The Supreme Court ruled against Planned Parenthood on Thursday, shooting down a lawsuit that challenged South Carolina’s law banning state Medicaid patients from using the abortion provider for their health care needs.
Under the law, Medicaid recipients are supposed to be able to use the provider of their choice.
But the high court, in a 6-3 ruling, said that’s not a privately enforceable right, meaning providers and beneficiaries can’t bring lawsuits against states that place restrictions on providers.
Justice Neil M. Gorsuch, writing the majority opinion, said Medicaid is a contract between the federal government and the states, and it’s up to Congress and the executive branch to enforce the rules — if they wish.
“It generally belongs to the federal government to supervise compliance with its own spending programs,” the Trump appointee wrote in a ruling joined by all of the other GOP appointees.
The decision could clear the way for other states to bar their Medicaid funding from going to Planned Parenthood, the network of women’s health clinics that accounts for roughly 40% of abortions performed in the U.S. each year.
Justice Ketanji Brown Jackson, writing the dissenting opinion for the three Democratic appointees, said the ruling upended a portion of the law that dates back to the Civil Rights Act of 1871 that gave private actors the ability to sue when they believed their civil rights were being violated.
Choosing a health care provider is one of those civil rights, she said.
“One of the conditions that the Medicaid Act imposes on participating States is the requirement that Medicaid recipients be able to choose their own healthcare providers without government interference,” the Biden appointee wrote.
The decision comes as Republicans on Capitol Hill battle for broader national limits on federal funding for abortion and Planned Parenthood in particular.
The GOP-led House earlier this year voted to defund Planned Parenthood.
That legislation is unlikely to get a stand-alone vote in the Senate, but Republicans have included language in the “big, beautiful bill” that would largely track what South Carolina did, limiting Medicaid funding for Planned Parenthood and other medical providers that focus on reproductive services and offer abortions as part of that.
Pro-choice advocates denounced Thursday’s ruling, saying it imposed an ideology on personal medical decisions.
“Today’s decision favors extremists who’d rather let someone die of cancer than let them get a cancer screening at Planned Parenthood. The Supreme Court overrode what the Medicaid law requires and every patient wants: the ability to choose their trusted health care provider,” said Nancy Northup, CEO of the Center for Reproductive Rights.
But pro-life groups cheered the decision, saying it will redirect money away from abortion providers.
“No one should be forced to subsidize the abortion industry with their tax dollars,” said Carol Tobias, president of National Right to Life.
Alan Wilson, South Carolina’s attorney general, said the “Supreme Court just slammed the door on Planned Parenthood’s latest attempt to force its radical agenda through the courts on our state.”
He added, “South Carolina, not federal judges or D.C. activist groups, gets to decide how we run our Medicaid program.”
South Carolina imposed its restriction in 2018. The governor said he didn’t want taxpayer money subsidizing abortions through Medicaid — a federal-state partnership program. Federal law, known as the Hyde Amendment, generally restricts federal funding for abortions except in cases of rape, incest or where the mother’s life is at stake.
South Carolina argued that allowing Medicaid money for other services to flow to Planned Parenthood indirectly boosted the organization’s abortion business.
Planned Parenthood South Atlantic, with offices in North Carolina, South Carolina, Virginia and West Virginia, along with a Medicaid client, challenged the state’s decision under the Medicaid Act. They said the law gives Medicaid recipients the ability to choose their providers.
A lower court sided with Planned Parenthood, which is the nation’s largest abortion provider.
Under the Medicaid Act, the provision at issue said plans must allow “any individual eligible for medical assistance” to obtain “assistance from any [provider] qualified to perform the service … who undertakes to provide,” according to court filings.
The Medicaid client argued she needed to go to Planned Parenthood for birth control since her diabetes made pregnancy dangerous, according to The Associated Press.
South Carolina, though, argued that the state secretary has discretion to decide who is a qualified provider, since that’s not defined in the Medicaid Act.
Other states tried to do the same, and lower courts delivered mixed results, leading to the case reaching the justices for a final resolution.
The case is Medina v. Planned Parenthood South Atlantic.
Chief Justice John G. Roberts Jr. announced that Friday would be the final opinion day of the term.
It’s expected the court will rule on four major disputes: the Trump administration’s request to limit lower court judges’ use of nationwide injunctions, parents wanting to opt out their children from LGBTQ story time, the legality of age verification measures for porn websites and a dispute over a second Black congressional district in Louisiana.
