A Pennsylvania appellate court struck down a four-decade-old restriction on using state Medicaid funds for abortion, declaring for the first time that the state constitution protects abortion rights. The 7-judge commonwealth court panel ruled Monday that the ban violates equal protection guarantees for low-income women.
The decision marks a significant win for Planned Parenthood and abortion clinic operators who challenged the 1982 law in 2019. It also places Pennsylvania among a small group of states where courts have found abortion protections embedded in state constitutional language, becoming increasingly important after the U.S. Supreme Court eliminated federal abortion protections in 2022.
The majority opinion emphasized that if Pennsylvania believes abortion can harm women psychologically, the state could regulate and educate about the procedure rather than categorically deny it to low-income patients through Medicaid. The court noted that the state could instead invest in maternal and infant health care if it truly wanted to encourage women to carry pregnancies to term.
The state's Republican attorney general's office had argued the funding ban served a legitimate state interest in protecting fetal life. Spokeswoman David Sunday said the office was reviewing the decision and did not immediately confirm whether it would appeal to Pennsylvania's Supreme Court.
Democratic Governor Josh Shapiro quickly praised the ruling, saying he has long opposed the funding restriction and declined to defend it as governor, arguing that reproductive access should not depend on a woman's income.
Stacy Garrity, the state treasurer and likely Republican nominee for governor, framed the decision as government overreach. She called the court's order to use taxpayer dollars for abortions "not only misguided, it is immoral." Michael Geer of the Pennsylvania Family Institute, an abortion-opposing group, said the court had overstepped by declaring a sweeping right to reproductive autonomy and forcing residents with life-beginning-at-conception beliefs to subsidize abortion.
The litigation traces back to 2019, when plaintiffs asked the state Medicaid program to cover abortions without restriction, claiming the 1982 funding ban violated equal protection rights for low-income women. A 2021 lower court ruling dismissed the case on standing grounds and cited a 1985 state Supreme Court decision upholding the original ban. But in 2024, Pennsylvania's highest court reversed that dismissal and determined that previous rulings had not fully examined state constitutional protections against discrimination that go beyond federal guarantees.
Abortion remains legal in Pennsylvania through 23 weeks of pregnancy under state law. The commonwealth court's decision is not final and could still reach the state Supreme Court on appeal.
Author James Rodriguez: "The court essentially said low-income women deserve the same access to a legal medical procedure as those who can pay out of pocket, a principle that cuts straight to the heart of what constitutional equal protection actually means."
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