High court allows exclusion of Planned Parenthood as Medicaid provider

A South Carolina woman does not have the right to sue the state over its exclusion of Planned Parenthood as a Medicaid provider, the U.S. Supreme Court ruled June 26.

Writing for the conservative majority in a 6-3 decision, Justice Neil Gorsuch said Medicaid’s guarantee that patients can choose their own health care providers “does not clearly and unambiguously grant” the right to enforce that provision through litigation. “Though it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so.”

Justice Ketanji Brown Jackson disagreed, describing Medina v. Planned Parenthood South Atlantic as a Civil Rights issue hindering patients’ right to sue when federal rights are denied.

“The majority’s effort to resist the natural and obvious rights-creating reading of the Medicaid Act’s free-choice-of provider provision is, ultimately, unpersuasive,” Jackson wrote in a dissenting opinion joined by justices Sonia Sotomayor and Elena Kagan.

In the process, the Supreme Court has undermined a core provision in the 1965 law, she added.

“Congress enacted the Medicaid Act’s free-choice-of-provider provision to ensure that Medicaid recipients have the right to choose their own doctors. The court’s decision … thwarts Congress’ will twice over: once, in dulling the tool Congress created for enforcing all federal rights, and again in vitiating one of those rights altogether.”

At the very least, the decision will rob South Carolina’s Medicaid recipients of the only meaningful method of enforcing a right bestowed by Congress, Jackson said.

“And, more concretely, it will strip those South Carolinians — and countless other Medicaid recipients around the country — of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.’ The court today disregards Congress’ express desire to prevent that very outcome,” she wrote.

The case stems from 2018, when South Carolina Gov. Henry McMaster ordered state health officials to remove Planned Parenthood from Medicaid coverage to prevent tax dollars for various women’s health care services from indirectly underwriting abortion services, SCOTUSblog reported. Although Planned Parenthood is known by its critics for providing abortion services, its mission is far broader and includes overall health care for women.

McMaster — following the line of many political and evangelical conservatives — said any money going to Planned Parenthood at least indirectly funds abortion services. Planned Parenthood has repeatedly denied this.

Plaintiff Julie Edwards complained the governor’s order prevented her from receiving other reproductive health and gynecological services from Planned Parenthood.

“That prompted Edwards and Planned Parenthood to go to federal court, where they argued that the exclusion of Planned Parenthood from the Medicaid program violates a provision of the Medicaid Act that allows any patient who is eligible for Medicaid to seek health care from any ‘qualified’ provider,” SCOTUSblog explained.

Lower courts previously ruled against the state based on the law’s requirement that Medicaid patients must be able to choose their own medical providers.

Separately, the state implemented a six-week abortion ban in 2023.

Planned Parenthood South Atlantic said the Supreme Court decision will deny South Carolinians enrolled in Medicaid the ability to receive cancer screenings, birth control, testing and treatment for sexually transmitted diseases and other preventative care.

The agency also expressed concern the ruling may inspire other states and some members of Congress to follow suit.

“Today’s decision is a grave injustice that strikes at the very bedrock of American freedom and promises to send South Carolina deeper into a health care crisis,” said Paige Johnson, president of Planned Parenthood South Atlantic. “Twice, justices of this court denied to even hear this case because Gov. McMaster’s intent is clear: Weaponize anti-abortion sentiment to deprive communities with low incomes of basic health care.”

The ruling demonstrates the Supreme Court’s willingness to accommodate Christian nationalism, said Annie Laurie Gaylor, co-president of the Freedom from Religion Foundation. “We’re watching the demolition of the separation of state and church in real time — and the people hurt the most are women and marginalized patients who need reproductive care. Religious dogma should never determine who can access public health services.”

But McMaster and other conservatives were delighted by the high court ruling.

“Seven years ago, we took a stand to protect the sanctity of life and defend South Carolina’s authority and values and today, we are finally victorious,” the governor said in response to the decision. “The legality of my executive order prohibiting taxpayer dollars from being used to fund abortion providers like Planned Parenthood has been affirmed by the highest court in the land.”

The Heritage Foundation applauded the ruling for adding another obstacle to abortion in the U.S.

“Abortion extremists have long wanted to force everyone to subsidize their agenda, including through Medicaid,” said Thomas Jipping, a senior legal fellow in the foundation’s Edwin Meese III Center for Legal and Judicial Studies. “South Carolina had enough and found a way to push back. Today, the Supreme Court reaffirmed that American taxpayers do not have to pay for others to kill their children.”

Two weeks ago, the Southern Baptist Convention adopted a resolution that called for the complete abolishment of Planned Parenthood, which has been a central focus of evangelical goals for decades.