Court Opinion

ID: 9881613
Source: CourtListenerOpinion
Date Created: 2023-10-03 15:28:22.701769+00
Date Added: 2024-06-11T14:13:27.867624
License: Public Domain

[J-50-2022]
                     IN THE SUPREME COURT OF PENNSYLVANIA
                                EASTERN DISTRICT

  BAER, C.J., TODD, DONOHUE, DOUGHERTY, WECHT, MUNDY, BROBSON, JJ.

 JASMINE WEEKS, ARNELL HOWARD,                      :   No. 22 EAP 2021
 PATRICIA SHALLICK, INDIVIDUALLY AND                :
 ON BEHALF OF ALL OTHERS SIMILARLY                  :   Appeal from the order of the
 SITUATED,                                          :   Commonwealth Court dated May 13,
                                                    :   2021 at No. 409 MD 2019.
                       Appellants                   :
                                                    :   ARGUED: September 14, 2022
                                                    :
                v.                                  :
                                                    :
                                                    :
 DEPARTMENT OF HUMAN SERVICES OF                    :
 THE COMMONWEALTH OF                                :
 PENNSYLVANIA,                                      :
                                                    :
                       Appellee                     :

                                           OPINION

CHIEF JUSTICE TODD                                         DECIDED: September 28, 2023
       Article III of the Pennsylvania Constitution, through a constellation of provisions,

ensures a transparent, orderly, and understandable process by which legislation is

passed into law in our Commonwealth. It accomplishes these goals by imposing certain

foundational requirements, and placing certain basic prohibitions, on the legislative

process. More specifically, Article III, Section 1 mandates that a law be passed through

a bill and prohibits the bill’s original purpose from being changed on its passage through

the Senate or the House of Representatives. 1 Similarly, Article III, Section 3 requires that

1 Article III, Section 1, entitled “Passage of laws,” provides in full as follows:

(continued…)
proposed legislation be contained in a single subject, and that that subject be clearly

expressed in a title. 2 In this direct appeal, we consider a class action challenge to the

constitutionality of Act 12 of 2019 (“Act 12”), 3 which, inter alia, enacted changes to the

Pennsylvania Human Services Code. 4 In particular, we must determine whether the

lawmaking which culminated in the passing of Act 12 satisfied Article III’s requirements. 5

For the reasons set forth below, we hold that the process by which the General Assembly

passed Act 12 satisfied both the “original purpose” and “single subject” mandates found

in Article III of our Constitution. Thus, we affirm the order of the Commonwealth Court

and find the statutory enactment to be constitutional.

                               I. Factual and Procedural History

       To fully analyze the constitutional questions presented by this appeal, a review of

the background of Act 12 is required. Central to the current dispute regarding Act 12 is

the General Assistance cash assistance (“Cash Assistance”) program, which was created

               No law shall be passed except by bill, and no bill shall be so
               altered or amended, on its passage through either House, as
               to change its original purpose.
Pa. Const. art. III, § 1.
2 Article III, Section 3, entitled “Form of bills,” provides in its entirety:

               No bill shall be passed containing more than one subject,
               which shall be clearly expressed in its title, except a general
               appropriation bill or a bill codifying or compiling the law or a
               part thereof.
Pa. Const. art. III, § 3.
3 Act of June 28, 2019, P.L. 43.       The Human Services Code was formally entitled the
Public Welfare Code.
4 Act of June 13, 1967, P.L. 31.

5 To be clear, we are considering only the constitutionality of the legislative enactment

process by which the General Assembly advanced Act 12, and are not passing upon the
propriety of the substantive provisions of this piece of legislation.

                                         [J-50-2022] - 2
in 1967.    This state program was administered by Appellee Department of Human

Services (“DHS”). DHS was authorized to disburse up to a maximum of $215 in monthly

cash assistance grants to individuals who were unable to work and had no other source

of income, including those who had physical or mental disabilities; were pregnant; were

victims of domestic violence and receiving protective services from DHS; were enrolled

in a substance abuse treatment program, which imposed conditions precluding them from

working; or were nonparental caretakers of children under the age of 13, or nonparental

caretakers of an individual suffering from a physical or mental disability. 62 P.S. § 432.

As of July 2019, over 12,000 individuals across Pennsylvania received Cash Assistance

benefits. Pennsylvania also provides a General Assistance medical assistance (“Medical

Assistance”) program which provides state-funded health insurance to individuals in

certain categories who do not qualify for the joint federal-state Medical Assistance

program.

       The Cash Assistance program ceased operation in July 2012 after then-Governor

Tom Corbett signed Act 80 of 2012, 6 which, like Act 12, provided for the program’s

elimination. Several individuals with disabilities who benefitted from the Cash Assistance

program, and organizations involved in the delivery of human services, challenged Act 80

by asserting that it violated Article III, Sections 1, 3, and 4 7 of the Pennsylvania

Constitution. In July 2018, our Court ruled that the means by which the General Assembly

passed Act 80 violated Article III, Section 4 – which requires that all legislation be

considered by each house of the legislature on “three different days.” See Washington

6 Act of June 30, 2012, P.L. 668.

7 Article III, Section 4, entitled “Consideration of bills,” provides in relevant part:

               Every bill shall be considered on three different days in each
               House.
Pa. Const. art. III, § 4.

                                        [J-50-2022] - 3
v. Department of Public Welfare, 188 A.3d 1135 (Pa. 2018) (holding that Article III, Section

4 had been violated because the various provisions of the legislation which became Act

80 were added late in the legislative session to an empty “shell bill,” the prior contents of

which had been removed and enacted by other legislation, and the added provisions were

not considered by each legislative chamber on three separate days, nor were they

germane, as a matter of law, to the subject matter of the deleted provisions of the bill, or

to each other). 8

       Subsequent to our decision in Washington, in August 2018, DHS again began

accepting applications for the Cash Assistance program, and, commencing in November

2018, DHS started issuing payments to applicants who met the eligibility criteria.

However, in January 2019, a renewed effort was made to eliminate the Cash Assistance

program, culminating in Act 12.

       As the specific lawmaking process leading to Act 12 is at the core of the instant

challenges, it is critical to review that process in some detail. Act 12 began with the

introduction of House Bill (“H.B.”) 33, Printer’s Number (“P.N.”) 0047. This bill was

entitled:

              Amending the act of June 13, 1967 (P.L. 31, No. 21), entitled
              “An act to consolidate, editorially revise, and codify the public
              welfare laws of the Commonwealth,” in public assistance,
              further providing for definitions, for general assistance-related
              categorically needy and medically needy only medical
              assistance programs and for the medically needy and
              determination of eligibility.
Id. The bill made four changes to the Human Services Code: it terminated the Cash

Assistance program; it affirmed that the Medical Assistance program would not be

8 As in this case, our Court denied the challengers’ appeal from the Commonwealth

Court’s denial of a preliminary injunction. Washington v. Department of Public Welfare,
76 A.3d 536 (Pa. 2013) (order).

                                      [J-50-2022] - 4
altered; 9 it created a definition of “General Assistance-related categorically needy medical

assistance,” which concerns medical assistance for certain types of “needy” persons; and

it deleted the provision of the Human Services Code which classified an individual as

“medically needy” and, thus, eligible for Medical Assistance benefits if he or she received

Cash Assistance grants. This bill was considered twice by the full House and then

referred to the House Appropriations Committee on March 27, 2019.

       The Committee adopted amendments to H.B. 33, P.N. 0047, which was expanded

to include revisions to other sections of the Human Services Code and was then

denominated H.B. 33, P.N. 2182.         These amendments included reauthorization of

Nursing Facility Incentive Payments to qualified non-public nursing facilities serving low

income individuals, i.e., Medicaid patients ― which were due to expire on June 30, 2019

― until June 30, 2020, and, as an incentive for such facilities to accept more Medicaid

patients, doubled the amount of these payments from $8 million to $16 million. 10 The

9 Specifically, Section 2 of Act 12, Section 403.2 of the Act, added June 30, 2012 (P.L.

668, No. 80), which was subsequently declared unconstitutional in Washington, was
reenacted and amended to read:
              Section 403.2. General Assistance-Related Categorically
              Needy and Medically Needy Only Medical Assistance
              Programs.--(a) Subject to subsection (b) and notwithstanding
              any other provision of law, the general assistance cash
              assistance program shall cease [August 1, 2012] July 1, 2019.
              (b) The general assistance-related categorically needy
              medical assistance program shall continue, including, but not
              limited to, the eligibility and work and work-related
              requirements under this article. The general assistance-
              related medical assistance program for the medically needy
              only shall continue.
10 The Medicaid program provides federal financial assistance to states choosing to
reimburse needy individuals for certain medical expenses. See Title XIX of the Social
Security Act, 42 U.S.C. §§ 1396-1396r. Assistance may be provided, however, only to
persons deemed to be “medically needy,” such that they do not have the income and
resources to meet necessary medical costs. Colonial Park Care Center, LLC v.
Department of Public Welfare, 123 A.3d 1094, 1097 (Pa. Cmwlth. 2015).

                                      [J-50-2022] - 5
amendments also extended assessments on “high volume Medicaid hospitals” in

Philadelphia (“Philadelphia Hospital Assessment”), which were set to expire on June 30,

2019, through June 2024, generating funding for low-income individuals. This revenue

raising measure draws down matching federal Medicaid dollars through a levy on

hospitals and generates over $165 million in revenue annually. H.B. 33, P.N. 2182,

Senate Appropriations Fiscal Committee Note (June 20, 2019).             Furthermore, the

amendments altered the definition of a high-volume Medicaid hospital from a hospital

providing over 90,000 days of care to Pennsylvania medical assistance patients to one

providing over 60,000 days of inpatient care to such patients. The amendments also

expanded the permissible uses by municipalities of the Philadelphia Hospital Assessment

by allowing the municipalities to retain a portion of the revenues from those assessments

for public health programs, including educational programs to reduce tobacco use and

obesity; air pollution monitoring; enforcement of lead-free rental requirements; programs

to promote immunization; water quality programs; childhood literacy programs; and the

provision of care services in neighborhood health centers. Additionally, the amendments

revised the definitions for the Statewide Quality Care Assessments, a program which

generates revenue to pay for healthcare for low-income individuals and constitutes a tax

on all hospitals statewide, and which permits Pennsylvania to draw down on supplemental

Medicaid payments from the federal government.

       The following additional language was also added to the title of the bill:

              and for medical assistance payments for institutional care; in
              hospital assessments, further providing for definitions, for
              authorization, for administration, for no hold harmless, for tax
              exemption and for time period; and, in statewide quality care
              assessment, further providing for definitions.
H.B. 33, P.N. 2182, Title.

                                      [J-50-2022] - 6
       The amended bill was reported out of the Appropriations Committee, and it was

passed by the full House on June 19, 2019 by a vote of 106-95. It was then sent to the

Senate. One week later, after being referred to the Senate Health and Human Services

Committee and Appropriations Committee, it was considered by the full Senate three

times and passed on June 26, 2019, by a vote of 26-24. Two days later, Governor Tom

Wolf signed the bill into law. The bill was published on July 13, 2019, in the Pennsylvania

Bulletin by the Legislative Reference Bureau, which designated it Act 12 of 2019, and

entitled it “Human Services Code-omnibus amendments.”            49 Pa. Bull. 3595.    The

provisions relevant to the elimination of the Cash Assistance program became effective

on August 1, 2019, and the other amendments became effective on July 1, 2019. Thus,

Act 12 eliminated the authority of DHS to disburse Cash Assistance benefits to qualified

recipients, reaffirmed the continued existence of the Medical Assistance program, as well

as effectuated the above changes to the Human Services Code.

       On July 22, 2019, Appellants Jasmine Weeks, Arnell Howard, and Patricia

Shallick, who were recipients of Cash Assistance benefits, as well as a class

encompassing over 12,000 other individuals who were receiving Cash Assistance

benefits when they were terminated by the enactment of Act 12 on August 1, 2019, filed

a “Class Action Petition for Review” in the Commonwealth Court’s original jurisdiction,

asserting that Act 12 was passed in violation of Article III, Sections 1 and 3 of the

Pennsylvania Constitution.

       Because DHS indicated that Act 12 would cause Cash Assistance payments to

cease on August 1, 2019, Appellants also sought a preliminary injunction, via an

“Application for Special Relief,” to enjoin DHS’s enforcement of Act 12. In support of their

motion for a preliminary injunction, Appellants attached affidavits from Cash Assistance

recipients attesting to the harm that they would suffer if this monthly stipend was

                                      [J-50-2022] - 7
terminated, as well as affidavits from social service professionals, public officials, and

legal professionals who represent Cash Assistance recipients.

       On August 1, 2019, the Commonwealth Court, sitting as trial court, denied

Appellants’ motion for a preliminary injunction, Weeks v. Department of Human Services,

No. 409 M.D. 2019 (Pa. Cmwlth. 2019) (“Weeks I”), and Appellants lodged an

interlocutory direct appeal. 11

       Our Court affirmed in an opinion authored by former-Chief Justice Saylor, which

was joined by five other Justices. Weeks v. Department of Human Services, 222 A.3d

722 (Pa. 2019) (“Weeks II”). We considered the Commonwealth Court’s denial of the

requested injunction under the appropriate standard of review, which requires that we

affirm a lower court if it had “any apparently reasonable grounds” for denying the

injunction.   Id. at 727.   However, we also noted the presumption of validity of any

enactment of the General Assembly, and the high burden on a petitioner to demonstrate

that the enactment clearly, palpably, and plainly violated the Constitution. Beginning with

the question of whether Appellants could demonstrate a likelihood of success on the

merits, our Court looked to our prior decisions in this area ― City of Philadelphia v.

Commonwealth, 838 A.2d 566 (Pa. 2003) and Pennsylvanians Against Gambling

Expansion (“PAGE”), 877 A.2d 383 (Pa. 2005) ― under which we held that an enactment

violates Article III, Section 3 if there is “no single unifying subject to which all of the

provisions of the act are germane.”         Weeks II, 222 A.3d at 728 (quoting City of

11 To obtain a preliminary injunction, a petitioner must establish:   (1) relief is necessary to
prevent irreparable harm that cannot be adequately compensated by a monetary award;
(2) greater injury will occur from the denial of the injunction than from its issuance; (3) the
injunction will restore the parties to their status quo as it existed before the alleged
wrongful conduct; (4) the petitioner is likely to prevail on the merits; (5) the injunction is
reasonably suited to abate the offending activity; and (6) the injunction will not adversely
affect the public interest. Summit Towne Centre, Inc. v. Shoe Show of Rocky Mount, Inc.,
828 A.2d 995, 1000 (Pa. 2003).

                                       [J-50-2022] - 8
Philadelphia, 838 A.2d at 589). The majority continued, offering that our Court deems an

Article III, Section 3 violation to occur only when provisions of legislation contain

“unrelated subject matter” that cannot be grouped together except under a conceptualized

“overly-broad topic” such as the “business of the courts, municipalities, or the economic

wellbeing of the Commonwealth.” Id. at 729 (quoting PAGE, 877 A.2d at 596). Applying

this standard, the Court reasoned that Act 12 “as a whole relates to the provision of

benefits pertaining to the basic necessities of life to certain low-income individuals.” Id.

at 730. The Court explained that “[s]ome of these benefits may be in the form of cash

assistance for such items as basic utility services, food, clothing, and personal hygiene

products, while others may be supplied through medical or nursing-home care, the

delivery of which is incentivized by payments to providers.” Id. The Court determined

that this theme was “both unifying and sufficiently narrow to fit within the single-subject

rubric.” Id. Thus, the Court concluded that the Commonwealth Court did not abuse its

discretion in rejecting a preliminary injunction under Article III, Section 3.

       Similarly, our Court found this same germaneness test applied to determine

whether an enactment violates Article III, Section 1. We noted that the original bill had

only three provisions relating to the Cash Assistance program. We opined that the

additional sections which became Act 12 all fit within the same unifying topic of “the

provision of benefits pertaining to the basic necessities of life to certain low-income

individuals.” Id. Moreover, we emphasized that this was not a situation “in which the

original bill was ‘gutted’ and its ‘hollow shell’ was then filled with distinct provisions.” Id.

at 731. Indeed, our Court found that the original provisions remained in the bill and all

the amendments added to the bill during the legislative process related to this same broad

                                       [J-50-2022] - 9
unifying topic. Thus, we concluded that the Commonwealth Court did not abuse its

discretion in denying a preliminary injunction under Article III, Section 1. 12

       Justice Wecht dissented, opining that the proposed unifying purpose set forth by

the majority appeared to him to be “very nearly as broad as the one we characterized in

Washington as ‘entirely too expansive.’” Id. at 744 (Wecht, J., dissenting) (quoting

Washington, 188 A.3d at 1154 n.36). In his view, the majority’s analysis should have

been held in abeyance until there was further development of the record through the

normal litigation process, so that the merits of the parties’ competing arguments could be

more thoroughly developed and considered by our Court.                From Justice Wecht’s

perspective, “[i]t is not at all clear that there is a common nexus between the subject of

the original bill, ending [Cash Assistance] payments, and that of the later amendments,

the generation and disbursement of revenue for the provision of health care services,

such that they may be considered part of a unifying scheme to accomplish a single

overarching purpose discernible in the original bill.” Id. at 745. Thus, he believed a

substantial question existed as to whether Act 12 complied with the requirements of

Article III, Sections 1 and 3. Because he also deemed Appellants to have set forth

sufficient irreparable harm from the termination of the Cash Assistance program, he would

have reversed the Commonwealth Court’s denial of their requested preliminary injunction.

       Following our decision in Weeks II, proceedings continued in the Commonwealth

Court. Appellants filed an amended petition for review in which they added a claim that

12 This author penned a separate concurring opinion in which I indicated that my joinder

hinged on the fact that, “[a]t the preliminary stage of this litigation, . . . this Court is not
asked to decide [the] ultimate constitutional question” of whether Act 12 violates Article
III, Sections 1 and 3. Id. at 731 (Todd, J., concurring). Rather, because our Court's task
involved the more limited inquiry of whether the lower court had “‘any apparently
reasonable grounds’ to support its denial of preliminary injunctive relief,” id. at 732
(quoting Summit Towne Center v. Shoe Show of Rocky Mount, 828 A.2d 995, 1000 (Pa.
2003)), I cautioned that I was withholding judgment on the merits of the underlying
constitutional questions. Justices Donohue and Dougherty joined my concurring opinion.

                                       [J-50-2022] - 10
Act 12 also violated Article III, Section 1 because the amendments to the bill transformed

its initial purpose and, consequently in their view, rendered its final title deceptive, in that

it failed to adequately apprise legislators of its true purpose. On May 11, 2020, DHS filed

preliminary objections and demurred to Appellant’s amended petition.

       On March 24, 2021, in a unanimous, published opinion and order, the

Commonwealth Court sustained DHS’s preliminary objections and dismissed Appellants’

petition for review in its entirety. Weeks v. Department of Human Services, 255 A.3d 660

(Pa. Cmwlth. 2021) (“Weeks III”). 13 With respect to Appellants’ Article III, Section 1

original purpose challenge, the Commonwealth Court noted that, in PAGE, our Court

explained that, in order to determine whether an Article III, Section 1 violation has taken

place, a reviewing court must consider the “original purpose of the bill . . . in reasonably

broad terms” and determine whether that purpose has changed in the final bill. PAGE,

877 A.2d at 409. The court continued that a reviewing court must “consider, whether in

its final form, the title and contents of the bill are deceptive.” Id. The title of a bill will not

be considered deceptive if “[i]t place[s] reasonable persons on notice of the subject of the

bill.” Id. Applying these criteria, the court opined that, “viewed in reasonably broad terms,

the original purpose of HB 33 was to amend the Human Services Code’s provisions on

medical assistance to low-income individuals.” Weeks III, 255 A.3d at 671. The court

reasoned that “[e]ach amendment, even the elimination of the [Cash Assistance]

program, pertained to the provision of medical assistance to certain low-income persons.”

Id.

       The Commonwealth Court also rejected Appellants’ claim that the title of the final

bill was deceptive. The court deemed the language in the title of H.B. 33, P.N. 0047 –

13 This opinion was authored by Judge Leavitt, and joined by Judge Leadbetter, as well
as then-President Judge, now-Justice, Brobson.

                                        [J-50-2022] - 11
“providing for definitions for general assistance” – to be sufficient to place legislators on

notice that “the bill pertained to the provision of medical services to ‘categorically needy

individuals,’” and apprised them that the Cash Assistance program would be eliminated.

In the Commonwealth Court’s view, the General Assembly was not required to identify

the specific deletions from the Human Services Code that Act 12 would effectuate. Id. at

672.

       Additionally, relying on the germaneness test set forth in City of Philadelphia,

supra, the court rejected Appellants’ Article III, Section 3 single subject challenge because

the court considered all of the provisions of Act 12 to pertain to variations of the single

unifying subject of “the provision of General Assistance to low-income individuals,” and

“the provision of ‘basic necessities of life to certain low-income individuals.’” Id. at 670

(quoting Weeks II, 222 A.3d at 730). 14 The court eschewed Appellants’ argument that

the revenue raising provisions for hospitals and nursing homes added to Act 12 were not

germane to the provisions of Act 12 terminating Cash Assistance. In the court’s view, the

addition of these provisions did not cause the legislation to deviate from this unifying

subject. 15 Appellants appealed the Commonwealth Court’s decision.

       Before our Court, Appellants raise two questions: (1) whether the enactment of

Act 12 was in violation of Article III, Section 1 of the Pennsylvania Constitution, because

its original purpose changed and its title was deceptive; and (2) whether the enactment

14  The Commonwealth Court also seemingly proffered the unifying subjects of “the
provision of health care assistance to certain low-income persons and the eligibility
criteria therefor” and “providing services to certain low-income individuals.” Weeks III,
255 A.3d at 669.
15  The Commonwealth Court rejected DHS’s argument that it should adopt our Court’s
analysis in Weeks II in toto, recognizing that our decision on the denial of the preliminary
injunction in that case did not constitute a decision on the merits of Appellants’ request
for a permanent injunction. Id. at 666. Nevertheless, it indicated that it found our analysis
of this issue to be “compelling.” Id.

                                      [J-50-2022] - 12
of Act 12 violated Article III, Section 3 because its provisions covered more than a single

subject. As both issues constitute pure questions of law, our scope of review is plenary,

and our standard of review is de novo. Buffalo Township v. Jones, 813 A.2d 659, 664

n.4 (Pa. 2002). Furthermore, as this appeal arises in the context of a demurrer, which

tests the legal sufficiency of the complaint, it is well established that, for purposes of

evaluating that sufficiency, a court must accept as true all well-pleaded, material, and

relevant facts alleged in the complaint, and inferences that are fairly deducible from those

facts. Commonwealth by Shapiro v. UPMC, 208 A.3d 898, 909 (Pa. 2019). The question

presented in such an analysis is whether, on the facts alleged, the law states with certainty

that no recovery is possible. Id. Where “a doubt exists as to whether a demurrer should

be sustained, this doubt should be resolved in favor of overruling it.” Id.

       Importantly, facial challenges to the validity of a statute are disfavored.

Commonwealth v. Heinbaugh, 354 A.2d 244, 245 (Pa. 1976). Indeed, every enactment

of the General Assembly is presumed valid – a presumption that extends to the manner

in which it was passed. Commonwealth v. Neiman, 84 A.3d 603, 611 (Pa. 2013). Thus,

a statute will only be stricken if the challenger demonstrates that it “clearly, palpably and

plainly violates the Constitution.” Harrisburg School District v. Zogby, 828 A.2d 1079,

1087 (Pa. 2003) (quoting Purple Orchid, Inc. v. Pennsylvania State Police, 813 A.2d 801,

805 (Pa. 2002)); cf. 1 Pa.C.S. § 1922(3) (directing courts to assume the legislature does

not intend to violate the state or federal Constitutions). Therefore, “[t]he party seeking to

overcome the presumption of validity bears a heavy burden of persuasion.” West Mifflin

Area School District v. Zahorchak, 4 A.3d 1042, 1048 (Pa. 2010).

       Finally, central to any analysis under Article III, Section 1 or Section 3,

amendments to a bill must be germane to and not change the general subject of the bill.

Because the germaneness inquiry is more prominent in a Section 3 inquiry, we will reorder

                                      [J-50-2022] - 13
the issues as stated in our grant of allocatur and address Appellants’ Article III, Section 3

challenge first.

                         II. Challenge under Article III, Section 3

       With respect to satisfaction of Article III, Section 3, Appellants contend that, rather

than a single unifying subject, the amended bill contained four disparate subjects: (1) the

elimination of Cash Assistance benefits; (2) the extension of Nursing Facility Incentive

Payments for another year and increasing state funds for those payments; (3)

amendments to reauthorize and increase a revenue-raising tax, the Philadelphia Hospital

Assessment, and to allow municipalities to use their portion of revenues raised by that

assessment for broad “public health programs”; and (4) changes to another revenue-

raising tax, the Statewide Hospital Quality Care Assessments, affecting which revenues

are subject to that tax. Appellants’ Brief at 45. Thus, Appellants posit that, even if our

Court could view the amendments as related to medical assistance to low-income

individuals (a view with which they disagree), those amendments reflected a change from

the original purpose, which involved cash benefits and not health care benefits.

       Building on this argument, Appellants highlight that the Philadelphia Hospital

Assessment included a change to allow municipalities to use a portion of their raised

revenue for broad public health endeavors. These general public health matters included

restaurant and retail food inspection, air and water quality, inspection of barber and

beauty establishments, and promoting childhood literacy, which, according to Appellants,

did not relate to medical care for low-income individuals, and would extend further than

merely impacting the basic needs of low-income individuals. Indeed, Appellants aver that

DHS concedes that, contrary to the Commonwealth Court’s finding, neither the original

bill nor the final bill makes any changes to the Medical Assistance program.

                                      [J-50-2022] - 14
       Appellants maintain that Act 12 is an omnibus bill in both name and substance and

any contention that the “single subject” of the bill is “programs overseen by the [DHS],” is

overbroad, as exemplified by our Court’s decision in Washington, which rejected as the

unifying subject of Act 80 “the regulation and funding of human services programs

regulated by the Department of Public Welfare.”          Appellants’ Brief at 49 (quoting

Washington, 188 A.3d at 1153 n.36). Related thereto, Appellants contend that none of

the hypothesized proposed subjects used to unify the disparate provisions of the bill allow

Act 12 to survive scrutiny under Article III, Section 3. Specifically, Appellants reject “the

provision of health care assistance to certain low-income persons” as a unifying theme,

as the elimination of Cash Assistance benefits is unrelated to medical assistance.

Likewise, the claim that the theme “the provision of General Assistance to low-income

individuals” is inapt as the provisions of Act 12 cannot be so unified, noting that “General

Assistance” is a term of art comprised of both Cash Assistance benefits and Medical

Assistance benefits; none of the amendments to the original bill impacted either of those

two programs; and certain of the amendments are not limited to low-income individuals.

Appellants’ Brief at 50. Moreover, Appellants argue that the subject of “the provision of

benefits pertaining to the basic necessities of life to certain low-income individuals” also

fails as overly broad, and nevertheless, not all of the pieces of Act 12 can be

constitutionally connected even under this moniker, as the Philadelphia Hospital

Assessment broadens the purposes for which municipalities may use their portion of the

assessment for various public health programs which are not limited to low-income

individuals. Id.

       Finally, Appellants emphasize that Governor Wolf, who supported the revenue

measures for hospitals and municipalities, but did not support the termination of the Cash

Assistance program, viewed Act 12 as presenting him with a “Hobson’s choice” whereby

                                      [J-50-2022] - 15
he was forced to sign the entirety of the legislation in order to secure funding for hospitals,

funding which was set to expire within a short period of time at the end of the

Commonwealth’s fiscal year. Appellants’ Brief at 58. Appellants contend that the hospital

assessments and nursing facility payments had extensive legislative support, noting that

they had easily passed the General Assembly in 2016 when they were last up for

reauthorization. Yet, even though those measures could have been enacted as separate

legislation, Appellants suggest that they were, instead, combined with the bill to eliminate

Cash Assistance in order to secure support among those legislators who might otherwise

have opposed the elimination of the Cash Assistance program, had that issue stood on

its own. Appellants therefore urge that the Commonwealth Court decision below cannot

stand because it countenances the very type of disfavored legislative practice — logrolling

— which the framers of Article III, Section 3 intended to prevent. 16

       Initially, DHS responds by stressing the heavy burden upon a challenger to the

constitutionality of a statutory provision, and it reminds that our Court should only

invalidate a statute that clearly, palpably, and plainly violates the Constitution. DHS

emphasizes that our Court, in PAGE, in setting forth the required two-prong test to

determine whether Article III, Sections 1 and 3 have been violated, allows a reviewing

16 In support of Appellants’ position, the American Civil Liberties Union of Pennsylvania,

three law professors who are experts in Pennsylvania Constitutional law, and a legal aid
attorney, filed an amicus brief. Amici focus heavily on the historical purposes of Article
III, Sections 1 and 3, noting they are required for a proper and transparent government.
Amici also challenge the Commonwealth Court’s analytical approach, asserting that the
original purpose rule requires an analysis separate from the single subject rule, and that
the single subject rule analysis requires that the court analyze whether the various
measures in the bill share a common nexus. Similarly, an amicus brief filed by a coalition
of nonprofit groups representing various individuals in need, including the Community
Justice Project, the Homeless Advocacy Project, the Coalition for Low Income
Pennsylvanians, and the Housing Alliance of Pennsylvania, emphasizes that the Cash
Assistance program is separate and distinct from the Medical Assistance program, and
the General Assembly’s characterization of Act 12 as health care-related masks this
distinction and the bill’s true intent to eliminate Cash Assistance and raise revenue.

                                      [J-50-2022] - 16
court to consider the contents of an initial bill and hypothesize a reasonably broad original

purpose from its text, and then compare it with the final version of the bill and determine

whether any subsequent amendments added during the legislative process fit within that

broad purpose. Second, the court considers whether, in its final form, the title and

contents of the bill are deceptive. Here, DHS offers that the original bill discontinued the

Cash Assistance program but left unchanged the Medical Assistance program. Thus,

according to DHS, the reasonably broad original purpose for this legislation was “to

amend existing provisions of the Human Services Code providing medical assistance to

low-income individuals,” and that the subsequent amendments to the original House bill

fit within that broad original purpose because each provision "pertain[ed] to the provision

of medical care to certain low-income individuals.” Appellee’s Brief at 16. Thus, because

the original and final bill related to the same broad purpose, DHS contends that the first

prong was satisfied.

       Related thereto, DHS notes that the Commonwealth Court's suggested initial

purpose ― regarding “benefits pertaining to the basic necessities of life to certain low-

income individuals” — is similarly suitable as a reasonably broad original purpose, and

the final bill likewise pertained to this subject.     Id. at 18.   DHS maintains that the

modifications the bill underwent between initial and final passage were significantly more

“modest” than those in PAGE, yet our Court approved the combining of disparate

provisions in that case under the broad umbrella of “regulation of gaming,” and it submits

the instant bill’s original and final subjects fit within either its suggested purpose or the

Commonwealth Court’s hypothesized single subject. Id. at 19.

       With respect to the second prong, DHS asserts that the title and final version of

Act 12 is not deceptive, as the title is not an index of a bill’s contents, and, here, it covers

all major provisions thereof. Indeed, DHS claims that one cannot credibly argue that the

                                       [J-50-2022] - 17
provisions that eliminate the Cash Assistance program were not adequately noticed or

were otherwise hidden in the final bill; in fact, DHS notes, the provisions regarding the

Cash Assistance program were part of the original bill.

       Thus, when viewed properly, DHS contends that the single subject of the bill did

not need to be limited to discontinuing the Cash Assistance program, but pertained to

whether health care assistance was to be provided by the Commonwealth to certain low-

income individuals, and which low-income individuals would receive that assistance.

According to DHS, as each of the amendments to the bill pertained to the provisions of

health care for certain low-income individuals, they did not violate the single subject

requirement, citing PAGE and Christ the King Manor v. Department of Public Welfare,

911 A.2d 624 (Pa. Cmwlth. 2006), aff’d 951 A.2d 255 (Pa. 2008) (per curiam). Indeed,

DHS finds Christ the King Manor to be “analytically indistinguishable” from this matter and

emphasizes the Commonwealth Court’s determination therein that the statute did not

violate the single subject requirement as it contained the unifying theme of “the regulation

of publicly funded health care services.” Appellee’s Brief at 30.

       DHS denies that, simply because some of the provisions in the final bill relating to

the raising of revenue or providing benefits to the public at large, this caused the bill to

have strayed from its original purpose. According to DHS, all of those provisions still

provided benefits to low-income individuals, just as the original bill concerned benefits to

low-income individuals. DHS maintains that, just because Act 12’s amendments also

contain ancillary benefits to the public at large, this does not amount to unconstitutional

logrolling, and stresses that the mere fact that lawmakers happen to agree with some, but

not all, of the provisions in a bill does not automatically indicate the bill was the result of

logrolling, or otherwise render the bill unconstitutional.

                                      [J-50-2022] - 18
       With these arguments in mind, we begin our analysis by considering the

foundations of Article III, Section 3. While the historical underpinnings of Section 3 are

now well traveled in our decisions, and our Court’s recent decision in Washington set

forth an extensive tracing of the origins and legal background of Article III, a condensed

summary of that narrative is beneficial to contextualize the issue before us.

       During the decade after the Civil War, the citizens of Pennsylvania became

increasingly dissatisfied with shortcomings in the legislative process. Washington, 188

A.3d 1145. Legislators failed to ensure the transparency of the lawmaking process and

disregarded the rules of procedure in acting upon bills, allowing for the passage of laws

that benefitted narrow interests and were injurious to the public weal. Specifically, such

practices led to “local and special laws to confer special benefits or legal rights to

particular individuals, corporations, or groups, benefits which were not afforded the

general public; deceptive titling of legislation to mask its true purpose; the mixing together

of various disparate subjects into one omnibus piece of legislation; and holding quick

votes on legislation which had been changed at the last minute such that its provisions

had not been fully considered by members of both houses.” Id. The public outcry

regarding these abuses led to the holding of the 1873 constitutional convention for the

dual goals of reformation of the legislative process, including a unified procedure for the

passage of all legislation, and the elimination of all special legislation.       This effort

culminated in the approval in 1874 of the modern version of Article III of the Pennsylvania

Constitution. Id. at 1146. 17

17 While Article III, Section 1 has remained unchanged since the 1874 Constitution, Article

III, Section 3 was amended in the 1968 Constitution to permit bills to contain multiple
subjects if they merely codify or compile existing laws or parts of laws; however, it did not
otherwise alter the mandate that legislation contain a single subject. Washington, 188
A.3d at 1147.

                                      [J-50-2022] - 19
       Article III, Section 3 actually predated the “Reform Constitution” of 1874 and was

born from a similar populist uprising during the Civil War regarding the misuse of omnibus

bills which incorporated multiple pieces of legislation, each pertaining to a different

subject, into one bill. In 1863, the legislature passed what is now Article III, Section 3,

which was thereafter approved by the voters in 1864 as an amendment to the 1838

Constitution. Washington, 188 A.3d at 1146 n.29. That amendment, virtually identical to

the core provision in today’s version of Section 3, read: “[n]o bill shall be passed by the

legislature, containing more than one subject, which shall be clearly expressed in the title,

except appropriations bills.” Pa. Const. of 1864, art. II, § 8. 18

       The drafters of Article III, Section 3, who sought a transparent and understandable

legislative process, were especially troubled by omnibus bills which permitted the

passage of “stealth legislation,” by which legislators and citizens were affronted by hidden

aspects of legislation. See John L. Gedid, “History of the Pennsylvania Constitution,” as

appearing in Ken Gormley, ed., The Pennsylvania Constitution A Treatise on Rights and

Liberties, 68 (2004) (“Requiring a single subject and statement of that subject in the title

of a bill, as well as controls on altering bills to change their nature during the passage

process without revealing the change, prevented ‘stealth’ legislation in which some

legislators might be misled about the contents of a bill, and also enabled the public to

know and follow what the legislature was doing.”).

       Additionally, “logrolling” was of particular concern to the citizenry and the

constitutional reformers. This technique “embrac[ed] in one bill several distinct matters,

none of which could singly obtain the assent of the legislature, and procur[ed] its passage

18 The 1873 constitutional convention made grammatical changes for clarity; however,

the foundational reasons for its original enactment and its restrictions on lawmaking were
reaffirmed by the delegates. Washington, 188 A.3d at 1146 n.29 (citing 5 Debates of the
Constitutional Convention of 1873, 243-46 (1873)).

                                       [J-50-2022] - 20
by combining the minorities who favored the individual matters to form a majority that

would adopt them all.” Neiman, 84 A.3d at 611 (quoting City of Philadelphia, 838 A.2d at

586). As a practical matter, this resulted in legislators voting for a bill containing aspects

with which they disagreed, solely to secure passage of other parts of the legislation that

they supported. As a remedy, the single subject requirement restricted the attachment of

riders, which could not be passed on their own, to popular bills which were certain to

become law, and constituted a significant step forward in curtailing both stealth legislation

and the practice of logrolling.

       Related thereto, and while not often discussed in our jurisprudence, an additional

salutary purpose served by the single subject requirement is protecting the integrity of the

gubernatorial veto: “Just as the single subject limitation seeks to ensure separate and

independent legislative consideration of proposals, it is intended to guarantee the same

freedom from ‘logrolling’ during executive review of legislative enactments. Thus . . . if

the governor desires to veto any of the sections in the legislation, he would have been

required to veto the entire act. To do so requires him to sacrifice desirable legislation in

order to veto what he considers undesirable legislation.” Robert F. Williams, The Law of

American State Constitutions, 261-262 (2009); see also Commonwealth ex rel. v. Barnett,

48 A. 976, 977 (Pa. 1901) (“[B]y joining a number of different subjects in one bill the

governor was put under compulsion to accept some enactments that he could not

approve, or to defeat the whole, including others that he thought desirable or even

necessary.”). Stated another way, “the single subject rule protects the governor’s veto

prerogative by ‘prevent[ing] the legislature from forcing the governor into a take-it-or-

leave-it choice when a bill addresses one subject in an odious manner and another

subject in a way the governor finds meritorious’ . . . . In a word, the single subject rule

protects the decision of the legislators and governor on each individual legislative

                                      [J-50-2022] - 21
proposal.” Martha Dragich, State Constitutional Restrictions on Legislative Procedure,

38 Harv. J. Legis. 103, 115 (2001). Thus, Article III, Section 3 also serves as a safeguard

of the Governor’s veto power set forth in a parallel constitutional provision. Pa. Const.

art. IV, § 15.

       Consequently, the reaffirmation of the principles of Article III, Section 3 in the

“Reform Constitution” of 1874, limiting each bill to a single subject, served to ensure that

every piece of legislation receives a “considered and thorough review” by legislators, and

safeguards the ability of all residents of the Commonwealth who will be impacted by a bill

to have the opportunity to make their views on its provisions known to their elected

representatives prior to their final vote on the measure. Neiman, 84 A.3d at 612. Article

III, Section 3 was designed to prevent the use of “omnibus bills” which combined multiple

pieces of legislation, each pertaining to a different subject, into one bill. Washington, 188

A.3d at 1146 (citing Thomas Raeburn White, Commentaries on the Constitution of

Pennsylvania, xxvi (1907) at 213 (hereinafter “White”)). The overarching purpose of these

and the other restrictions on the legislative process contained in Article III was to ensure

“our Commonwealth’s government is open, deliberative, and accountable to the people it

serves.” Id., at 1147 (citing City of Philadelphia, 838 A.2d at 585). Indeed, as we

summarized in PAGE, “while these changes to the Constitution originated during a unique

time of fear of tyrannical corporate power and legislative corruption, these mandates

retain their value even today by placing certain constitutional limitations on the legislative

process.” PAGE, 877 A.2d at 394; see also Stilp v. Commonwealth, 905 A.2d 918, 951–

52 (Pa. 2006).

       With this review of its historical origins and purpose, we turn to our analysis of

Appellants’ Article III, Section 3 challenge. In interpreting a constitutional provision, “we

view it as an expression of the popular will of the voters who adopted it, and, thus,

                                      [J-50-2022] - 22
construe its language in the manner in which it was understood by those voters.”

Washington, 188 A.3d at 1149 (citing Stilp, 905 A.2d at 939; Commonwealth v. Harmon,

366 A.2d 895, 899 (Pa. 1976)). Thus, our Court should not consider constitutional

language in a “technical or strained manner, but [should] interpret its words in their

popular, natural and ordinary meaning.” Id. (citing Scarnati v. Wolf, 173 A.3d 1110, 1118

(Pa. 2017)).    That being the case, “we must favor a natural reading which avoids

contradictions and difficulties in implementation, which completely conforms to the intent

of the framers, and which reflects the views of the ratifying voter.” In re Bruno, 101 A.3d

635, 659 (Pa. 2014) (quoting Commonwealth ex rel. Paulinski v. Isaac, 397 A.2d 760,

766 (Pa. 1979)). As “[o]ur ultimate touchstone is the actual language of the Constitution

itself,” Stilp, 905 A.2d at 939, we initially turn to the text of Section 3.

       Article III, Section 3 of our state charter, commonly referred to as the “single

subject” requirement, more precisely contains twin mandates:

               No bill shall be passed containing more than one subject,
               which shall be clearly expressed in its title, except a general
               appropriation bill or a bill codifying or compiling the law or a
               part thereof.

Pa. Const. art. Ill, § 3; see also PAGE, 877 A.2d at 394 (offering that this constitutional

provision “sets forth dual mandates for the General Assembly which prohibit the passing

of a bill that contains more than one subject and requires that the subject be clearly

expressed in its title”).

       By its express language, Article III, Section 3 could be understood to permit a bill

to contain only, and literally, a single subject, meant in its narrowest sense. However, our

case law has never given Section 3 such a circumscribed interpretation. Indeed, due to

the nature of the legislative process, of which the offering of amendments by legislators

or the insertion or deletion of various provisions is a wholly accepted part of the path

                                        [J-50-2022] - 23
through each house of the General Assembly, our Court has strived over the years to

strike the appropriate balance between allegiance to the intent and purpose of Article III,

Section 3, and, at the same time, to give a broad enough meaning to the provision to

allow the legislative process to operate reasonably unimpeded. This endeavor has

proven to be complex and does not lend itself to bright-line rules. These characteristics

of a single subject analysis, in turn, have resulted in a waxing and waning in how narrowly

Section 3 has been construed.

       For example, over 100 years ago, in Payne v. School District of Borough of

Coudersport, 31 A. 1072, 1074 (Pa. 1895) (per curiam), our Court explained the

expanding and contracting lens through which a single subject analysis may be viewed,

and adopted an analytical approach which required the various legislative provisions

comprising a bill to accomplish a single general purpose, reasoning that:

              [f]ew bills are so elementary in character that they may not be
              subdivided under several heads; and no two subjects are so
              wide apart that they may not be brought into a common focus,
              if the point of view be carried back far enough. . . . Those
              things which have a ‘proper relation to each other,’ which fairly
              constitute parts of a scheme to accomplish a single general
              purpose, ‘relate to the same subject’ or ‘object.’ And
              provisions which have no proper legislative relation to each
              other, and are not part of the same legislative scheme, may
              not be joined in the same act.

Id. at 1074. This standard has come to be generally described by our Court in more

recent cases as a “germaneness” test, which requires a commonality between the

provisions contained in the legislation, such that the various parts of the bill can be fairly

regarded as working together to accomplish a singular purpose. Id.

       On the heels of the 1874 Constitution, in the late 19th and early 20th centuries, our

Court applied this germaneness construct stringently. See, e.g., id. at 1073 (finding

legislation that originally related to a single school in Coudersport borough, and which

                                      [J-50-2022] - 24
expanded to “Coudersport and East Fork road district, which includes a part of three

townships never therefore connected in any way with Coudersport school district and it

affects not merely the graded school, but all the schools within the territory,” contained

more than a single subject in violation of the Constitution); Commonwealth ex rel.

Woodruff v. Humphrey, 136 A. 213, 217 (Pa. 1927) (holding statute as written treated two

subjects ― “engineering” and “land surveying” ― not as the latter being a subordinate

branch of the former, but as two professions, ultimately setting forth two subjects of

legislation in one statute, in violation of Section 3 of the Constitution); Yardley Mills Co. v.

Bogardus, 185 A. 218 (Pa. 1936) (eschewing unifying subject of “water canals” in striking

legislation containing provisions requiring canal companies to maintain waterways,

granting these companies the right to sell water for commercial purposes, and allowing

the Commonwealth to acquire canal lands by gift and sell portions of them).

       More recently, in our 2003 decision in City of Philadelphia, we recognized the

constitutional mandate that the differing provisions within the bill must be “germane” to

each other, although we acknowledged what we have considered germane and not

germane has fluctuated throughout the years. City of Philadelphia, 838 A.2d at 586-87. 19

Therein, adopting a “middle-course framework,” we explained that, to pass constitutional

muster under Article III, Section 3, differing subjects contained in legislation must

constitute parts of a unifying scheme to accomplish a single purpose. Weeks II, 222 A.3d

at 727.    Our Court’s decision was animated by concerns raised earlier in Payne,

explaining that “[t]here must be limits . . . as otherwise virtually all legislation, no matter

how diverse in substance, would meet the single-subject requirement.”                   City of

Philadelphia, 838 A.2d at 588. Adopting a more moderate approach to Section 3, our

19 Indeed, in Weeks II, we described City of Philadelphia as “chart[ing] something of a

middle course between overly-strict and overly-lenient enforcement of Section 3” and
employing a “middle-course framework.” Weeks II, 222 A.3d at 727, 729.

                                       [J-50-2022] - 25
Court concluded that a bill which made multiple disparate amendments to the

Philadelphia City Code could not be brought together under the single broad category of

“municipalities,” given the various subjects did not “constitute part of a unifying scheme

to accomplish a single purpose” and, thus, was unconstitutional. Id. at 588-89. 20

       Only two years later, however, our Court authored its arguably broadest

interpretation of the single subject requirement in PAGE. The Court reiterated that,

“‘where the provisions added during the legislative process assist in carrying out a bill's

main objective or are otherwise ‘germane’ to the bill's subject as reflected in its title,’ the

requirements of Article III, Section 3 are met;” but we conceded that, under the teachings

of Payne, “defining the constitutionally-valid topic too broadly would render the

safeguards of Section 3 inert.” PAGE, 877 A.2d at 395. Nevertheless, the PAGE Court

found that a bill which originated as a simple measure to allow background checks by the

state police for persons involved in harness racing, but to which the entirety of the present

Gaming Act was added to it late in the legislative session, including subjects of seemingly

diverse topics, 21 did not violate Article III, Section 3. This legislation survived a single

20 These multifarious subjects included authorizing the Philadelphia parking authority to

undertake mixed-use development projects and imposing requirements and limitations
on the terms and service of parking authority board members; transferring authority over
Philadelphia’s taxis and limousines from the Public Utility Commission to the Philadelphia
Parking Authority; repealing Section 209(k) of the Pennsylvania Intergovernmental
Cooperation Authority Act as applied to Philadelphia, as well as restricting the political
activities of police officers employed by all municipalities; authorizing all municipalities to
hold gifts in trust; imposing a citizenship requirement for board members of municipal
business improvement districts; and general bond and indemnification provisions for all
municipal authorities and governing bodies.
21 These provisions regulated the horse-racing industry; authorized the creation of a slot-

machine industry in Pennsylvania; created the Gaming Control Board and a regulatory
regime therefor; provided for the distribution of licensing fees and tax revenue from
casinos; established policies and procedures for gaming licenses for the installation of
slot machines; created a general gaming fund for tourism development, property tax relief,
and treatment for compulsive gambling; and placed exclusive jurisdiction in the
(continued…)

                                      [J-50-2022] - 26
subject challenge, despite the expansive number of different matters in the final bill,

because all the topics related to the subject of the “regulation of gaming.” Id. at 396.

       Our Court’s decisions in the last decade have reinvigorated a narrower

understanding of the single subject requirement, rendering our decision in PAGE an

outlier. For example, in 2013, in Pennsylvania State Association of Jury Commissioners

v. Commonwealth, 64 A.3d 611 (Pa. 2013), our Court considered an omnibus bill

providing counties with the right to electronically auction surplus farm products and

miscellaneous personal property, as well as abolish the office of jury commissioner. We

determined that the legislation violated Article III, Section 3 because these subjects could

not be grouped together under the broad topic of “powers of county commissioners” or it

would contravene the teachings of Payne and render nugatory the protections of that

constitutional provision. Id. at 619 (“The addition of a completely unrelated legislative

operation to the bill under the auspices of ‘powers of county commissioners’ could only

have survived the instant single subject challenge ‘if the point of view [were] carried back

far enough’ to eviscerate the rule.” (citations omitted)).

       Similarly, that same year in Neiman, supra, our Court struck an omnibus bill which

contained Megan’s Law sex offender registration provisions, as well as amendments to

deficiency judgment procedures, county park police jurisdiction, and the statute of

limitations for asbestos claims, as violative of the single subject rule as they were not

germane to effectuating a singular purpose. In doing so, our Court rejected as proposed

unifying subjects “refining civil remedies or relief” or “judicial remedies and sanctions” as

too expansive to satisfy Article III, Section 3’s constitutional mandate; rather, we reasoned

that “such subjects are virtually boundless.” Neiman, 84 A.3d at 613.

Pennsylvania Supreme Court over gambling license disputes and constitutional
challenges to the statute.

                                      [J-50-2022] - 27
       Finally, in Leach, in a challenge to an omnibus bill that amended the crimes of theft

of precious metals and criminal trespass, while also eliminating the right of municipalities

to regulate the possession, ownership, or transport of firearms, we found the legislation

violated the single subject rule because there was no common nexus to a single purpose

― that is, the provisions therein were not part of a unifying scheme to accomplish a single

purpose. Leach, 141 A.3d at 430. In coming to this conclusion, our Court rejected the

assertion that all of the statute’s provisions amended aspects of the Crimes Code, as well

as the alternative theory that the enactment encompassed Crimes Code amendments

involving the regulation of firearms or the ability to own a firearm. Id. at 434.

       The single subject test, as described above, contains both a “germaneness” and

a “clear expression” requirement. 22 As to the “germaneness inquiry,” in considering

whether the manner of passage of a bill violates Article III, Section 3, a court asks whether

the various provisions within the bill are germane to each other. Neiman, 84 A.3d 612. 23

The various subjects contained in a legislative enactment are germane to each other if

they “have a nexus to a common purpose.” Id. Alternatively stated, the bill’s various

provisions must be part of “a unifying scheme to accomplish a single purpose.” Id.

(quoting City of Philadelphia, 838 A.2d at 589).

       In deference to the legislative process, when engaging in a germaneness analysis,

a court may hypothesize a reasonably broad purpose for a bill that encompasses the

original text and amendments thereto, regardless of whether that hypothesized subject is

proposed by the party defending the constitutional challenge or is conceived by the court.

22 As to the second part of the Article III, Section 3 analysis, whether the subject was

clearly expressed in its title, we note that Appellants have not raised a clear title challenge.
Appellants’ Reply Brief at 9.
23 As we discuss below, our Court utilizes the same germaneness test in considering

compliance with Article III, Sections 1 and 4. Washington, 188 A.3d at 1151; Stilp, 905
A.2d at 959; PAGE, 877 A.2d at 410.

                                       [J-50-2022] - 28
However, when the court must hypothesize an “unduly expansive” subject to sustain an

enactment, the General Assembly has violated its constitutional mandate. Washington,

188 A.3d at 1152; City of Philadelphia, 838 A.3d at 588 (cautioning that “otherwise

virtually all legislation, no matter how diverse in substance, would meet the single-subject

requirement” undercutting Section 3’s safeguards); see also Weeks II, 222 A.3d at 738

(Wecht, J., dissenting).

       Applying the germaneness inquiry to the legislation before us, we conclude that

the provisions contained in Act 12 are germane to each other, as we have interpreted that

requirement. As we explained in Weeks II, the essence of the decisions analyzed above

is that a bill will be held to violate the single-subject rule only if it includes provisions with

“unrelated subject matter.” 222 A.3d at 729. Of course, the hypothesized unifying topic

cannot be overly broad, as illustrated by such rejected topics as the “business of the

courts, municipalities, or the economic wellbeing of the Commonwealth” – expansive

topics “which would empty the germaneness test of all meaning.” Id. (citations omitted).

       While strong arguments have been made on both sides, and while we find this to

be a close case, we conclude that the provisions of Act 12 are not so far removed from

each other that they are “unrelated,” or that sanctioning their inclusion together would

strip the germaneness test of meaning. Rather, as in Weeks II, we believe that the act

as a whole has a “nexus to a common purpose,” Neiman, 84 A.3d at 612 ― that is,

hypothesizing a reasonably broad purpose, we find its provisions all relate to benefits

pertaining to the basic necessities of life to low-income individuals. See Weeks II, 222

A.3d at 730. 24 This unifying single subject covers the elimination of Cash Assistance,

24 We recognize that our Court in Weeks II accepted this unifying theme under the “highly

deferential” standard of review pertaining to preliminary injunctions, which required
affirmance of the Commonwealth Court’s order if there were “any apparently reasonable
grounds” for the Commonwealth Court denying the injunction. 222 A.3d at 727. We are
(continued…)

                                        [J-50-2022] - 29
which provided cash for basic items such as utility services, food, clothing, and personal

hygiene products, as well as the continued provision of Medical Assistance benefits and

nursing-home care, the delivery of which is incentivized by payments to providers and

benefits to those institutions which serve Medicaid patients. 25 Furthermore, we find that,

although Act 12’s amendments additionally addressed ancillary benefits to the populous

at large ― through municipal funding of public health programs, including educational

programs to reduce tobacco use and obesity; air pollution monitoring; enforcement of

lead-free rental requirements; programs to promote immunization; water quality

programs; childhood literacy programs; and the provision of care services in

neighborhood health centers ― they still fall within the unifying single subject of “the

provision of benefits pertaining to the basic necessities of life for low-income individuals.”

Similarly, and because of this common subject, the amendments do not amount to

unconstitutional logrolling. Rather, Act 12 in its original form and as amended has a

unifying scheme to accomplish a singular purpose.

       Additionally, we conclude that “the provision of benefits pertaining to the basic

necessities of life to low-income individuals” is not unreasonably broad. Indeed, this

subject is far narrower than the all-encompassing topics such as “municipalities” (City of

Philadelphia), “refining civil remedies or relief” or “judicial remedies and sanctions”

(Neiman), “amendments to the county code” or “powers of county commissioners” (Jury

not, however, precluded from coming to a similar conclusion – that is, utilizing a similar
unifying theme – at this merits stage.
25 Nevertheless,   we respectfully disagree with DHS to the extent it suggests Act 12
passes single subject scrutiny because all of its provisions concern the provision of
medical benefits to low-income persons. We agree with Appellants that the Cash
Assistance benefits were not medical benefits or medical care, and it was not a medical
benefit or health care program. Thus, contrary to DHS's assertion, the original purpose
of Act 12 is unrelated to the providing of medical benefits to low-income people; however,
it passes constitutional muster, as the provisions contained therein all relate to benefits
pertaining to the basic necessities of life to low-income individuals.

                                      [J-50-2022] - 30
Commissioners), or “regulation of firearms” or “ability to own a firearm” (Leach) which we

have rejected over the years as unconstitutional. Those pieces of legislation contained

provisions on disparate topics that simply could not be reconciled under even a broad

hypothesized single subject. Indeed, unlike these cases, here, all of the amendments

pertain to benefits for low-income individuals. It is also narrower than the subject ― “the

regulation and funding of human services programs regulated by the [DPW]” ― about

which we expressed skepticism in our prior decision in Washington, 188 A.3d at 1154

n.36, albeit in the context of an Article III, Section 4 challenge.

       Again, we conclude this appeal presents a close call, and find it is at the very

boundary of what is permissible under the single-subject mandate in Article III, Section 3.

That being the case, we repeat that facial challenges to the validity of a statute are

disfavored and every legislative enactment, including the process by which a bill becomes

law, is presumed valid. Ultimately, we find that Appellants have not met their heavy

burden of establishing that the legislative process “clearly, palpably and plainly” violated

our Constitution. Zogby, 828 A.2d at 1087. For these reasons, we hold that the legislative

process which culminated in the passage of Act 12 satisfies the single subject mandate

of Article III, Section 3.

                             III. Challenge under Article III, Section 1

       Having found that the legislative process which led to the enactment of Act 12 did

not violate Article III, Section 3, we turn to the question of whether its enactment was in

violation of the requirements of Article III, Section 1 of the Pennsylvania Constitution. As

we discuss infra, this provision contains twin mandates: (1) that, on its passage through

the legislature, a bill is not to be altered or amended so as to change its original purpose;

and (2) that the title and contents of the bill in its final form are not deceptive. We address

each mandate in turn.

                                        [J-50-2022] - 31
                                   A. Original Purpose

       Appellants begin with an overview of Article III and the history and policy underlying

that provision, as set forth above, emphasizing the origins of the amendments to Article

III, including the corrosive effects of the last-minute consideration of important measures,

logrolling, mixing substantive provisions in omnibus bills and the attachment of unrelated

provisions in the amendment process. Appellants’ Brief at 23 (citing City of Philadelphia,

838 A.2d at 588-89). Specifically, Appellants proffer that the original purpose rule was

intended to abolish the addition of riders to bills during the legislative process so as to

prevent the addition of proposed legislation on a subject matter unrelated to that of the

bill as originally passed.

       Appellants explain that, central to an analysis under Article III, Section 1,

amendments to a bill must be germane to, and not change, the general subject of the bill.

Appellants assert that the Commonwealth Court erred when it held that the purpose of

the original bill was to amend the Human Services Code's provisions on Medical

Assistance. Rather, Appellants stress that, as sponsored and summarized, the sole

stated purpose of the bill, as reflected in its title and text, was to eliminate the Cash

Assistance program without changing the Medical Assistance program, which, according

to Appellants, is a completely different type of benefit. With respect thereto, Appellants

maintain that, prior to the passage of Act 12, the Cash Assistance program provided only

cash benefits, which, as noted above, are small amounts of cash given to needy

individuals who may spend it on a variety of basic life needs, including rent and food.

This, according to Appellants, can be contrasted with Medical Assistance, which, as its

name suggests, provides medical benefits to eligible individuals, through the

Commonwealth's Medical Assistance program (albeit not the broader health care

assistance provided through the federal Medicaid program).

                                     [J-50-2022] - 32
       In support of its assertion that the original bill’s purpose solely related to Cash

Assistance, Appellants contend that the original bill's change in the definition of “General

assistance” to “General assistance-related categorically needy medical assistance” was

necessary because of the elimination of the cash benefits provided by the Cash

Assistance program. Appellants’ Brief at 31. Appellants submit that, formerly, the receipt

of such cash benefits automatically enabled the recipient to receive medical assistance

through the Medical Assistance program, but, since the bill was eliminating cash benefits,

a further technical revision was necessary to remove this trigger provision. Appellants

assert that these “purely technical” references related only to the state-funded Medical

Assistance program, and not to the federally-funded Medicaid program, and, thus, not to

the Philadelphia Hospital Assessments and Nursing Facility Incentive Payments.

Appellants’ Brief at 32-33. Indeed, Appellants emphasize that the DHS admitted that the

Medical Assistance program was not affected by Act 12.

       Appellants submit that the bill’s amendments were designed to achieve purposes

beyond the elimination of Cash Assistance (its sole original purpose, according to

Appellants). Indeed, Appellants assert that the final bill: (1) reauthorized the Nursing

Facility Incentive Payments; (2) revised definitions for the Statewide Quality Care

Assessment, a tax on hospitals statewide that permitted Pennsylvania to draw down on

supplemental Medicaid payments from the federal government; (3) reauthorized the

Philadelphia Hospital Assessment, permitting Pennsylvania to draw down $165 million in

revenue from the federal government; and (4) changed the Philadelphia Hospital

Assessment to permit municipalities to use their portion of revenues raised by that

assessment for “public health programs.” Appellants’ Brief at 35.

       Thus, contrary to the Commonwealth Court’s conclusion, Appellants maintain that

the original purpose of the bill was not “to amend the Human Services Code’s provisions

                                     [J-50-2022] - 33
on medical assistance to low-income individuals,” but was solely to eliminate the Cash

Assistance program. Id. Similarly, Appellants reject as an original purpose “medical

assistance to low-income individuals,” id., given that the amendments concerned revenue

assessments crucial to the budget, and the Philadelphia Hospital Assessment was altered

to allow municipalities to use the generated revenues for broad public health programs,

including restaurant and retail food inspection, air and water quality, and inspection of

barber and beauty establishments, and promoting childhood literacy.                 Id. at 36.

Appellants contend that these uses do not relate to medical care for low-income

individuals, and impact more than the basic needs of low-income individuals. Appellants

eschew as an original purpose the “provision of benefits pertaining to the basic

necessities of life to certain low-income individuals,” asserting it is overly broad, and, thus,

fails the germaneness test. Id. According to Appellants, even under a reasonably broad

view of the original purpose of the bill, it could not encompass the “multiple and wide-

ranging disparate purposes of the final, amended bill.” Id. at 37. Appellants submit that

our Court rejected such amendments regarding different programs in PAGE, Washington,

and Leach.

       After setting forth the “extremely deferential” standard of review regarding the

constitutionality of Act 12, DHS counters that, with respect to the original purpose

requirement, a court must look at the original purpose broadly, Appellee’s Brief at 13

(citing PAGE, 877 A.2d at 409), reflecting that legislation often changes significantly

during its path to becoming law. Here, DHS maintains that the final bill had the same

broad purpose as the original bill. Specifically, DHS offers that the original purpose of the

bill, broadly stated, was “to amend existing provisions of the Human Services Code

providing medical assistance to low-income individuals.”             Appellee’s Brief at 16.

According to DHS, the final bill likewise amended existing provisions of the Human

                                       [J-50-2022] - 34
Services Code, pertaining to the provision of medical care to low income individuals, by

“(1) extending and increasing funding for certain nursing facilities that provide medical

care to low-income individuals; (2) amending the definitions to the Statewide Quality Care

assessment (otherwise referred to as the statewide hospital assessment), which

authorizes an assessment on hospitals to generate funding to pay for health care services

to low-income individuals; and (3) renewing and extending the Philadelphia Hospital

Assessment through June 30, 2024, which authorizes an assessment on Philadelphia

hospitals to generate funding to pay for health care services for low-income individuals.”

Id. at 16-17. Thus, DHS contends that the original purpose test is satisfied.

       Related thereto, DHS notes that its proffered broad purpose is not definitive, as it

is for the courts to hypothesize a reasonably broad purpose, not the litigants. Thus, DHS

points to the similarly broad purpose we hypothesized in Weeks II, concluding that the

provisions of Act 12 all concerned “benefits pertaining to the basic necessities of life to

certain low-income individuals.” Weeks II, 222 A.3d at 730. Regardless of which purpose

is hypothesized ― the one it proffers, or our formulation in Weeks II ― DHS contends

that both pass the constitutional requirements of Article III, Section 1. In support thereof,

DHS offers that the amendments in the final bill were significantly narrower than those in

PAGE, which began as a bill intended for police background inspection in the horse racing

industry and expanded to include the authorization of slot machine gambling in the

Commonwealth. While the amendments were significant, our Court nevertheless found

no violation of Article III, Section 1 as both the original and final form of the bill related to

the same broad purpose ― the regulation of gaming ― and, thus, satisfied the original

purpose test.

       Our analysis begins with the language of Article III, Section 1. This constitutional

provision, entitled “Passage of laws,” provides: “No law shall be passed except by bill,

                                       [J-50-2022] - 35
and no bill shall be so altered or amended, on its passage through either House, as to

change its original purpose.” Pa. Const. art. III, § 1.

       As noted by the parties, Article III, Section 1 was newly adopted by the 1873

constitutional convention and was primarily intended to abolish the practice of attaching

“riders” to bills during the legislative process by preventing amendments on a subject

matter unrelated to that contained in the bill as originally introduced. Washington, 188

A.3d at 1146 (citing White at 211). Its objective was to give legislators considering a bill

sufficient notice of all of its provisions so that “they might vote on it with circumspection.”

Consumer Party of Pennsylvania v. Commonwealth, 507 A.2d 323, 334 (Pa. 1986).

       All parties agree that PAGE sets forth the relevant inquiry for a challenge to

legislation under Article III, Section 1. Therein, we explained that, generally speaking,

“the language adopted by the conventioneers, as well as their purpose in adopting Article

III, Section 1 counsel towards, and are best served by, an analytical construct that

involves comparison between the original purpose and the final purpose of the bill[].”

PAGE, 877 A.2d at 408. Notably, the PAGE Court set forth a two-prong test. First, a

reviewing court must consider the original purpose of the legislation “in reasonably broad

terms,” compare it to the final purpose, and then decide whether there has been an

alteration or amendment that changed the original purpose. Second, the court must

consider whether the title and contents of the bill in its final form are deceptive. If the

legislation “passes both the purpose comparison and deception inquiries, it will pass

constitutional muster.” PAGE, 877 A.2d at 409; Stilp, 905 A.2d at 956.

       Additionally, in an original purpose inquiry, a court looks at that original purpose

broadly. PAGE, 877 A.2d at 409. This is reflective of the reality that legislation changes

significantly as it proceeds through the House and Senate, and, indeed, is fully expected

to do so. Id. (acknowledging “the ‘expectation’ that legislation will be transformed during

                                      [J-50-2022] - 36
the enactment process”). Furthermore, our Court looks at the original purpose broadly

out of deference for legislative matters and respect for the corollary presumption that

legislation is constitutional.   Id. (offering that “our Court is loathe to substitute [its]

judgment for that of the legislative branch under the pretense of determining whether an

unconstitutional change in purpose of a piece of legislation has occurred during the

course of its enactment”). It is for these reasons that a court is free to hypothesize a

reasonably broad original purpose in the initial bill and determine whether there has been

an alteration or amendment that changed the original broad purpose. Id.

       As with the Article III, Section 3 challenge, we believe this to be a close case and

the parties have supplied reasonable arguments in support of their respective positions.

Viewed in reasonably broad terms, the original purpose of Act 12 was to eliminate Cash

Assistance while favoring health-specific benefits for low-income individuals, as

evidenced by the Human Services Code's provisions which eliminated the Cash

Assistance program and reaffirmed the continuance of the Medical Assistance program

for low-income individuals. Now we must compare this original purpose of the legislation

to the final purpose, and then determine whether there has been an alteration or

amendment that changed the original purpose. PAGE, 877 A.2d at 409. While the

amendments made to the original bill were extensive, as recognized above, the central

objective of the legislation remained to “eliminate Cash Assistance while favoring health-

specific benefits for low-income individuals.” The purpose of both the original bill and the

final bill is the same. Thus, we find that Appellants have not met their heavy burden of

establishing that Act 12 violates Article III, Section 1’s original purpose requirement.

                                     B. Deceptive Title

       Turning to the second prong of the construct announced in PAGE, we must

consider whether the title of the final bill (relative to the bill’s contents) was deceptive.

                                      [J-50-2022] - 37
Appellants claim that it was. Appellants offer that a bill is not deceptive if the “title place[s]

reasonable persons on notice of the subject of the bill.” Appellants’ Brief at 39 (citing

PAGE, 877 A.3d at 409). While the title indicated that Act 12 was amending the Medical

Assistance program, Appellants submit that it made no changes to the Medical

Assistance program other than technical changes to accommodate the elimination of

Cash Assistance. Indeed, Appellants emphasize that, both in the original and final form,

the title did not reference the elimination of the Cash Assistance program in any way. As

a result, Appellants contend that the title was deceptive. In this vein, Appellants challenge

the Commonwealth Court’s assertion that legislators were placed on notice that the bill

pertained to the provision of medical services to categorically needy individuals, as the

bill made no changes to the Medical Assistance benefits.

       In support thereof, Appellants point to case law from other states wherein courts

struck legislation for defective titles. See, e.g., City of Helena v. Omholt, 468 P.2d 764,

767-69 (Mont. 1970) (finding title deceptive where the title contained a statement

regarding a certain distribution method while the body of the legislation contained no such

method); Warren v. Walker, 71 S.W.2d 1057, 1059 (Tenn. 1934) (determining the repeal

of certain legislation mentioned in the title only affected one county, and, thus, was

defective because it did not give notice that only one county was the subject of the

legislation); Warren, Coutieri v. City of New Brunswick, 44 N.J.L. 58, 59 (N.J. 1882)

(holding title defective where the title spoke to the regulation of salaries of city officers in

cities of the state, although the bill only applied to the city of New Brunswick). Here,

according to Appellants, the title of the bill at all times omitted the critical information that

the bill eliminated, or even related to, Cash Assistance. Thus, Appellants aver that Act

12’s title was defective in violation of Article III, Section 1.

                                        [J-50-2022] - 38
       For its part, DHS argues that Appellants are contending for the first time that the

final version of Act 12 was deceptive because it disguised the fact that the legislation

eliminated Cash Assistance.        According to DHS, the title was sufficiently detailed,

covering all major provisions of Act 12, such that no reasonable person would have been

deceived by what was contained in the bill, and that legislators were put on notice that

the legislation pertained to the provision of medical services to categorically needy

individuals. DHS rejects Appellants’ contention to the contrary as incredible. Further,

DHS contends that the contents of the original and final bills were well-advertised and

robustly debated, reflecting no intent to deceive and pointing out that there is no allegation

that any lawmaker, or any individual, did not have reasonable notice of the contents of

Act 12. Indeed, DHS submits that this was not an instance, as in Washington, where the

original bill was “gutted” and became a “hollow shell” which was filled with distinct

provisions. See Weeks II, 222 A.3d at 731 (discussing Washington). Thus, DHS argues

that, here, both the spirit and the letter of Article III, Section 1 was satisfied.

       We begin our analysis by quoting the final title for Act 12. It stated, in full:

               An Act amending the Act of June 13, 1967 (P.L. 31, No. 21),
               entitled “An Act to Consolidate, Editorially Revise, and Codify
               the Public Welfare Laws of the Commonwealth,” in public
               assistance, further providing for definitions, for general
               assistance–related categorically needy and medically needy
               only medical assistance programs, for the medically needy
               and assistance programs, for the medically needy and
               determination of eligibility and for medical assistance
               payments for institutional care; in hospital assessments,
               further providing for definitions, for authorization, for
               administration, for no hold harmless, for tax exemption and for
               time period; and, in statewide quality care assessment, further
               providing for definitions.

H.B. 33, 2019 Leg., Reg. Sess. (Pa. 2019).

                                       [J-50-2022] - 39
       As noted by the parties, we must consider whether, in its final form, the title of the

bill was deceptive. PAGE, 877 A.2d at 408-09. Whether the deceptive title requirement

is met is a question of notice. See Scudder v. Smith, 200 A. 601, 604 (Pa. 1938) (offering

that Article III, Section 1 is “to put the members of the Assembly and others interested,

on notice, by the title of the measure submitted, so that they might vote on it with

circumspection.” (emphasis original)). As with Article III, Section 3, Article III, Section 1

was not intended to overwhelm legislators with excessively precise and picayune

standards for drafting a bill's title. Cf. Commonwealth v. Stofchek, 185 A. 840, 843 (Pa.

1936) (“[Article III, Section 3] was not intended to exercise a pedantic tyranny over the

grammatical efforts of legislators, nor to place them between the horns of a constructional

dilemma, namely, that the title of an act must be so general or so particularized as to

include all of its subject-matter, and yet not so general as to give no indication of its

purpose, nor so particular as to inferentially exclude from its scope any items inadvertently

omitted.”). Indeed, the intent of the constitutional mandate is “to prevent fraudulent efforts

to sneak legislation past unknowing legislators or the Governor. . . . In short, as difficult

as it may be to have a statute declared unconstitutional for failing to clear the low fence

of germaneness, it is that much harder to set aside a statute for the reason that it moved

through the legislative process under a deceptive title.” DeWeese v. Weaver, 824 A.2d

364, 372 n.15 (Pa. Cmwlth. 2003).

       We find that the final title of Act 12 was not deceptive. While the amendments to

Act 12 were substantive and expansive, its final title placed a reasonable person on notice

that the bill concerned benefits pertaining to the basic necessities of life to low-income

individuals. See PAGE, 877 A.2d at 406. To satisfy Article III, Section 1, the title did not

have to identify language that would be stricken from the Human Services Code, as “[t]he

title serves as a signal not a précis of the bill’s contents.” DeWeese, 824 A.2d at 372.

                                      [J-50-2022] - 40
The fact that the legislature could have chosen more precise language in the title of the

bill does not demonstrate deception. Moreover, we reiterate that a statute must be upheld

unless it clearly, palpably, and plainly violates the Constitution. Under that standard, we

cannot find the title of the final bill was deceptive in violation of Article III, Section 1.

       Accordingly, having found that the amendments to Act 12 did not change the

original purpose of the bill, and that its title was not deceptive, we must reject Appellant’s

Article III, Section 1 challenge.

       The order of the Commonwealth Court is affirmed.

       Jurisdiction relinquished.

       Justices Dougherty and Mundy join the opinion.

       Justice Dougherty files a concurring opinion.

       Justice Mundy files a concurring opinion.

       Justice Donohue files a dissenting opinion.

       Justice Wecht file a dissenting opinion.

       The Late Chief Justice Baer did not participate in the decision of this matter.

       Justice Brobson did not participate in the consideration or decision of this matter.

                                        [J-50-2022] - 41