The Attorney General of Texas
JIM MAl-TOX Qril 8, 1986
Attorney General
Supreme Court Building Honorable Erwin W. Barton Opinion No. .IiG4'0
P. 0. Box 12548 cheirman
Austin, TX. 78711. 2549
Humsn sarviccs Committee Re: CoGtitutional validity of a
5121475.2501
Telex 91O/S74-1387 Texas Aouse of Re~lresentatives municipal ordinance which requires
Telecopier 512/475-0255 P. 0. Box 2910 participants in a medical assis-
Austin, Texas 'Et769 tance program to apply for other
available benefits
714 Jackson, Suite 700
Dallas, TX. 75202-4505
214i742-8944 Dear Repre8entati.c:Barton:
You ask whether the Similar Benefits Rule which is incorporated
4824 Alberta Ave., Suite 160 in the Medical P.ssistance Program of the city of Austin violates
El Paso, TX. 793052793
individuals' constItutiona "freedom of choice." The city of Austin's
915/533-34a4
Similar Benefits Rule makes it a prerequisite to the expenditure of
city funds for 'xalth care services for indigent or low income
1001 Texas, Suite 700 recipients that liuch persons must first utilize whatever "federal,
Houston, TX. 77002~3111 state or private funds or similar benefits are available for the
713/223-59@ payment for [such] services. . . ." We find that this rule does not
violate any constjxutional "freedom of choice."
808 Broadway, Suite 312
Lubbock, TX. 79401.3479 Austin is a Rome Rule City, created pursuant to article XI,
KW747-5235 section 5 of the Texas Constitution, with broad authority to provide
for the health antiwelfare of its citizens. V.T.C.S. arr. 1175, 5528,
4309 N. Tenth, Suite S 34. Its governir.gbody is empowered to establish and regulate the
MAtlen, TX. 78501-1685 provision of medical and health services, including the operation of
512l5824547 hospitals. V.T.C.S. art. 1015, §§l, 4. The Austin City Council
enacted the SimiLr' Benefits Rule in 1977, by resolution, as follows:
200 Main Plaza, Suite 400
San Antonio, TX. 792052797 Whenever federal, state or private funds or
512l225.4191 similar benefits are available for the payment for
servicczi to indigent or low income health care
recipient:s,no city funds shall be used to pay for
An Equal Opportunityl such care. Persons who are eligible for partial
Aftirmatlve Action Employer
benefitzl from other third party sources may be
eligible for supplamental clinic card benefits
provided that such supplemental benefits are
extended only as a source of payment of last
resort lrhenbenefits from other sources have been
exhausted or are inadequate to fully cover the
cost of medically necessary services.
p. 2150
Honorable Erwin W. Barton - Page 2 (JM-470)
You ask whether this rule violates any right to "freedom of choice,"
to choose between various Sovernment benefit programs.
The right to "freedom of choice” in certain matters is part of
the right to privacy. See Roe v. Wade, 410 U.S. 113, 152-53 (1973);
see also Harris v. M&a,,'448 U.S. 297, 312 (1980) (part of liberty
interest protected by the Due Process Clause of the Fourtemth
Amandment). The most commonly recognized matters of personal privacy
involve activities and dlzcisions regarding marriage, procreation,
contraception, and a freedom of personal choice in certain other
matters associated with family life. sci?3 see also Santosky v.
Kramer, 455 U.S. 745, 753 (1,982). Thereye.no cases which hold that
a person has a constitut&xlal right to select the source of public
assistance under the right of privacy.
In Harris v. &Rae, 44.8U.S. 297, 316 (1980), the United States
Supreme Court denied the ezristenceof a constitutional entitlement to
sufficient financial resources to participate in the full range of
protected choices. See aljg;Maher v. Roe, 432 U.S. 464, 474 (1977).
As the McRae court explainsd,
[allthough the l.iberty protected by the Due
Process Clause affords protection against un-
warranted government interference with freedom of '
choice in the context of certain personal
decisions, it does not confer an entitlement to
such funds as ma:rbe necessary to realize all the
advantages of that freedom.
448 U.S. at 317-18. The c.ourtreasoned that the manner of providing
benafits which the government is not constitutionally required to
provide Is a legislative matter rather than a matter of constitutional
entitlement. 448 U.S. at 318; see also Burgess v. City of Houston,
718 F.2d 151. 154 (5th CII. 19S3);mney v. Meade, 466 S.W.2d 341,
342 (Tax. Civ. App. - Austdn 1971, writ ref'd n.r.e.1.
Consequently, the constitutional right of individuals to privacy
and the freedom of choice j,npersonal matters which that right antalls
does not prevent the city c’f Austin from requiring that applicants for
medical assistance which ::s funded bv the citv first exhaust other
available sources of medical assistance. See alao Schweiker v. Hogan.
457 U.S. 569, 591 (1982) (allocating scarce benefits ou the basis of
financial ability to meet needs not inconsistent with constitutional
principles of equal treatmfnt).
SUMMARY
The constitul:ional right of individuals to
privacy and the freedom of choice in personal
p. 2151
Honorable Erwin W. Barton -'Page 3 (JM-470)
matters which t3,o.tright entails do not prevent
the city of AustLn from requiring that applicants
for medical assistance which is funded by the city
first exhaust other available sources of medical
assistance.
IA-t+-
VeryItruly your!
JIM MATTOX
Attorney General of Texas
JACE HIGHTOWER
First Assistant Attorney Goneral
MARY KELLER
Executive Assistant Attorney General
ROBERT GRAY
Special Assistant Attorney General
RICE GILPIN
Chairman, Opinion Committee
Prepared by Jennifer Riggs
Assistant Attorney General
p. 2152