Nevada Medicaid to expand abortion coverage after state declines to appeal court decision

Nevada Medicaid will now cover medically necessary abortion services after state officials did not appeal a judge's ruling requiring the health insurance program to cover the procedure.

The decision, seen as a victory for abortion rights advocates, ruled in favor of the American Civil Liberties Union (ACLU) of Nevada, which filed a lawsuit last August seeking to reverse the state's limits on abortion coverage for Medicaid recipients on behalf of Silver State Hope Fund, a Nevada nonprofit that provides abortion services. The insurance program already covers abortion for cases involving rape, incest or when the pregnant person's life is in danger.

The ACLU had argued that the limits on abortion coverage violated Nevada's Constitution through the state's equal rights amendment, which prohibits sex-based discrimination by categorizing abortion services separately from other medically necessary procedures.

Though Clark County District Court Judge Erika Ballou made the ruling in March, she did not issue a full order explaining her ruling until August, giving the state 30 days to appeal. The Nevada attorney general's office, which represented the Department of Health and Human Services in the case, opposed the lawsuit in district court but did not file an appeal by the 30-day deadline.

A representative for the attorney general's office declined a request for comment.

Chris Peterson, the legal director of the ACLU of Nevada, said in a Thursday statement that the implementation of the judge's order proves the legal strength of Nevada's equal rights amendment, adopted by voters in 2022.

"A right that a person cannot afford is no right at all," Peterson said. "This case is about more than state Medicaid coverage, it's about affirming (that) Nevada's Equality of Rights of Amendment is more than words on a page."

Nevada was previously one of 19 states to have its Medicaid program follow the guidelines of the Hyde Amendment, a federal legislative provision enacted in 1977 that restricts the use of federal funds for abortions, though it does not prevent state funds from being used to cover abortion services. A March KFF research brief indicates that 17 states use state funds to pay for abortions for women covered by Medicaid in circumstances that are not allowed under the Hyde Amendment.

"Nevada Medicaid will be updating its coverage policy to reflect the court's ruling that such coverage should expand to abortion services when they are considered medically necessary by a qualified health care provider," a Nevada Medicaid spokesperson wrote in a statement.

Medicaid is a federal health insurance program that funds coverage for low-income families, qualified pregnant women and children and certain people with disabilities. Program costs are shared between the federal government and state, which is responsible for around a quarter of program spending. As of July, Nevada Medicaid had almost 800,000 participants, an estimated 28 percent of the state's population.

The attorney general's office initially argued against the case, saying that Silver State Hope Fund lacked standing and that the proper parties in the case would be pregnant people or those who are capable of becoming pregnant.

Erin Bilbray-Kohn, the executive director of the Silver State Hope Fund, said the ruling will allow Nevadans to make the best medical decisions for themselves and their families.

"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, which, as the court recognized, includes abortion," Bilbray-Kohn said in a statement.

This story was updated on 9/12/2024 at 1:21 p.m. to include that the attorney general's office declined to comment.