Nevada Court Orders Medicaid to Cover Abortion, Marking Historic Win for Reproductive Rights

Photo byACLU of Nevada

In a landmark decision, Nevada’s state court mandates the inclusion of abortion care under Medicaid, marking the first legal victory based on the state's new Equal Rights Amendment.

A Nevada court ruled that the state’s Medicaid program must cover abortion care, recognizing the previous exclusion as sex-based discrimination under the state's Equal Rights Amendment (ERA). This historic ruling paves the way for expanded access to abortion for low-income Nevadans.

Historic Ruling Expands Abortion Access Under Nevada Medicaid

In a groundbreaking decision with national implications, a Nevada state court has ruled that the state’s Medicaid program must cover abortion care, marking the first legal challenge under Nevada’s Equal Rights Amendment (ERA). The court’s ruling, which is final and not subject to appeal, recognizes the denial of abortion coverage as sex-based discrimination, in direct violation of the ERA that Nevada voters overwhelmingly approved in 2022.

The case, brought by Silver State Hope Fund, the American Civil Liberties Union (ACLU), and the ACLU of Nevada, represents a pivotal victory for reproductive rights in the state, particularly for low-income individuals. This decision places Nevada among the 19 states that offer Medicaid coverage for abortion services, expanding critical healthcare access in a post-Roe v. Wade landscape.

Court’s Decision Marks First ERA-Based Legal Challenge

The crux of the court’s ruling is the violation of the state constitution’s Equal Rights Amendment, which mandates equality under the law regardless of sex. According to Rebecca Chan, a staff attorney for the ACLU Reproductive Freedom Project, “Nevada’s Equal Rights Amendment prohibits discrimination on the basis of sex, including discrimination based on pregnancy and abortion.” The court’s order made clear that withholding Medicaid coverage for essential health services, such as abortion, disproportionately impacts those who can become pregnant, reinforcing gender-based inequality.

For Erin Bilbray-Kohn, executive director of the Silver State Hope Fund, the ruling fulfills the promise of the ERA by ensuring that Medicaid recipients have access to comprehensive reproductive healthcare, including abortion. “We’re thrilled that the promise of our state’s Equal Rights Amendment will be fulfilled for more people, especially those who rely on Nevada Medicaid for essential health care,” said Bilbray-Kohn.

Impact on Low-Income Nevadans: Medicaid’s Role in Health Equity

Nevada’s Medicaid program exists to provide quality healthcare to low-income individuals who otherwise might not afford it. Despite this mission, Medicaid previously denied abortion coverage, leaving many low-income Nevadans unable to access reproductive healthcare. The ruling dramatically shifts the landscape for Nevadans who depend on Medicaid, ensuring they can make the best medical decisions for themselves without financial barriers.

This court decision is especially significant for Silver State Hope Fund, a nonprofit that offers financial assistance to Nevadans seeking abortion care. The organization supports individuals with expenses for travel, lodging, and childcare to ensure they can access abortion services. Until this ruling, many of their clients faced a healthcare gap—Medicaid would not cover abortion, forcing individuals to rely on limited resources and support from nonprofits like Silver State Hope Fund to afford the procedure.

Chris Peterson, legal director of the ACLU of Nevada, emphasized the broader significance of the case. “A right that a person cannot afford is no right at all,” he stated, highlighting that this legal victory not only grants Medicaid recipients access to abortion but also affirms that the state's ERA is more than just symbolic. “This case is about more than state Medicaid coverage, it’s about affirming that Nevada’s Equal Rights Amendment is more than words on a page.”

Roe v. Wade Reversal and Nevada’s Reproductive Rights Landscape

The legal fight to secure Medicaid abortion coverage in Nevada gained urgency in the wake of the U.S. Supreme Court’s 2022 decision to overturn Roe v. Wade, the landmark case that had protected abortion access nationwide for nearly 50 years. In response to this monumental rollback of federal abortion rights, Nevadans overwhelmingly passed the ERA, enshrining protections for gender equality into the state constitution.

Nevada’s ERA, passed in the aftermath of Roe's reversal, has become a key legal tool in defending reproductive rights in the state. With this ruling, the state’s ERA has demonstrated its capacity to challenge policies that create or reinforce gender-based disparities, particularly those affecting individuals who can become pregnant. This decision positions Nevada as a model for other states grappling with the fallout of the Supreme Court’s decision and searching for ways to protect reproductive rights at the state level.

Abortion Rights, Economic Justice, and Health Equity

At the heart of the Silver State Hope Fund’s lawsuit was the argument that denying Medicaid coverage for abortion disproportionately impacts low-income individuals, deepening economic and health inequities. Without Medicaid coverage, people who could not afford the procedure were forced into impossible situations, often needing to continue unwanted pregnancies or resort to unsafe alternatives.

The court’s ruling addresses this disparity directly, ensuring that low-income Nevadans can access the same reproductive health options as their wealthier counterparts. For those without access to private insurance, Medicaid is often the only means of obtaining essential healthcare, including abortion. As such, the decision is a crucial step toward health equity and reproductive justice.

For reproductive rights advocates like Bilbray-Kohn, the ruling represents a significant win in the ongoing fight for healthcare justice. “More Nevadans will be able to make the best personal medical decisions for themselves and their families,” she said, emphasizing that access to healthcare should not depend on a person’s income or gender.

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