbroadest sease, nor have we adopted a policy position on extending coverage to include\ncases of rape and incest.\nThe December 30 letter you received from Ray Hanley, Arkunsas Medicaid director and\nSMDA chair. raised concerns with the process HCFA followed in promulgating the new\npolicy - Medicaid funding given the president's certier directives related to closer\nconsultation with states. APWA has consistently pressed for a strong and effective\nfederal-state partnership including advance notice of rulemaking with opportunity for\nreview, and thus shares Ray Hanley's concern with the process followed in this instance.\nSincerely Did yours,\nA. Sidney Johnson III\nExecutive Director\n810 First Street, N.E., Suite 500, Washington D.C. 20002-6267 (202) 682-0100 FAX: (202) 289-6555\nJAN-05-1994 04:47 FROM DEP SEC HHS\nTO\n94562878 P.02\nDraft: 1/4/94\nJanuary 4, 1994\nRay Hanley\nDraft\nDear Ray:\nfile:abortion\nI am responding to your letter of December 30, concerning the\n\"Hyde Amendment.\" I hope my comments will help clarify the\nimplementation process for this Congressional action.\nMedicaid law mandates coverage of certain medically necessary\nservices, such as physician services. Other health services are\noptional for the States to cover. Without a \"Hyde Amendment\",\nevery medically necessary abortion performed by a physician would\nbe a mandatory service.\nThe Hyde Amendment prohibits the use of Federal funds for\nabortions, with certain exceptions. When Congress this year\nchanged the Hyde Amendment to lift the prohibition on funding for\nabortions of pregnancies resulting from rape or incest, those\nabortions then became subject to the same standards for medically\nnecessary physician services as any other medical procedure.\nThe decision to implement this policy nationwide was not\ndiscretionary. Under the Supremacy Clause of the Constitution,\nwhen State law conflicts with Federal law, the Federal law takes\n1\nJAN-05-1994 04:48 FROM DEP SEC HHS\nTO\n94562878 P.03\nDraft: 1/4/94\nprecedence by the doctrine of pre-emption. The legislative\nhistory of the Hyde Amendment extends back over most of two\ndecades and has always dealt with the mandatory services\nprovisions of the Medicaid program. In the fiscal years between\n1981 and 1983, Congress enacted the Bauman Amendment to the Hyde\nprovision, which specifically relieved the States of the Medicaid\nmandate to fund medically necessary abortions, and thus created\nan exception to the rule of pre-emption. The Bauman Amendment\nmade State funding of medically necessary abortions\ndiscretionary; absent such language it is not. That language has\nbeen absent from the Hyde Amendment since 1984.\nWhen Congress enacted the Hyde Amendment this year, it added\nabortions in the case of pregnancies resulting from the tragedy\nof rape or incest to the category of abortions for which Medicaid\nfunds must be made available. Thus, if State law conflicts with\nthis enactment, the State law must give way to the Federal law\ninsofar as it applies to the Medicaid program. State law is\nunaffected for programs that use only State funds.\nThese changes to the Hyde Amendment were enacted in October 1993.\nThe intent of the letter which we issued in December 1993 was to\nadvise States of the need to come into compliance with Federal\nlaw. As with any modification to a State plan, States can make\n2\nJAN-05-1994 04:48 FROM DEP SEC HHS\nTO\n94562878 P.04\nDraft: 1/4/94\nchanges up to the last day of a quarter, and those changes may be\nretroactive to the first day. By notifying States prior to the\nend of the first fiscal quarter (October through December 1993),\nStates which paid for abortions resulting from rape or incest now\nhave the opportunity to qualify for Federal matching funds for\nthose expenditures. Other States have until March 31, 1994 to\namend their plans in order for those changes to be effective\nJanuary 1, 1994.\nIn your letter, you assert that the implementation of the Hyde\nAmendment imposes another unfunded Federal mandate on States and\nis therefore contrary to the President's Executive Order. The\nPresident's order concerns areas of policy and regulation where\nFederal agencies have discretionary authority. No such\ndiscretion rests with the Administration when Congress enacts a\nmandate as law.\nIn addition, the amount of State funds involved is negligible\nbecause the revision of the Hyde Amendment expands abortion\ncoverage to a very small group of women.\nThose\nwho will be served by the Hyde Amendment of 1993 are poor women\nwho have been the victims of rape or incest, who have suffered\nphysical and mental abuse and who, beyond that, have been made\npregnant by those acts. Congress has extended needed medical\n3\nJAN-05-1994 04:49 FROM DEP SEC HHS\nTO\n94562878 P.05\nDraft: 1/4/94\nservices to these women.\nFinally, where statutory language permits, I believe we have\nworked hard to consult with States on the implementation of\npolicies--as promised. Our work on the drug rebate program,\nhome and community-based services waivers, and issues in health\ncare reform are prime examples of these collaborative efforts.\nAs in the past, we will continue to be as flexible as we can in\nhelping States implement this law. We have made considerable\nstrides in allowing State flexibility and will continue to work\ntoward this end in assisting States in their efforts to comply\nwith the law.\nI appreciate your concerns, but we must move forward to carry out\nthe Congressional mandate to provide Medicaid support to women\nwho are victims of these terrible abuses.\nI look forward to our continued collaboration on State health\npolicy issues.\nSincerely,\nBruce Vladeck, Administrator\n4"
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