Pennsylvania’s doctors, warning of risk to abortion rights, join fight over state Supreme Court retention votes

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With Election Day less than a month away, physicians from across Pennsylvania convened to issue a warning: The outcome of the upcoming judicial retention vote could alter the future of reproductive health care in the commonwealth.

The retention race, which asks voters to decide “yes” or “no” on whether to keep three Democrats — Justices Christine Donohue, Kevin Dougherty and David Wecht — has attracted national attention, large political spending and fierce debate over what role courts should play in protecting or restricting abortion access.

In a virtual press conference hosted by the Committee to Protect Health Care, Pennsylvania doctors said the outcome of the vote could reshape access to abortion, Medicaid coverage and patients’ rights across the state. The doctors warned that the outcome of the vote could have far-reaching consequences for access to abortion, birth control, prenatal care and other medical rights.

The doctors said that while they’re nonpartisan, the risk of losing reproductive health rights in the state prompted them to speak out.

“It’s a little bizarre and surreal for doctors to be involved in these kinds of really niche votes that really should not be part of the discourse, but the reason that we’re all here is that there is a lot at stake and specifically when it comes to the health of people in Pennsylvania,” said Dr. Ghady Haidar, an infectious disease doctor in Pittsburgh. “And for this reason, I really cannot overstate the importance of the vote to retain and to say yes to all three of these Supreme Court justices.”

Dr. Amanda Cai, a cardiologist in Hershey who specializes in women’s heart health, called it a serious matter that should be beyond politics.

“The right for women to choose what happens to their bodies when they are up against tremendously difficult decisions is key,” Cai said. “For patients like these, abortion access can be a life or death decision.”

The state Supreme Court’s role

Since the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, states have become the primary battlegrounds in the fight over abortion rights. With federal protections erased, the legality and accessibility of abortion now depend entirely on state legislatures, constitutions and courts.

As a result, the country has fractured into a patchwork of laws, with some states enacting near-total bans and others reinforcing access through legislative or judicial action. In this new landscape, state supreme courts wield immense power, often serving as the final arbiters in high-stakes cases that determine whether people can access reproductive health care in their communities.

Justices elected as Democrats currently hold a 7-to-2 majority on the Pennsylvania Supreme Court. In 2024, the court effectively struck down the 1982 statute that bans the use of Medicaid funds to pay for abortions — a case known as Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services. In its ruling, the court deemed the ban “presumptively unconstitutional” and allowed a fresh hearing under scrutiny of sex discrimination provisions.

The justices’ decision to take up the case signals that they see Medicaid abortion coverage not merely as a policy choice but as a constitutional issue tied to equal protection, suggesting they would continue to preserve abortion access in the state. A more conservative majority may see the issue otherwise.

Pennsylvania retention election fight

That has built higher stakes in this election. Haidar said that the Dobbs case has made state supreme courts the “last line of defense.”

“Thankfully, last year, the Pa. Supreme Court ruled that abortion is protected under the state constitution,” Haidar said. “So retaining these three justices will allow us to maintain this and prevent any attacks on reproductive rights from the federal level.”

Sensing an opportunity to push the court in another direction, Republican activists have mounted an aggressive, monthslong campaign to remove the three justices from the bench. They argue that the court’s rulings on mail-in ballots and pandemic restrictions are evidence of partisanship.

If even one justice is not retained and a new appointment takes effect, the ideological balance of the court could tilt.

In response, Democrats and the state’s legal establishment are mobilizing. The Democratic National Committee has boosted funding and media outreach around the retention fight — a rare intervention in what is usually a low-key judicial vote.

The court itself has pushed back on accusations of political bias. During a recent public “fireside chat,” the justices called for judicial independence and said they apply the law fairly, even when outcomes are unpopular.

“When we put that black robe on, we hung up that partisan title,” Justice Dougherty said.

Also joining the fray is the Pennsylvania Pro-Life Federation, which is calling on voters to vote against the justices, based on their positions on abortion, infanticide and euthanasia.

Executive Director Maria Gallagher also argues that the issue is beyond partisanship but that the three justices are “on the wrong side of history and the wrong side of the law.”

“We want to see people protected and their lives protected under the law and, unfortunately, those three candidates have been labeled very pro-abortion and they are not going to be protective of the rights of the most vulnerable among us and, therefore, we are urging a ‘no’ vote on them,” she said.

Gallagher added that the state is far from prohibiting abortion since the governor and Pennsylvania House of Representatives are currently “pro-abortion.”

“Given those two factors, it unfortunately is very difficult to pass legislation protective of preborn children and their mothers,” she said.

However, she added “there is hope that eventually the situation in Pennsylvania will change” and when “that day comes,” it will be important to have a state Supreme Court that won’t overrule legislative efforts to restrict abortion.

Reproductive health

Dr. Jessica Geida, an OBGYN in Philadelphia offered real-life examples of what patients could face if abortion were restricted or criminalized, including that of “Emily,” who is “thrilled about her first pregnancy.”

“And unfortunately, the anatomy scan shows that there’s severe fetal anomalies that are incompatible with life,” Geida said. “On top of that, Emily’s blood pressure is increasing. She gets diagnosed with early but severe preeclampsia … Ending the pregnancy is an act of love and self-preservation.”

Geida and other physicians emphasized that reproductive health goes beyond abortion alone and other aspects may also be at risk, including contraception, fertility care, safe childbirth, postpartum care and the ability to manage complex conditions like preeclampsia, diabetes or heart disease during pregnancy. It also encompasses screenings for cervical cancer, testing and treatment for sexually transmitted infections and counseling around family planning. For many patients, abortion and other reproductive health care is connected to other aspects of well-being — mental health, economic stability and chronic disease management.

Haidar added that the makeup of the state Supreme Court has implications for many other areas of healthcare not related to reproductive rights at all, including protection against predatory billing practices or “if insurers and hospitals can continue to saddle families with crushing medical debt.”

“They also decide on cases when it comes to medical billing disputes, Medicaid coverage – which I think everyone’s aware is under threat imminently – patient privacy rights, what’s going on with trans patients and protection from unfair insurance practices,” he said. “These are things that are going to have direct implications on the day-to-day life and the health and wellbeing — and honestly, freedom — of Pennsylvanians. The Pa. Supreme Court has behaved as a safeguard against the threats to our healthcare and other systems that are coming from the federal level.”