PENNSYLVANIA — A divided seven-judge panel of Pennsylvania's Commonwealth Court ruled Monday that the state constitution guarantees a right to abortion, striking down a decades-old law that banned the use of state Medicaid funds to cover abortion costs. The decision marks the first time the right to an abortion has been protected by the Pennsylvania constitution.

The majority of the seven judges sided with the plaintiffs, who first sued the state in 2019. The case could still be appealed to Pennsylvania's Supreme Court.

Planned Parenthood and abortion clinic operators initiated the litigation in 2019, asking the court to order the state's Medicaid program to begin covering abortions without restriction. The plaintiffs argued that a 1982 Pennsylvania law restricting state Medicaid funding violated the constitutional equal protection rights of low-income women.

In 2021, a lower court ruled that the plaintiffs did not have standing and said they were bound by a 1985 Pennsylvania Supreme Court decision upholding the 1982 law. The Pennsylvania Supreme Court overturned that 2021 ruling in 2024, determining that previous court decisions did not fully consider state constitutional protections against discrimination beyond those provided by the federal constitution.

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. "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.

The attorney general's office had argued that the state had an interest in "protecting fetal life" and that excluding Medicaid coverage for abortion helped support that goal. A spokesperson for Attorney General David Sunday said the office was reviewing the decision and did not say whether it would appeal.

"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. Gov. Josh Shapiro also commented on the ruling. "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," Shapiro said.

Michael Geer, president of Pennsylvania Family Institute, opposed the ruling. "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," he said.

Abortion is legal under Pennsylvania state law through 23 weeks of pregnancy. A handful of states have protections for abortion access under their state constitutions. In 2022, the U.S. Supreme Court overturned Roe v. Wade, ending nearly a half-century of federal abortion protections.