Pennsylvania Court Recognizes Constitutional Right to Abortion, Strikes Down Medicaid Funding Ban
A Pennsylvania appellate court ruled April 20 that the state constitution protects a right to abortion, striking down a decades-old law that barred the use of state Medicaid funds to cover the procedure. The decision by a divided panel of the Commonwealth Court addresses whether the state can limit access to abortion care based on income.
The case was brought by Planned Parenthood affiliates and abortion providers, who challenged a 1982 law restricting Medicaid coverage for abortions. The lawsuit argues the policy violates constitutional protections by allowing the state to fund pregnancy and childbirth services while denying coverage for most abortion care.
The ruling follows the 2022 decision by the U.S. Supreme Court to overturn Roe v. Wade and return authority over abortion regulation to the states. In Pennsylvania, abortion remains legal through 23 weeks of pregnancy. State law, however, has long limited when public funds can be used to pay for the procedure.
The challenged law restricts Medicaid coverage for most abortions, even though the program covers other pregnancy-related care. The case centers on whether the state can treat those services differently under its public health program.
At issue is the concept of equal protection, which requires governments to treat people in similar situations the same, unless there is a sufficient reason to treat them differently. The providers argue that by covering childbirth-related care but excluding most abortion services, the state created unequal treatment tied to income. The court found that the distinction placed a burden on low-income individuals who depend on Medicaid.
The decision also turns on how courts evaluate fundamental rights under a state constitution. When a right is recognized at that level, limits on it must meet the highest legal standard. The government must show a compelling reason for the policy and prove it is narrowly focused on achieving that goal. The court found the Medicaid restriction did not meet that requirement.
The legal dispute has developed over several years. A lower court dismissed the case in 2021, pointing to an earlier Pennsylvania Supreme Court decision from 1985 that upheld the funding restriction. In 2024, the state’s high court reversed that outcome and said prior rulings did not fully examine the scope of constitutional protections against discrimination, allowing the challenge to proceed.
In its opinion, the Commonwealth Court said the state may pursue its policy goals through other approaches rather than excluding a medical procedure from coverage for certain groups. The court rejected arguments from the attorney general’s office that the restriction served an interest in protecting fetal life.
Governor Josh Shapiro said he had opposed the funding restriction and supported broader access to reproductive care. Critics of the decision said it expands constitutional protections and requires taxpayer funding for abortions. The attorney general’s office said it is reviewing the ruling and has not indicated whether it will appeal.
The Pennsylvania Supreme Court could review the case.
