The Alaska Supreme Court on Friday upheld a previous decision preventing the state from enforcing two regulations that limit Medicaid coverage of abortion services.

Brought by Planned Parenthood of the Great Northwest, the lawsuit argued that the regulations violated the equal protection clause of Alaska’s constitution by discriminating against women choosing to have an abortion.

Under the contested law, abortions would only be covered under Medicaid though additional requirements. The 2013 regulation, 7 AAC 160.900(d)(30), required a physician to certify an abortion only for circumstances permitted under the Hyde Amendment or if deemed medically necessary. The Hyde Amendment only allows federal funding for an abortion when the mother’s life is endangered by a full-term pregnancy term or the pregnancy resulted from rape or incest.

In 2014 a certificate accompanying 7 AAC 160.900(d)(30) defined “medical necessity” through a series of outlined criteria. Additionally, Alaska’s legislature sought to codify a broad definition of “medical necessity” in statute AS 47.07.068.

Planned Parenthood argued that the restrictive definition provided for the “medical necessity” of an abortion singled out the procedure from other Medicaid-funded services. By doing so, the regulations subjected women to discriminatory practices and violated their guarantee of equal protection. A superior court declared the laws unconstitutional and subsequently prevented the laws from taking effect. The state appealed, arguing the statute and regulation should be interpreted more leniently.

In this opinion, the state supreme court reaffirmed the ruling and stated the laws are under-inclusive, singling out abortion among other argued “elective” procedures available to pregnant women. The court found that the laws facially treated pregnant women differently based on their “exercise of reproductive choice.” Therefore, the court determined it was justified to apply strict scrutiny of their interpretation.