Supreme Court allows states to cut off Medicaid funding for Planned Parenthood

A divided Supreme Court on Thursday ruled against Planned Parenthood, saying Medicaid patients do not have a right to sue to obtain nonabortion health care from the organization’s medical providers.

The decision allows South Carolina to cut off Medicaid funding for Planned Parenthood. It also has implications for patients in other states at a time when Republicans in Congress and the Trump administration are separately trying to defund even nonabortion health care offered by the nation’s largest abortion provider.

The 6-3 ruling, with all three liberal justices dissenting, reversed a lower-court decision that had allowed Planned Parenthood South Atlantic and a patient to seek to reinstate the group’s clinics as qualified health care providers after South Carolina cut off all Medicaid funding for the organization because it offers abortion services.

The decision means patients who rely on Medicaid will not be able to use the government insurance program for the poor to get services at the Planned Parenthood clinics in South Carolina.

The state already bans abortion after six weeks of pregnancy, and federal law prevents states from using Medicaid funds to cover abortions in most cases. But this case – Medina v. Planned Parenthood South Atlantic – involves other types of reproductive health care, such as birth control and cancer screenings.

In 2018, South Carolina Gov. Henry McMaster (R) issued an order directing all state agencies to stop providing public funds to any physician or professional medical practice affiliated with an abortion clinic. The state had paid for non-abortion health care at Planned Parenthood for decades through the joint state and federal Medicaid program, which supports low-income people.

In a statement Thursday, McMaster said he had taken “a stand to protect the sanctity of life and defend South Carolina’s authority and values – and today, we are finally victorious.”

The long-running Supreme Court case was brought by Julie Edwards, a patient at Planned Parenthood’s Columbia location who said her plans to obtain gynecologic and reproductive care at the clinic were disrupted when funding was terminated.

Alexis McGill Johnson, president of Planned Parenthood Federation of America, said the ruling “sided with politicians who believe they know better than you, who want to block you from seeing your trusted health care provider and making your own health care decisions.”

“And the consequences are not theoretical in South Carolina or other states with hostile legislatures,” her statement said.

At issue for the justices was whether a provision of the federal Medicaid Act allows individual Medicaid patients to sue to obtain care from their provider of choice. The federal statute says a state that participates in Medicaid must ensure that “any individual” insured through Medicaid “may obtain” care from any qualified and willing provider.

Several justices during oral argument seemed eager to provide clarity to help lower courts determine when a statute simply confers a benefit to an individual and when it goes further, empowering those individuals to sue to enforce that benefit or right. The Supreme Court has typically set a high bar for allowing lawsuits against the government, seeking to shield public officials from liability.

Writing for the majority, Justice Neil M. Gorsuch said the question of whether individuals can sue to enforce certain rights “poses delicate questions of public policy” and that, in this case, Congress had not authorized individuals to sue over benefits.

“New rights for some mean new duties for others. And private enforcement actions, meritorious or not, can force governments to direct money away from public services and spend it instead on litigation,” wrote Gorsuch, joined by Chief Justice John G. Roberts Jr. and Justices Clarence Thomas, Samuel A. Alito Jr., Brett M. Kavanaugh and Amy Coney Barrett.

“The job of resolving how best to weigh those competing costs and benefits belongs to the people’s elected representatives, not unelected judges charged with applying the law as they find it.”

The court’s three liberal justices disagreed. They took issue with the majority’s interpretation of the statute and said Congress intended to allow Medicaid recipients to choose their own providers.

The decision is “likely to result in tangible harm to real people,” wrote Justice Ketanji Brown Jackson, joined by Justices Elena Kagan and Sonia Sotomayor. “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.’ ”

A district court judge had sided with Edwards and Planned Parenthood, and the U.S. Court of Appeals for the 4th Circuit affirmed that decision, saying South Carolina had impinged on the rights of Medicaid patients by terminating Planned Parenthood as a qualified provider.

“We refuse to nullify Congress’s undeniable desire to extend a choice of medical providers to the less fortunate among us, individuals who experience the same medical problems as the more fortunate in society but who lack under their own means the same freedom to choose their health care provider,” wrote Judge J. Harvie Wilkinson III of the 4th Circuit. “In the Medicaid Act, Congress attempted a modest corrective to this imbalance.”

Wilkinson, a nominee of President Ronald Reagan, was joined by Judge James A. Wynn Jr., a nominee of President Barack Obama.

The Trump administration, which backed South Carolina’s position in court, is separately withholding Title X funding from nine Planned Parenthood affiliates with clinics across 20 states that receive money through the federal family-planning program.

On Capitol Hill, Republicans celebrated the Supreme Court’s ruling.

“Americans should never have been forced to pay for abortionists masquerading as ‘health care clinics,’ ” Sen. Mike Lee (R-Utah) said on X.

Democrats, meanwhile, decried the decision as a partisan maneuver to block Americans from health care access.

“Blocking Medicaid funds from Planned Parenthood threatens health care for those with few other places to turn,” Sen. Dick Durbin (Illinois), the top Democrat on the Senate Judiciary Committee, said in a statement.