In Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services, (PA Commonwealth Ct., April 20, 2026), the Pennsylvania Commonwealth Court, in a 4-3 decision in a case on remand from the state's Supreme Court,, held that the Pennsylvania law which denies Medicaid coverage for most abortions violates the equal protection provisions and the Equal Rights Amendment to the Pennsylvania state Constitution. Pennsylvania permits Medicaid coverage for abortions only in cases involving the life of the mother, rape or incest. The majority opinion said in part:
Initially, we are not persuaded that the state interests the Attorney General has identified are compelling within the Equal Rights Amendment analysis. First, regarding fetal life, the Attorney General has narrowly defined this as an interest in preserving already-existing fetuses. He has disclaimed any interest in promoting human reproduction in general, or in preventing unplanned pregnancy. In this way, the Attorney General appears to have embraced the necessary implication of this view: the interest “can be understood only as an interest that is advanced at the cost of forcing women to bear children against their will....
Second, regarding women’s psychological well-being, the Attorney General has not identified any other context in which we have found a compelling state interest in protecting a competent adult from feeling regret for her free choices....
... [W]e conclude that the Coverage Exclusion violates the Equal Rights Amendment in Article I, Section 28 of the Pennsylvania Constitution. Further, we conclude that Article I of the Pennsylvania Constitution guarantees a fundamental right to reproductive autonomy, that the Coverage Exclusion does not operate neutrally with respect to that right and is not properly justified in doing so, and accordingly the Coverage Exclusion violates the equal protection guarantee in Article I, Section 26 of the Pennsylvania Constitution.
Judge Wojcik filed a concurring opinion, saying in part:
... I write separately to emphasize the clear and unbroken line of the foundational legal documents establishing a fundamental right to personal freedom, equality, and tolerance in this great Commonwealth of ours that compel this result as well....
Judge McCullough joined by Judges Covey and Wallace filed a dissenting opinion, saying in part:
Today the four-member Majority declares that the corporate petitioners, four of which operate for profit (Abortion Providers), have a constitutionally-mandated ability to bill Pennsylvania taxpayers to pay for abortions-on-demand sought by Medical Assistance recipients. What is more, however, is that the Majority got where it wanted without a hearing, without factfinding, without even an answer to Abortion Providers’ Petition for Review. The Majority’s decision is based entirely on unvetted “stipulations” submitted jointly by Abortion Providers and Respondents after Respondents abandoned any defense of the constitutionality of the abortion funding restrictions challenged in this litigation....
To impose this funding burden onto taxpayers, the Majority summarily re-writes longstanding Pennsylvania public policy favoring the protection of the life of an unborn child.... The Majority also creates a fundamental but nebulous constitutional right to “reproductive autonomy,” inserts it into the 152-year-old article I, section 1 of the Pennsylvania Constitution....
... The only interest asserted by the Commonwealth and identified by the General Assembly to support the Coverage Exclusion is the interest in unborn child life already conceived, which, I believe, is compelling on its face....
I am not convinced that a right to reproductive autonomy or anything like it exists in the Pennsylvania Constitution to afford anyone a constitutional right to obtain an abortion....
Judge Wallace, joined by Judge McCullogh, filed a dissenting opinion, saying in part:
The Attorney General identifies three state interests he asserts are compelling on behalf of the Commonwealth: protecting fetal human life, preserving the health of the mother, and safeguarding the conscience rights of Pennsylvania citizens....
Without providing the Attorney General the opportunity to present evidence to this Court regarding these asserted interests, the Majority simply dismisses them,...
... [I]t does not escape me that in a post-Dobbs era, ... our legislative branch has not restricted or ended abortion access in our Commonwealth. Nonetheless, the judicial branch in a power grab is effectuating policy by determining that a state constitutional right to abortion exists....
