In a landmark ruling, the Nebraska Supreme Court has determined that a law combining abortion restrictions with measures to limit gender-affirming health care for minors does not violate the state's constitutional amendment requiring bills to adhere to a single subject. The decision comes after a lawsuit was brought by the American Civil Liberties Union (ACLU) representing Planned Parenthood of the Heartland, challenging the law that has been in effect since 2023.

The Nebraska Supreme Court, in its ruling, acknowledged that abortion and gender-affirming care are distinct types of medical care but found that they both fall under the broad subject of medical care. The court relied on a passage from a 1895 ruling to affirm that as long as a bill has one general object and its title accurately reflects the subject, it does not violate the state constitution's single-subject rule.

The controversial law, passed by the Republican-dominated Nebraska Legislature, restricted abortion to 12 weeks of pregnancy, banned gender-confirming surgery, and placed restrictions on hormone treatments for transgender minors. These provisions triggered an epic filibuster during the 2023 session, where lawmakers sought to block all bills, even those they supported, to prevent the law's passage.

The ACLU argued that the law violated Nebraska's single-subject rule since abortion and transgender care were initially introduced as separate bills. However, the court determined that the subject of health care encompassed both aspects and concluded that the law was constitutional.

Notably, Justice Lindsey Miller-Lerman dissented and criticized the majority for applying different standards to bills passed by the Legislature compared to those sought by voter referendum. She cited a previous ruling that blocked a ballot initiative seeking to legalize medical marijuana, arguing that separate provisions within the initiative violated the single-subject rule.

The ruling has drawn mixed reactions, with opponents vowing to continue fighting for abortion access and the rights of transgender youth. Planned Parenthood, despite expressing disappointment, stated it would continue providing abortions up to 12 weeks of pregnancy in Nebraska.

The decision comes at a time when many Republican-controlled states have implemented various abortion bans since the U.S. Supreme Court overturned Roe v. Wade in 2022. Nebraska and North Carolina are the only states that have enacted bans at the 12-week mark. Similarly, a significant number of GOP-controlled states have also prohibited gender-affirming care for transgender minors.

It is worth noting that voters in Nebraska might have the final say on abortion access. Two competing questions relating to abortion are likely to appear on the November ballot: one aiming to add a right to abortion to the state constitution and the other seeking to solidify the existing 12-week ban.

As the legal battle continues, this ruling serves as a significant development on the intersection of abortion rights and gender-affirming care in Nebraska. The implications of the decision are sure to reverberate across the state and the nation.