In the heated debate over funding for abortion, one argument often silences both sides: Taxpayers aren’t paying for abortions anyway, since federal funding has been prohibited by the Hyde Amendment for four decades.
But Massachusetts is one of 17 states where abortions are taxpayer-funded — with money from the state.
Antiabortion activists are now trying to change that, launching a petition drive to change the state Constitution, which — the state’s high court ruled in 1981 — grants women on Medicaid the right to a state-funded abortion.
If their effort proves to be successful, it would return a thorny political debate long silenced by the judiciary to the legislative arena, where activists could then try to pressure their representatives to cut off public funding.
Right now, “you can’t really discuss it with your legislators because they have their hands tied,” said Thomas Harvey, an attorney and chairman of the Alliance to Stop Taxpayer Funded Abortions ballot campaign.
“It’s got to be made, in my view, a political issue,” Harvey added. “And right now, it’s not.”
In a state where abortion rights have long been a given, opponents hope the effort will give them an opening to start posing uncomfortable questions that politicians may prefer not to address.
For instance, state Representative James J. Lyons Jr., a sponsor of the measure, pointed to language in Massachusetts law, defining abortion as “the knowing destruction of the life of an unborn child.”
“When you put it out there like that, you think, ‘Why are we spending our tax dollars on that?’ ” said Lyons.
“I guess what we’re trying to do is just bring an awareness to what’s going on in Massachusetts,” he added. “You talk to people and say, ‘Do you know that our tax dollars pay for abortion in Massachusetts?’ And they’ll say, ‘No, no, that doesn’t happen.’ ”
It’s unclear exactly how much Massachusetts spends on abortion services each year, though it’s a small share of the state’s spending on health care, which dominates the overall budget. Medicaid, known in Massachusetts as MassHealth, covers about 1.9 million residents and cost the state $6.2 billion in the past fiscal year, with the federal government picking up the rest of the $15.2 billion tab.
Sharon Torgerson, a spokeswoman for the state’s Executive Office of Health and Human Services, could not provide a sum specific to abortion but said the state spends $5.7 million on all MassHealth family planning services.
Conservatives object to the state sending their tax dollars to abortion clinics. But abortion-rights defenders think the Hyde Amendment itself is discriminatory, making it more difficult for poor women in most states to gain access to safe abortions. The amendment blocks federal dollars from being used for abortion, except in cases of rape or incest or to save the life of the pregnant woman, noted Tricia Wajda, director of communications for the Planned Parenthood League of Massachusetts.
“Every woman — regardless of her ZIP code — should have the ability to make decisions about her health and abortion without barriers,” Wajda said in an e-mail. “While 17 states do provide Medicaid coverage for abortion with state dollars, many women still do not have affordable access to abortion care.”
She noted that they include women who work for the federal government, regardless of where they live; veterans who use the veterans affairs system; uniformed service members and their families around the world; federal prisoners; Peace Corps volunteers; and beneficiaries of Indian Health Services.
Massachusetts also barred state funding for abortions for a brief period, starting in 1978, following the Legislature’s passage of what was known as the Flynn-Doyle bill. One of its authors was then-Representative Raymond Flynn, who would later become mayor of Boston.
But in 1981, the Massachusetts Supreme Judicial Court ruled that women eligible for Medicaid have a constitutionally protected right to funding for abortion.
“The right to safe, legal abortion means little to the woman who cannot afford her care,” Wajda said. “The Massachusetts Supreme Judicial Court has recognized this, ruling that prohibiting state funding for abortion for Medicaid-eligible women renders the right to an abortion illusory.”
The initiative petition now proposed directly targets that decision and seeks to disentangle abortion from other constitutional rights.
“Nothing in this Constitution requires the public funding of abortion,” according to the language the measure would add to the Constitution. It would require another act of the Legislature to actually alter the funding.
In Tennessee, a 2014 constitutional amendment went even further, directly prohibiting state funding for abortions. Since then, Tennessee passed one of the most restrictive abortion laws in the country, banning the procedure after 20 weeks.
Abortion rights defenders fear an erosion of rights under the Trump administration and have been trying fend off incremental restrictions on abortion rights at various state legislatures.
“The current national political environment is one of the most hostile in recent memory to health care access, women, and reproductive rights,” Wajda said. But she thinks resistance has only built in Massachusetts. “The people of Massachusetts and our lawmakers have responded to this dangerous climate by rallying to support access to affordable health care and basic rights whenever they have been challenged.”
In Massachusetts, any change in abortion funding is a long way from reality. An initiative petition starts with a proposal submitted to the attorney general’s office by at least 10 voters. The petition must then demonstrate public support by attracting the signatures of a certain number of registered voters — this year 64,750 — and submitting them to local election officials by November.
If this signature drive succeeds, the petition would then require the approval of one-quarter of the Legislature — 50 lawmakers — in two successive legislative sessions, meaning the earliest it could appear on a ballot is 2020.
The signature-gathering effort is being pushed by the Renew Massachusetts Coalition, a conservative advocacy group that worked on last summer’s successful signature drive for a 2018 ballot question that would repeal the state’s transgender accommodations law.
Harvey said he thinks it could garner more support than other abortion measures because it also deals with fiscal issues.
“It’s not up or down on abortion. It’s what your tax dollars are going to,” he said.
Typically, the Planned Parenthood Advocacy Fund can rely on the support of 131 of the 198 members of the Massachusetts House and Senate (with two Senate vacancies).
In Massachusetts, even many leading Republicans wholeheartedly defend abortion rights. In the spring, Governor Charlie Baker pledged to shore up Planned Parenthood funding in Massachusetts if Congress followed through on threatened budget cuts. Asked about the governor’s position about the initiative petition, Torgerson said in a statement that “the governor opposes any efforts to defund women’s health and family planning services in the Commonwealth.”
Abortion rights advocates remain confident that they will prevail. And even if the public supported it, the measure would not take away taxpayer funding unless the Legislature took up a whole new effort to do so.
Abortion opponents acknowledge they don’t have those votes, but they want to start the conversation.
“Unless it’s an issue that people talk about,” Harvey said, “nothing’s ever going to change.”
Stephanie Ebbert can be reached at Stephanie.Ebbert@globe.com. Follow her on Twitter @StephanieEbbert.