State public funding of abortion is affected by two things: Medicaid and the Hyde Amendment. In 1965, Medicaid was first authorized. Since then, it has provided low-income families with health care. After the case of Roe v. Wade, all state Medicaid programs covered abortions without any restrictions. The Hyde Amendment which was enacted in 1976 limited federal funding for abortion care. Under the Hyde Amendment, specifications have been made that designates what abortion services are covered under Medicaid. Presently, Medicaid only covers abortions unless in the case of rape, incest, or if the woman's life is endangered. Even if a state has laws that are more restrictive than the Hyde Amendment, abortions must be covered under these specifications. Since the Hyde Amendment, the majority of the states have adopted this policy as their own with the exception of four states. Hawaii, Washington, and New York fund provide funding voluntarily if the woman's life is in endangered. Maryland also funds abortions voluntarily in the case of fetal abnormality. Only 17 states publicly fund abortion for low-income women on the same or similar basis as other pregnancy or health related issues while 13 states have declared independent protection for reproductive choice and have non-discrimatory public funding for abortion. None of these states are located in the Midwest.