On Wednesday, Feb. 5, the Commonwealth Court of Pennsylvania re-heard a civil case against the Pennsylvania Department of Human Services. The case, Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services, represents a decades-long fight by reproductive health organizations to remove Medicaid restrictions on abortion funding.
Medicaid is a government-funded health insurance program that provides coverage for low income individuals and families who meet certain eligibility requirements. Medicaid helps ensure access to essential healthcare services for those who might not otherwise afford them — especially reproductive healthcare as low-income individuals experience unintended pregnancies and seek abortions at significantly higher rates than those with higher incomes. Additionally, research shows that those who are denied abortions are more likely to experience poverty than people who receive them, an effect that lasts up to 4 years after being denied an abortion. This ruling will affect low-income people who can become pregnant by determining whether Medicaid will provide funding for their abortions.
To understand the civil case, readers should understand the history of this issue. The Abortion Control Act was enacted in Pennsylvania in 1982, which banned Medicaid from covering abortion care except in the cases of rape, incest or the life of the mother. That same year, appellants filed Fischer v. Department of Public Welfare, challenging the constitutionality of the Medicaid ban because it violated the Pennsylvania Equal Rights Amendment. Unfortunately, the Supreme Court of Pennsylvania upheld the Medicaid Ban in 1985.
34 years later, Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services was filed in the Commonwealth Court of Pennsylvania. Their arguments stated that there is precedent for allowing state Medicaid funds to cover abortion beyond the three exceptions, that there is no “parallel exclusion of coverage” for men” and that pregnancy and childbirth expenses are covered under this program even though they are more expensive than an abortion.
Regardless, the court upheld the Medicaid ban, leading the various healthcare providers to file the case with the Supreme Court of Pennsylvania, which overturned Fischer last January. The Supreme Court determined that providers had standing to pursue claims and that members of the legislature should not be permitted to intervene in the case.It also provided new standards for evaluating discrimination claims. Finally, it sent the case back to the Commonwealth Court of Pennsylvania so the appropriate standards could be applied.
In its January 2024 verdict, the PA Supreme Court established that the ERA applies to abortion restrictions, a major win for the feminist movement! A particularly important line of the decision reads, “…the right to reproductive autonomy, like other privacy rights, is fundamental.”
The PA Supreme Court declared that the Medicaid coverage exclusion “treats the fundamental right to reproductive autonomy non-neutrally” because pregnant people seeking an abortion are not provided with funding, in contrast to pregnant people who are planning to carry their pregnancy to term. This implies that the Commonwealth Court of Pennsylvania will rule in favor of Allegheny Reproductive Health Center and the other providers. However, it could take between a few days to many months for the judges to publish a decision.
