A Pennsylvania court overturned a decades-old ruling that prevented the use of state funding for abortions last week, establishing abortion access as a statewide right.
In the case — titled Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services — the court recognized “a fundamental right to reproductive autonomy” under the Pennsylvania Constitution. The Daily Pennsylvanian spoke with Penn faculty and staff about the potential implications of the ruling for access to abortion.
The case, which began in 2019, arose when plaintiffs argued that barring public funding for abortion procedures violated women’s equal protection rights. On April 20, seven years later, the court concluded that this “coverage exclusion” violates the Equal Rights Amendment of the Pennsylvania Constitution.
According to Master of Public Health faculty member Patricia Skuster, while the case originally centered on Medicaid coverage for abortion, it became “something much more” after the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization.
Dobbs overturned the United States Supreme Court’s 1973 decision in Roe v. Wade, which had affirmed abortion as a constitutional right at the federal level and prevented states from banning abortion before the first trimester of pregnancy.
“In 2022, with the Dobbs decision, Pennsylvania and every single American lost their right to abortion under the federal Constitution,” Skuster explained.
While abortion stayed legal in Pennsylvania — generally permitted up to 23 weeks and 6 days of gestation — Dobbs led to a wave of abortion restrictions across the country. Among states where abortion is legal, Pennsylvania is now the 21st to offer state funding for abortion.
“So this case initially was just about funding, but then it became something else: abortion rights within the state constitution,” Skuster explained.
Without public insurance, some patients might not be able to afford “the care that they want and need,” Penn Medicine obstetrician-gynecologist Sarah Gutman told the DP.
She said she hopes the Allegheny decision will allow her to “provide the safest, best care” for patients based on their needs, without having to consider financial constraints. Gutman added that while nonprofits can assist with funding, those routes can often “take a lot of time.”
She also acknowledged equity gaps in abortion access based on factors such as race and income.
“The patients who are going to have the most challenging pregnancies, or that often will have the highest risk, are also the patients who have the least access to care that could end a pregnancy, if that is the care they need,” she said. “I think that making Medicaid patients have better availability for abortion care is hugely important.”
According to Penn Med obstetrician-gynecologist Sarita Sonalkar, having insurance can help patients in time-sensitive situations.
“If their abortion is covered, then they can just access care, rather than waiting to pull funds together,” Sonalkar said. “Each week that abortion care is delayed increases the risk of the abortion, so increased risk of bleeding and other complications, and so this insurance coverage of abortion makes abortion safer for patients.”
Sonalkar called the Allegheny ruling “one of the best decisions” she has seen made in her career.
“I think this is going to really change the landscape of care, and I think patients are going to be healthier because of this,” she said.
Both doctors clarified that they do not speak on behalf of Penn Med.
While Skuster described the Allegheny decision as a “relief” and a “tremendous victory for women’s rights,” she added that Pennsylvania could take the additional step of allocating money for abortion in its annual budget.
“Investing in abortion care as an essential health care service is something that governments, including the state of Pennsylvania, could look to in the future,” Skuster said.
Despite the city’s historical support, Philadelphia’s latest annual budget decreased funding to local reproductive health care organizations. Earlier this month, demonstrators in favor of abortion rights joined city council members to call for increased Planned Parenthood funding.
State officials offered a range of perspectives on the Allegheny ruling.
“Pennsylvania’s Commonwealth Court just struck down the state ban on Medicaid coverage for abortion care,” Pennsylvania Gov. Josh Shapiro wrote in an April 20 press release. “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.”
Pennsylvania Treasurer Stacy Garrity wrote in an April 20 social media post that it is “immoral” for “tax dollars to pay for abortion.”
The case may still face an appeal at the Pennsylvania Supreme Court.
