The Supreme Court ruled Thursday that South Carolina can defund Planned Parenthood, clearing the way for other Republican-led states seeking to deprive the country’s largest abortion provider of taxpayer money.
In a 6–3 decision that split along ideological lines, the high court found the 1965 Medicaid Act does not allow individual patients to sue states over decisions to disqualify their preferred providers from receiving Medicaid money — enabling South Carolina to cut off funding for Planned Parenthood.
The ruling overturns lower court decisions that had allowed patients’ lawsuit to move forward. The Richmond, Va-based Fourth Circuit Court of Appeals favored Planned Parenthood by slapping an injunction on South Carolina’s implementation of its ban on funding for abortion.

“Like other States, South Carolina has an administrative process that lets providers challenge their exclusion from the State’s Medicaid program,” Justice Neil Gorsuch wrote for the majority.
“… private enforcement does not always benefit the public, not least because it requires States to divert money and attention away from social services and toward litigation. And balancing those costs and benefits poses a question of public policy that, under our system of government, only Congress may answer.”
In 2018, South Carolina Gov. Henry McMaster signed an executive order preventing all abortion clinics, including Planned Parenthood South Atlantic, from receiving Medicaid funding.
Medicaid is a federal and state government program that provides health insurance to over 70 million low-income Americans.
Attorneys for plaintiff Julie Edwards, a patient who is eligible for Medicaid, and Planned Parenthood argued that the ban violated federal law that states beneficiaries “may obtain” medical treatment from qualified providers.
Gorsuch noted that the 60-year-old statute did not define what “qualified” meant and that, typically, concerns about whether states are violating conditions for federal funding usually get addressed by lawsuits from the federal government.

“The decision whether to let private plaintiffs enforce a new statutory right poses delicate questions of public policy. New rights for some mean new duties for others,” his opinion stressed. “Though it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so.”
Liberal Justice Ketanji Brown Jackson penned the dissent and was joined by her two liberal peers, arguing that the Medicaid Act gave patients the right to sue if their preferred provider was deemed disqualified.
“The provision’s history confirms what the text makes evident: that Congress intended the provision to be binding,” Jackson wrote. “Congress made a deliberate choice to protect Medicaid recipients’ ability to choose their own providers by employing statutory language that it knew, based on its Medicare experience, would achieve that end.”
“Congress’s intent could not have been clearer.”
Direct federal funding of abortion is already against the law, but conservatives have long sought to cut off entitlement money that goes to health care providers who provide abortion, even though that money is technically used for services that are unrelated to terminating a pregnancy.
Conservative Justice Clarence Thomas inked a concurring opinion arguing that the high court should go further in limiting plaintiffs’ abilities to sue for constitutional violations under the Civil Rights Act of 1987.
South Carolina has a law on the books that bans abortion after six weeks, but Planned Parenthood still has clinics in Charleston and Columbia that legally terminate pregnancies.
Medina v. Planned Parenthood South Atlantic was the most high-profile abortion-related case before the Supreme Court this term.
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