Pennsylvania court overturns limits on Medicaid coverage for abortions
[April 21, 2026]
By KIMBERLEE KRUESI and MARC LEVY
A Pennsylvania court on Monday said that the state's constitution
guarantees a right to abortion while striking down a decades-long law
banning the use of state Medicaid funds to cover abortion costs.
The ruling by a divided seven-judge panel of the appellate-level
Commonwealth Court is a major victory for Planned Parenthood and
abortion clinic operators who first sued Pennsylvania over its Medicaid
funding restrictions in 2019.
While the case initially centered over state Medicaid limitations, the
stakes significantly expanded after the U.S. Supreme Court in 2022 ended
nearly a half-century of federal abortion protections by overturning Roe
v. Wade.
The court's finding on Monday marks the first time that the right to an
abortion is protected by the Pennsylvania constitution, joining a
handful of states where reproductive rights advocates have found success
in protecting abortion access by pointing to state constitutions.
The case could still be appealed to Pennsylvania's Supreme Court.
“Today, our Commonwealth Court, looking at the Pennsylvania
constitution, held that there is a right to reproductive autonomy, and
it’s the highest possible level of a right,” said Susan Frietsche,
executive director of the Women's Law Project, which helped represent
the clinics.
A spokesperson for Attorney General David Sunday, a Republican, said the
office was reviewing the decision and did not say whether it would
appeal.
Democrats roundly praised the decision, as did abortion rights
advocates.
“I’ve long opposed this unconstitutional ban, and as Governor, I did 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.
The likely Republican nominee to challenge Shapiro in the fall general
election, state Treasurer Stacy Garrity, said in a statement that the
court's decision “to force our tax dollars to pay for abortions is not
only misguided, it is immoral.”
In 2019, plaintiffs asked the court to order the state’s Medicaid
program to begin covering abortions, without restriction, arguing that a
1982 Pennsylvania law restricting state Medicaid funding violated the
constitutional equal protection rights of low-income women.
[to top of second column]
|
 The case has since taken several
turns, with a lower-court ruling in 2021 that the plaintiffs did not
have standing and also saying that they were bound by a state
Supreme Court 1985 decision upholding the 1982 law.
However, in 2024, the state Supreme Court overturned the lower
court's ruling and also determined that previous court decisions did
not fully consider the breadth of state constitutional protections
against discrimination beyond those provided by the federal
constitution.
The seven judges on the lower court who heard the case largely sided
with the plaintiffs on Monday. The majority opinion said the state
should invest in maternal and infant health care and other resources
if it believes that women should carry a pregnancy to term.
The attorney general's office had argued that the state had an
interest in “protecting fetal life” and that the Medicaid coverage
exclusion helped support that goal.
“If the state believes certain medical procedures may
psychologically harm women, the state can license, regulate, and
educate around such care. That is less intrusive than taking an
entire medical procedure off the table categorically 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 quickly criticized Monday's decision.
“By declaring a sweeping constitutional ‘right to reproductive
autonomy’ and mandating taxpayer-funded abortion 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 to subsidize the killing of unborn
children," said Michael Geer, president of Pennsylvania Family
Institute, which opposes abortion rights.
In Pennsylvania, abortion is legal under state law through 23 weeks
of pregnancy.
All contents © copyright 2026 Associated Press. All rights reserved
 |
