Montana Laws Limiting Medicaid-Funded Abortion Struck by Court

Three Montana laws placing new restrictions on Medicaid coverage of abortions violate the state’s constitution, a Montana court said Tuesday.

Judge Mike Menahan, of the Montana District Court for Lewis and Clark County, granted summary judgment to organizations representing medical providers who sued the state over the measures. The ruling permanently blocks the measures following Menahan’s preliminary injunction in 2023.

“A woman’s right to choose to protect her health by terminating her pregnancy prior to fetal viability outweighs the State’s interest in protecting a potential life at the expense of her health,” Menahan wrote.

The challenged laws are HB 544, HB 862, and a Montana Department of Public Health and Human Services rule. They define when an abortion is medically necessary in a way that restricts Medicaid coverage, the court said.

The laws bar abortion coverage unless the abortion is performed by a physician, require pre-authorization approval, a physical examination, and the submission of extensive supporting documentation, the court said.

The laws violate the Montana Constitution’s right to privacy because they interfere with an individual’s right to make medical decisions and the state didn’t have a compelling justification for doing so, the court said.

Menahan rejected Montana’s argument that the requirements for Medicaid-funded abortions are justified as safety precautions.

“The State has offered no medically acknowledged, bona fide health risk addressed by the new definition, nor has it offered any reason to implement a definition of medical necessity unique to abortion,” Menahan wrote.

Graybill Law Firm, Planned Parenthood Federation of America Inc., and Yellowstone Law represented the plaintiffs.

The case is Planned Parenthood of Mont. v. State, Mont. Dist. Ct., No. DV-2023-0000299, 3/11/25.