This story originally appeared on Spotlight PA.

Abortion is legal in Pennsylvania. And with a Democratic governor in power who supports access, it will almost certainly remain so for at least the next three years.

But that doesn’t mean it’s as easy to get an abortion in the commonwealth as supporters want it to be.

It also doesn’t mean that attempts to restrict the procedure are dead. Less than two years ago, Republican lawmakers launched a robust attempt to enshrine language in the state constitution that would have said there was no right to abortion. While the legislature has since changed significantly, many members who supported the effort are still in office.

With new federal abortion laws not forthcoming post-Roe v. Wade, and decisions about access still firmly in states’ hands, here’s a primer on where abortion policy stands in Pennsylvania.

What is Pennsylvania’s abortion law?

Pregnancies can be ended in the commonwealth up to 24 weeks gestation, a deadline tied to the concept of viability that was introduced in 1973’s Roe v. Wade. Abortions can be performed after that cutoff if a pregnant person’s life or health is in danger.

Pennsylvania doesn’t have language on its books protecting the right to an abortion, unlike many other states. For instance, voters in California, Michigan, and Vermont in 2022 enshrined guarantees of abortion rights in their state constitutions, which constrain future abortion-restricting bills unless those amendments are repealed.

Pennsylvania also imposes several other rules on people who wish to end pregnancies.

One of them is a requirement for pre-abortion counseling, followed by a 24-hour wait before the person can undergo the surgical procedure or obtain medication. Before a minor can get an abortion, their parent or guardian must also consent unless a judge signs off on a judicial bypass.

Other restrictions involve insurance coverage. Plans for public employees who are paid using state funds don’t cover abortion except in cases of rape, incest, or a life-endangering health condition. Medicaid coverage in the commonwealth includes the same caveats — as does coverage under plans in the Affordable Care Act exchange, unless the purchaser buys a rider for additional coverage.

These restrictions have long been opposed by organizations like Planned Parenthood. Signe Espinoza, who heads the group’s advocacy arm in Pennsylvania, said the commonwealth is “quite literally punishing poor people for not allowing them to use their own health care for life-saving care.”

There are, however, several organizations in the commonwealth that raise money to pay for abortion costs when insurance won’t. The state keeps a public list of these groups.

Some of Pennsylvania’s abortion restrictions stem from Planned Parenthood v. Casey, a landmark U.S. Supreme Court decision related to a law Pennsylvania passed in 1982.

The law imposed the parental consent requirement for minors to get abortions, the 24-hour waiting period, and a requirement that people seeking abortions get spousal consent. After the law was challenged on the basis that it ran afoul of Roe, the spousal consent provision was overturned.

Has the end of Roe affected Pennsylvania?

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, 21 states have further tightened abortion restrictions. Fourteen have near-total bans and two have bans after six weeks, which is before many people know they’re pregnant. Five states now have 12- to 18-week bans.

Pennsylvania has not passed any additional restrictions. When Roe was overturned, the commonwealth was led by a Democratic governor who supported abortion access. It now has another Democratic governor, Josh Shapiro, who has been a similarly staunch opponent of restrictions, as well as a narrow Democratic state House majority whose leaders have taken the same stance.

Pennsylvania is one of 22 states that use roughly the same, viability-influenced cutoff for abortions under most circumstances. Seven states and Washington, D.C. place no gestational limit on the procedure, but the landscape could shift as state courts rule on the issue and legislatures pass new laws and turn over members.

In 2022, the most recent year for which there is complete data, 34,838 abortions were performed in Pennsylvania, of which 22,104 were performed at eight weeks or less of gestation.

The commonwealth’s Planned Parenthood chapter projects significant demand increases for Pennsylvania as other states continue to ban or restrict the procedure, though for now West Virginia is the only neighboring state with a total ban.

Will Pennsylvania ban abortion or further change access?

One big question mark remaining about abortion access in Pennsylvania has to do with the law that mostly keeps the procedure from being covered under Medicaid.

In 2019, abortion providers sued the state, arguing that the ban — which only excludes cases of rape, incest, and serious health risk — violates the state constitution’s equal protection provisions and Equal Rights Amendment.

The case has been working its way through the courts and is now before the Pennsylvania Supreme Court, which heard oral arguments in 2022 and could rule at any time.

The other abortion-related action currently happening in the commonwealth is likewise mostly geared toward expanding access.

Until recently, the commonwealth’s legislature was fully controlled by Republicans. Under that status quo, abortion-restricting legislation came up frequently. Perhaps most significantly, the body began moving an amendment in 2022 that would enshrine language in the state constitution that explicitly says abortion is not a protected right.

The move would tie the state Supreme Court’s hands and prevent judges from ruling any abortion-restricting legislation unconstitutional.