PA medicaid abortion exclusion deemed “presumptively unconstitutional”

Though access to abortion is still legal in Pennsylvania, it is highly restricted for Medicaid recipients, prompting several reproductive healthcare centers in the state to file suit against the Department of Public Health in an effort to increase accessibility for people of all economic backgrounds. 

Last week, several abortion providers, including the Allegheny Reproductive Health Center, argued their case before the Pennsylvania Commonwealth Court. They claim that banning Medicaid coverage for abortion is a form of sex discrimination, which directly violates the Equal Rights Amendment (ERA) provisions reinstated in 2024.

This case was initially filed in 2019, with the Allegheny Reproductive Health Center and other abortion clinics claiming that excluding abortion access from Medicaid coverage under Pennsylvania’s Abortion Control Act was unconstitutional. However, it wasn’t until 2024 that the Pennsylvania Supreme Court issued its groundbreaking ruling that providers have the right to challenge the exclusion of abortion coverage, ruling that it violates both the Equal Rights Amendment and the state constitution’s Non-Discrimination Clause. In its ruling, the court decided that abortion providers are entitled to sue on behalf of their patients, and anti-abortion legislators in Pennsylvania are forbidden to intervene.  

While the higher court labeled the Medicaid abortion funding ban as “presumptively unconstitutional” under the reinstated Equal Rights Amendment, it referred the case to the lower court, Commonwealth Court, for further review with this new ruling in mind. In the meantime, the ban on using state Medicaid funds for abortion remains in effect. Although the Department of Human Services withdrew its opposition to the case, it continues to enforce the funding restriction as long as the current law remains in effect. 

If the Commonwealth Court rules in favor of the Allegheny Reproductive Health Center, it could set a legal precedent for other states to strengthen abortion access under their own state constitutions, something reproductive rights advocates feel is long overdue.

At last week’s hearing, Dr. Sheila Ramgopal, CEO of Allegheny Reproductive Health Center, said the case was about reproductive freedom for all Pennsylvanians. 

“As plaintiffs, we are technically representing the interests of our patients but the way I see it, we’re fighting for reproductive autonomy for every Pennsylvanian,” Ramgopal said. “Abortion care is healthcare, full stop. We witness the harm of political meddling in medical care every single day. That’s why we’re fighting in court while serving patients in the exam room.” 

Although abortion remains legal in Pennsylvania, Medicaid recipients face significant barriers where access is determined by economic status—a disparity that Signe Espinoza, executive director of Planned Parenthood Pennsylvania, said needs to be addressed once and for all.

“Women are denied bodily autonomy just because of their income and the kind of health insurance that they carry.Men and women should not have different access to care, and furthermore we can’t perpetuate this separate and unequal health system for women: one for women with money and one for women without. It’s time for this ban to be stricken and the cruelty to end.”