The Supreme Court’s conservative supermajority has opened the door for Republican-controlled states to “defund” Planned Parenthood, ruling in Medina v. Planned Parenthood South Atlantic that South Carolina can kick the nation’s largest family provider out of its Medicaid programs.
In a 6-3 decision on Thursday, the Court ruled that Planned Parenthood and patients do not have the right to sue South Carolina to enforce a provision in the Medicaid Act that ensures people can obtain health care from a provider of their choosing. “Congress knows how to give a grantee clear and unambiguous notice that, if it accepts federal funds, it may face private suits asserting an individual right to choose a medical provider,” Justice Neil Gorsuch wrote in the majority opinion. However, he added, “that is not the law we have.”
The three liberals in the Court dissented. In a scathing opinion, Justice Ketanji Brown Jackson said, “The project of stymying one of the country’s great civil rights laws continues.” She added, “South Carolina asks us to hollow out that provision so that the State can evade liability for violating the rights of its Medicaid recipients to choose their own doctors. The Court abides South Carolina’s request. I would not.”
The case centered on a 2018 executive order in which Republican governor Henry McMaster directed South Carolina’s department of health and human services “to terminate abortion clinics as Medicaid providers.” U.S. law already bans the use of federal funding to pay for abortion care except in cases of rape or incest or in order to save the life of the pregnant person. But McMaster argued that any Medicaid funds going to these providers “results in the subsidy” of abortions — even if the money doesn’t go directly toward reimbursing this care.
Planned Parenthood of South Atlantic, the local affiliate, sued in response to McMaster’s order. About one in five South Carolinians rely on Medicaid, including about 400,000 women between the ages of 15 and 44. The affiliate has said it receives about $100,000 in Medicaid reimbursements, which goes toward only non-abortion reproductive-health services, including birth control, prenatal and postpartum care, testing and treatment for sexually transmitted infections, and cancer screenings. South Carolina also currently bans abortion care after fetal cardiac activity is detected, which happens at around six weeks of gestation. “Medicaid does not pay for any abortions at Planned Parenthood South Atlantic,” Vicki Ringer, the affiliate’s director of public affairs, previously told The Cut. “The restrictions on that are very narrow.”
The consequences of Medina are certain to be felt nationwide. Arkansas and Texas already ban Planned Parenthood from receiving Medicaid funding, and it’s likely that other Republican-controlled states will follow suit in an effort to kneecap the organization. Such policies could also affect other independent reproductive-health clinics that offer abortion care, making it harder for patients, particularly those who live in health-care deserts. After all, the people who will bear the brunt of these policies are low-income patients who rely on Medicaid. If states can kick Planned Parenthood affiliates and other clinics out of their programs, it would force providers to either turn poor patients away or charge them out of pocket.
“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,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement. “The decision will put fuel on the fire of the multi-year campaign to deny Medicaid patients their right to see Planned Parenthood providers for contraceptives, STI testing, and other non-abortion services. Right now, Congress is seeking to replicate South Carolina’s ban nationwide, putting politics above patients in making health care decisions.”