States can block Medicaid money for health care at Planned Parenthood,
the Supreme Court says
[June 27, 2025]
By LINDSAY WHITEHURST
WASHINGTON (AP) — States can block the country’s biggest abortion
provider, Planned Parenthood, from receiving Medicaid money for health
services such as contraception and cancer screenings, the Supreme Court
ruled on Thursday.
The 6-3 opinion by Justice Neil Gorsuch and joined by the rest of the
court’s conservatives was not directly about abortion, but it comes as
Republicans back a wider push across the country to defund the
organization. It closes off Planned Parenthood's primary court path to
keeping Medicaid funding in place: patient lawsuits.
The justices found that while Medicaid law allows people choose their
own provider, that does not make it a right enforceable in court. The
court split along ideological lines, with the three liberals dissenting
in the case from South Carolina.
Public health care money generally cannot be used to pay for abortions,
but Medicaid patients go to Planned Parenthood for other needs in part
because it can be difficult to find a doctor who takes the publicly
funded insurance, the organization has said.
South Carolina Gov. Henry McMaster, a Republican, said Planned
Parenthood should not get any taxpayer money. The budget bill backed by
President Donald Trump in Congress would also cut Medicaid money for the
group. That could force the closure of about 200 centers, most of them
in states where abortion is legal, Planned Parenthood has said.
McMaster first moved to cut off the Medicaid funding in 2018, but he was
blocked in court after a lawsuit from a patient, Julie Edwards, who
wanted to keep going to Planned Parenthood for birth control because her
diabetes makes pregnancy potentially dangerous. Edwards sued under a
provision in Medicaid law that allows patients to choose their own
qualified provider.
South Carolina argued that patients should not be able file such
lawsuits. The state pointed to lower courts that have been swayed by
similar arguments and allowed states such as Texas to act against
Planned Parenthood.
The high court majority agreed.
“Deciding whether to permit private enforcement poses delicate policy
questions involving competing costs and benefits — decisions for elected
representatives, not judges,” Gorsuch wrote. He pointed out that
patients can appeal through other administrative processes if coverage
is denied.
McMaster, in a statement, said his state had taken “a stand to protect
the sanctity of life and defend South Carolina’s authority and values —
and today, we are finally victorious.”
White House spokesman Harrison Fields called the opinion “a major
victory for common sense” and said it underscores the Republican
president's position that states should determine abortion policy.
In a dissent joined by her liberal colleagues, Justice Ketanji Brown
Jackson said the ruling is “likely to result in tangible harm to real
people.”
“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,'" she wrote.
Planned Parenthood officials said the decision will hinder access to
care like preventive screenings for 1 million Medicaid recipients in
South Carolina. The state didn’t accuse Planned Parenthood of providing
inadequate care, she said, calling the decision to cut it off a
political one.
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Supreme Court is seen on Capitol Hill in Washington, April 25, 2024.
(AP Photo/J. Scott Applewhite, File)
 “Instead of patients now deciding
where to get care, that now lies with the state,” said Katherine
Farris, chief medical officer of Planned Parenthood South Atlantic.
“If they fall on hard financial times, as many are right now, they
are fundamentally less free."
Other conservative states are expected to follow South Carolina's
lead with funding cuts, potentially creating a “backdoor abortion
ban,” said Alexis McGill Johnson, president and CEO of Planned
Parenthood Federation of America. Eighteen states weighed into the
case in support of South Carolina.
Medicaid patients make up 3.5% of the organization’s South Carolina
patients who go for services unrelated to abortion or
gender-affirming care, officials said. Because South Carolina has
not expanded its Medicaid program, reimbursements do not cover its
preventive care costs, spokesperson Molly Rivera said.
Planned Parenthood will continue to provide care for women who need
it in South Carolina, but won’t bill the government, said Vicki
Ringer, a spokesperson for the South Carolina branch.
“This does not close us down despite the governor’s best efforts,”
Ringer said.
Up to one-quarter of people in the U.S. use Medicaid, and lawsuits
have been the only real way they've been able to make sure they can
choose their doctor, according to court papers filed by the American
Cancer Society and other public health groups. Removing the ability
to sue could reduce access to health care, especially in rural
areas, the advocates said.
Patient lawsuits are an important accountability tool because
regulators “can’t possibly monitor all federal requirements in all
states at all times," said Julian Polaris, a lawyer who regularly
advises state programs and health care providers. The ruling raises
questions about whether patients can still sue to secure medically
necessary services and eligibility determinations, he said.
In South Carolina, $90,000 in Medicaid funding goes to Planned
Parenthood every year, a tiny fraction of the state’s total Medicaid
spending. The state banned abortion at about six weeks’ gestation
after the Supreme Court overturned it as a nationwide right in 2022.
The conservative Christian legal-advocacy group Alliance Defending
Freedom, which represented South Carolina officials, said the ruling
would allow the state to direct Medicaid dollars to “comprehensive
health care" for low-income patients.
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Associated Press writers Jeffrey Collins in Columbia, South
Carolina, and Meg Kinnard contributed to this report.
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