Current Pennsylvania law says no government funds, like Medicaid, can pay for an abortion except in cases of rape, incest, or if the mother’s life is in danger.

Monday, Pennsylvania’s Supreme Court published an opinion that could change that status quo.

The Court ruled in favor of abortion providers in a 3 to 2 decision published January 29, 2024.

Multiple abortion providers sued the Department of Human Services (DHS) for a law that prohibits Medicaid from covering elective abortions.

They argued that the ban on coverage violates Pennsylvania’s Equal Right’s amendment in the state’s constitution.

The case was originally dismissed, and then appealed by providers, at the Commonwealth Court level in 2021.

Yesterday's ruling overturns previous Supreme Court precedent from 40 years ago, when seven Justices unanimously agreed the state law was constitutional.

Now, the case will go to trial again at the Commonwealth Court, where it will require courts to reexamine if government insurance should cover all abortions.

Planned Parenthood is counting the decision as a victory.

“We know it has never been acceptable to deny Pennsylvanians access to life affirming and essential healthcare. And that is no longer defensible," said Signe Espinoza, executive director of Planned Parenthood Pennsylvania Advocates. "And I think yesterday was a huge win and we are certainly celebrating and looking ahead.”

Pro-Life institutes are emphasizing the term ‘elective’ as they respond to the decision.

“Even those who would profess to be pro-choice don’t unanimously believe that tax payer funding should be used to pay for elective abortions," said Cheryl Allen, a former Superior Court judge who now acts as counsel as PA Family Institute. "Where someone just elects to have an abortion for their own individual purposes or their own convenience, where there are no medical issues involved.”

Espinoza says there are less than 20 abortion clinics left in the state, with the cost of abortion often going past the medical procedure to travel expenses as well.

“I’d be curious to see what other elective procedures have this level of scrutiny and restrictions," said Espinoza, "that are not rooted in science or have any kind of medical backing."

A quick study of insurance shows that there is wide variety on how providers define which procedures are, or are not, elective. For Medicaid, a basic rule of thumb is if the surgery is medically required. Some are automatically included, like family planning. At least 40 states cover vasectomies with Medicaid.

Medicaid was originally banned from covering abortions- except when the mother's life was in danger- at the federal level in 1976 with the 'Hyde Amendment'. Congress expanded the law to include rape and incest in 1978. Pennsylvania adopted the current federal legislation in 1982.

In one measure of public opinion, an Ipsos poll says 78% of Pennsylvania voters say the amount of money someone has or does not have should not determine whether they can get healthcare services, including abortion.

The same poll says 60% of PA voters favor Medicaid covering all pregnancy-related healthcare, including abortion.

Until the trial in the Commonwealth Court, which has no set date, the ban on coverage for elective abortions remains.