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Restrictions on Low-Income Women's Access to Abortion

Pennsylvania prohibits public funding for abortion for women eligible for state medical assistance for general health care unless the procedure is necessary to preserve her life or the pregnancy is the result of rape or incest.  If the woman has been raped or is the victim of incest, she must personally report the incident to a law-enforcement agency or child protective services before the abortion, unless the physician certifies that the woman was unable to report the crime for physical or psychological reasons.  Pa. Dep't of Public Welfare, Medical Assistance Bulletin, Clarification of Payment Policy for Abortion Services (Nov. 28, 2006) at; Medical Assistance Program Provider Handbooks and Billing Guides (Jun.12, 2009) at

Partially invalid and partially enjoined statutes provide that a woman eligible for state medical assistance may not obtain public funds for an abortion unless a second, independent physician certifies that the procedure is necessary to preserve her life or the pregnancy is the result of a rape personally reported by the victim to a law-enforcement agency prior to the abortion or incest personally reported by the victim to a law enforcement agency or to child protective services prior to the abortion. 18 Pa. Cons. Stat. Ann. §§ 3215(c), (j) (Prior Statute Enacted 1974; Current Statute Enacted 1982; Last Amended 1989); 62 Pa. Cons. Stat. Ann. § 453 (Enacted 1980).

A court held that § 3215(c)'s independent-physician certification and § 3215(j)'s non-waivable rape and incest-reporting requirements conflict with federal law, and issued an injunction prohibiting their enforcement.  Elizabeth Blackwell Health Ctr. for Women v. Knoll, 61 F.3d 170 (3d Cir. 1995), cert. denied, 516 U.S. 1093 (1996).

A court upheld in part and invalidated in part previous versions of § 3215(c) and § 453 that limited funding to cases of life endangerment, or rape or incest reported within 72 hours.  The court held that limiting funding to cases of life endangerment, rape, or incest did not violate the Pennsylvania Constitution by denying some medically necessary abortion services; however, the court held that the 72-hour reporting requirement for rape and incest was unconstitutional.  Fischer v. Dep't. of Pub. Welfare, 482 A.2d 1148 (Pa. Commw. Ct. 1984), aff'd, 502 A.2d 114 (Pa. 1985) (addressing only the limiting of funding for some medically necessary abortions).

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