The ruling was made by a divided seven-judge panel of the appellate-level commonwealth court, with the judges largely siding with the plaintiffs. The case initially centered over state Medicaid limitations, but the stakes significantly expanded after the US Supreme Court overturned Roe v Wade in 2022. A lower-court ruling in 2021 said the plaintiffs did not have standing and were bound by a state supreme court 1985 decision upholding the 1982 law. In 2024, the state supreme court overturned the lower court's ruling and determined that previous court decisions did not fully consider the breadth of state constitutional protections against discrimination.
The case could still be appealed to Pennsylvania's supreme court. A spokesperson for Republican David Sunday, the attorney general, said the office was reviewing the decision and did not say whether it would appeal. Democrats roundly praised the decision, as did abortion rights advocates.
In its reasoning, 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. How this ruling will immediately affect Medicaid coverage for abortions in Pennsylvania remains uncertain.