Pennsylvania Supreme Court clears way for challenge to ban on Medicaid abortion coverage

The Supreme Court of Pennsylvania issued a ruling Monday finding that a 1982 state bill barring Medicaid from covering most abortions can be challenged in court, years after the initial legal petition was dismissed.

The court ruled on a case brought forward by health care providers in 2019 on behalf of their patients challenging the Pennsylvania Abortion Control Act of 1982, which prevents abortions from being covered under Medicaid unless the pregnancy is a result of rape, incest or it threatens the life of the mother.

The plaintiffs in the case argued that the 42-year-old legislation violated the Pennsylvania Constitution as well as the state’s Equal Rights Amendment and equal protection provisions. They further argued that other states permit their Medicaid programs to have abortion coverage that goes beyond the few exceptions allowed under the Abortion Control Act.

The case was dismissed by a lower court in 2021.

While the higher court did not ultimately rule on the question of the coverage exclusion’s constitutionality, the opinion Monday cleared the way for plaintiffs to once again challenge it in court.

In reviewing the case, the Pennsylvania Supreme Court found that the state’s constitution guaranteed a “fundamental right to reproductive autonomy,” which included the decision on whether to have an abortion, though only two of the five justices who considered the case explicitly concurred with this ruling.

In Pennsylvania, abortion is allowed up to 24 weeks into a pregnancy.

A lower court had previously ruled that a prior state case from 1985 — Fischer v. Department of Public Welfare — had affirmed that the abortion coverage exclusion was constitutionally sound and also ruled in favor of the Pennsylvania Department of Human Services, which had argued the providers lacked standing to challenge the law.

The Pennsylvania Supreme Court ruled in its opinion Monday that the providers have standing, as they had “plainly established that they are aggrieved by the Coverage Exclusion,” and also overruled the prior ruling based on the Fischer case.

The court also found that discrimination based on sex-based characteristics was a violation of the Equal Rights Amendment, which differed from the lower court’s ruling.

“Today’s decision is a landmark victory for reproductive freedom,” Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, said in a statement.

“With abortion under attack across the country, Pennsylvania continues to be a beacon of hope. Planned Parenthood Federation of America applauds the advocates and providers, including our Pennsylvania affiliates, who fought tirelessly for this win,” she added.