Updated June 26, 2025 at 12:48 PM EDT
The Supreme Court on Thursday allowed South Carolina to bar Planned Parenthood's access to federal Medicaid funding for non-abortion services. The decision allows states to ban the organization from getting Medicaid reimbursements for cancer screenings and other care not related to abortion.
At issue was a provision of the federal Medicaid law that guarantees Medicaid patients the ability to choose their doctors, or in the words of the statute, they are entitled to "any qualified and willing provider." South Carolina, however, maintained that it could disqualify Medicaid providers for "any reason that state law allows." Or as Gov. Henry McMaster, a Republican, put it, "Taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs."
On Thursday, the Supreme Court — by a 6-3 vote along ideological lines — agreed.
Justice Neil Gorsuch, writing for the court majority, said that regardless of the words in the statute, the law does not "clearly and unambiguously" provide individuals the right to sue to enforce the "any qualified provider" measure, as Congress didn't specifically authorize such suits.
"Though it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so," he wrote. And he wrote that allowing someone to sue over one aspect of Medicaid plan requirements could also open the door to a flood of lawsuits over other requirements.
Justice Ketanji Brown Jackson, writing for the dissenting liberal justices, described the case as a civil rights issue, saying citizens have the right to sue over deprivation of rights.
South Carolina is evading its liability "for violating the rights of its Medicaid recipients to choose their own doctors," she wrote.
Dispute over who is a "qualified" provider
Since 1976, federal law has prohibited using federal Medicaid funding for abortion services with limited exceptions for rape, incest and life-threatening complications. But the Medicaid program reimburses "any qualified medical provider" for non-abortion services, and in South Carolina, a state with a shortage of primary care providers, Planned Parenthood South Atlantic has long provided routine medical services for low-income residents — including physical exams and cancer screenings.
When the governor removed the clinics from the state's Medicaid roster, the clinics sued, arguing that Medicaid patients should be able to choose their own health care providers, "including those who provide abortion."
They won, not once but repeatedly. Lower courts ruled that Planned Parenthood South Carolina is qualified to provide Medicaid services, and that since they are willing to provide those services, patients have a right to seek them out. Blocking the governor's order, the 4th Circuit Court of Appeals required South Carolina to include Planned Parenthood in its Medicaid program, granting residents the right to choose their health care providers.
The Supreme Court reversed that decision on Thursday.
The court's decision comes at an important time for Planned Parenthood, which is facing financial difficulties nationwide — NPR reports that Planned Parenthood has closed at least 34 clinics since last year. And in Congress there is pending federal legislation that, if passed, would eliminate all federal funding for Planned Parenthood.
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