Judge gives Pennsylvania the green light to fund abortions through Medicaid

Gov. Josh Shapiro’s administration can pay for abortions through the state’s Medicaid program while an appeal of the April ruling that recognized “a fundamental right to reproductive autonomy” plays out, a Commonwealth Court judge ruled.

Judge Matthew S. Wolf last week granted a request from abortion providers to allow Medicaid to fund the procedure during the appeal from the Pennsylvania Attorney General’s Office because the state Supreme Court held previously that the funding restriction was “presumptively unconstitutional.”

The Philadelphia Democrat wrote the April majority opinion that struck down a decades-old state law limiting public funding for abortions to cases involving rape, incest, or danger to the life of the mother.

Attorney General Dave Sunday appealed the ruling to the Pennsylvania Supreme Court, where three justices previously signaled their willingness to rule that abortion access is a right.

The appeal led to an automatic stay on the Commonwealth Court ruling, which meant Medicaid could fund abortion only in the cases allowed by the state’s Abortion Control Act.

The coalition of abortion providers that brought the lawsuit in 2019 argued the stay would cause irreparable harm because it would force “an unknown number of their patients to carry pregnancies to term” during the appeal, the opinion said.

If the coverage ban were to remain in place, despite the ruling holding it amounts to sex-based discrimination and recognizing the right to reproductive autonomy, that would violate the constitutional rights of Pennsylvanians, Wolf wrote.

Sunday’s office argued that lifting the stay would allow more abortions, despite the opposition of many taxpayers.

“There can be no legitimate interest — for the Commonwealth or the public — in knowingly violating constitutional rights," Wolf said, rejecting the attorney general’s argument.

A spokesperson for Sunday declined to comment.

“At last, a terrible injustice that has harmed Pennsylvanians for decades has ended,” Susan Frietsche, executive director of Women’s Law Project, which represented the providers, said in a statement.

Sunday, a Republican, stepped in to defend the law when Shapiro’s administration bowed out after the 2024 state Supreme Court ruling, which used language strongly endorsing abortion access as a constitutional right. But the justices were ultimately split on whether they were ready to make that call and sent the case back to the Commonwealth Court.

The statewide court that oversees government-related matters sided with the abortion providers in a 4-3 ruling.

It is unclear how quickly medical providers will be able to bill Medicaid for abortions. The Pennsylvania Department of Human Services has not issued guidance for providers yet.

“Gov. Shapiro has a proven track record of defending a woman’s right to choose and protecting access to safe, legal abortion services,” Rosie Lapowsky, a spokesperson for Shapiro, said. “He will continue to fight for women’s right to make their own medical decisions in consultation with their doctor.”