In State v. Planned Parenthood of the Great Northwest, the Alaska Supreme Court held that AS 47.07.068 (the statute) and Alaska Administrative Code Title 7 § 160.900(d)(30) (the regulation) violated the Equal Protection Clause of the Alaska Constitution by restricting Medicaid funding of abortions with insufficiently narrow tailoring. In 2013, the Alaska Department of Health and Social Services (DHSS) amended the regulation by raising the requirements for Medicaid funding for abortions by necessitating a more strenuous certificate from a doctor for a patient to obtain state Medicaid funding for an abortion. In 2014, the state legislature passed the statute, similarly requiring that DHSS not pay for an abortion with state Medicaid funding unless it is “medically necessary” or the pregnancy was the result of rape or incest. Planned Parenthood of the Great Northwest brought suit alleging that the regulation and statute both violated Alaska’s Equal Protection Clause by singling out abortion services for a restrictive definition of “medically necessary.” The superior court ruled that both provisions violated the state Equal Protection Clause by impermissibly discriminating against indigent women seeking abortions. The State appealed, arguing the constitutionality of the provisions based on a broad and inclusive definition of an abortion’s medical necessity.
First, the supreme court found that the statute’s language is ambiguous because “threat of a serious risk” is not properly defined and its catch-all provision does not meaningfully expand its permissive scope. Next, the court found that the statute’s legislative history supports a restrictive reading, and that the statute therefore means neither that suffering from a listed condition is sufficient to obtain funding nor that mental health and lethal fetal anomalies are covered. Considering the regulation, the court found that although it was less restrictive than the statute, it is not sufficiently less restrictive to meaningfully differentiate its coverage from that of the statute.Based on these interpretations, the court applied strict scrutiny to evaluate the particular means here employed by the state to further a compelling state interest. The court concluded that the statute and regulation are not narrowly tailored to meet the State’s goal of preserving Medicaid funds, and that the State failed to sufficiently prove that the differences between the affected classes justify the discriminatory treatment. The court therefore affirmed the ruling of the superior court finding that the regulation and the statute violate the state constitution’s Equal Protection Clause.
 436 P.3d 984 (Alaska 2019)