A Pennsylvania court said Monday that the state constitution guarantees the right to an abortion and struck down a decades-old law that banned the use of state Medicaid funds to cover abortion costs.
The ruling by a divided seven-judge panel of the appeals-level Commonwealth Court is a major victory for Planned Parenthood and abortion clinic operators who first sued Pennsylvania in 2019 over Medicaid funding restrictions.
Although the case initially focused on state Medicaid limitations, in 2022 the US Supreme Court ruled in Roe v. The stakes widened significantly after overturning Wade ended nearly half a century of federal abortion protections.
Monday’s court finding marks the first time abortion rights are protected by Pennsylvania’s constitution, joining a handful of states where reproductive rights advocates have succeeded in protecting abortion access by pointing to state constitutions.
The case can still be appealed to the Pennsylvania Supreme Court.
“Today, our Commonwealth Court, looking at the Pennsylvania Constitution, held that there is a right to reproductive autonomy, and it is the highest possible level of that right,” said Susan Frittse, executive director of the Women’s Law Project, which helped represent the clinics.
A spokesman for Republican Attorney General David Sunday said the office is reviewing the decision and has not said whether it will appeal.
Democrats roundly applauded the decision, as did abortion rights advocates.
“I have long opposed this unconstitutional ban, and as governor I will not defend it — because a woman’s ability to access reproductive care should never be determined by her income,” Gov. Josh Shapiro said in a statement.
State Treasurer Stacey Garrity, a likely Republican candidate to challenge Shapiro in the fall general election, said in a statement that “the court’s decision to force our tax dollars to pay for abortions is not only wrong, it is immoral.”
In 2019, plaintiffs asked the court to order the state’s Medicaid program to begin covering abortions, without restrictions, arguing that a 1982 Pennsylvania law restricting state Medicaid funding violated the constitutional equal protection rights of low-income women.
The case has taken several turns, with a lower-court ruling in 2021 saying the plaintiffs lacked standing and were bound by a 1985 state Supreme Court decision upholding the 1982 law.
However, in 2024, the state Supreme Court overturned the lower court’s decision and also determined that previous court decisions did not fully consider the breadth of state constitutional protections against discrimination provided by the federal Constitution.
The seven lower court judges who heard the case on Monday sided with the plaintiffs. The majority opinion said that the state should invest in maternal and child health services and other resources in the belief that women should complete their pregnancies.
The attorney general’s office argued that the state had an interest in “protecting fetal life” and that the Medicaid coverage exclusion supported that goal.
“If a state believes that certain medical procedures may harm women psychologically, the state may license, regulate and educate around such care. This is clearly less intrusive than taking an entire medical procedure off the table for some women, some of whom may benefit from that procedure — a fact the Attorney General does not dispute,” the majority opinion said.
Abortion opponents immediately criticized Monday’s decision.
“By declaring a broad constitutional ‘right to reproductive autonomy’ and mandating taxpayer-funded abortions through Medicaid, the Court has overstepped its authority, ignored the plain text of our state constitution, and forced millions of Pennsylvanians who believe life begins at conception,” said Pennsylvain President Michael. Opposes abortion rights.
In Pennsylvania, abortion is legal under state law through 23 weeks of pregnancy.
