JUNEAU — The Alaska Supreme Court on Friday struck down as unconstitutional a state law and regulation seeking to define what constitutes medically necessary abortions for purposes of Medicaid funding.

The court, in a 4-1 decision, upheld a 2015 lower court ruling that had also barred the measures from being enforced.

Both the law, passed in 2014, and regulation, penned during the administration of then-Gov. Sean Parnell, sought to define medically necessary abortions. Supporters argued the state should not be required to pay for elective abortions.

The measures were challenged by Planned Parenthood of the Great Northwest and the Hawaiian Islands.

The majority opinion written by Justice Susan Carney states that disparate restrictions on government funding for women based on their choice of abortion or childbirth deter the exercise of a fundamental right because rejection of one option entails embrace of the other.

The state argued the feasibility of a program like Medicaid depended on the ability to set limits, according to the decision. However, the legislative record contained no evidence that Medicaid had actually funded non-medically necessary abortions, the ruling states.

The law and regulation violate the state constitution’s guarantee of equal protection, the court ruled.

Justice Craig Stowers dissented, saying he believes the Legislature can constitutionally determine as a matter of state policy what is medically necessary for purposes of Medicaid funding.

He said the court in the majority opinion “goes to great lengths in construing the statute and regulation to ensure that the conclusion of unconstitutionality is inevitable.” The order listed Stowers as chief justice, a title he held at the time of arguments.

Jessica Cler, Alaska state director for Planned Parenthood Votes Northwest and Hawaii, praised the court for striking down “this cruel, inequitable restriction on abortion access for low-income women. Politics have no place in the exam room, and today Alaska’s highest court agreed, again.”

State Department of Law spokeswoman Cori Mills had no immediate comment.

The law defined medically necessary abortions as those needed to avoid a threat of serious risk to a woman’s life or physical health from continuation of a pregnancy. That could mean a serious risk of death or “impairment of a major bodily function” because of one of 21 different conditions, such as congestive heart failure, seizures and epilepsy.

It also included a more general category: “another physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy that places the woman in danger of death or major bodily impairment if an abortion is not performed.”

The regulation is similar but also included consideration of psychiatric disorders.

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• By BECKY BOHRER, The Associated Press

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