Supreme Court rules on states blocking Medicaid funding to Planned Parenthood

The Supreme Court has ruled that South Carolina has the power to block Medicaid funding for Planned Parenthood clinics, in a technical interpretation over healthcare choices that has emerged as a larger political fight over abortion access.

The case,Medina v. Planned Parenthood South Atlantic, centers on whether low-income Medicaid patients can sue in order to choose their own qualified healthcare provider. 

The case involves South Carolina’s blocking of Medicaid funding for Planned Parenthood South Atlantic, which the organization argued violated federal law, prompting what is known as a Section 1983 lawsuit. Section 1983 is the first section of the Civil Rights Act of 1871. The federal-state program has shared responsibility for funding and administering it, through private healthcare providers.

The opinion, authored by Justice Neil Gorsuch, noted that the typical redress for such a violation would be for the Secretary of Health and Human Services to withhold Medicaid funding from the state, not for an individual to sue the state.

“Section 1983 permits private plaintiffs to sue for violations of federal spending-power statutes only in ‘atypical’ situations … where the provision in question ‘clear[ly]’ and ‘unambiguous[ly]’ confers an individual ‘right,’” Gorsuch wrote, ruling that the law in question in the present case “is not such a statute”

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“After all, the decision whether to let private plaintiffs enforce a new statutory right poses delicate questions of public policy,” he added. “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. 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.”

South Carolina Gov. Henry McMaster had been pushing to block public health dollars from going to Planned Parenthood, but a resident and patient at Planned Parenthood South Atlantic argued that doing so violated her rights under the Medicaid Act. 

The key provision in the 1965 Medicaid Act guarantees patients a “free choice of provider” that is willing and qualified. Much of the conflict dealt with whether Planned Parenthood was a “qualified provider” under the Medicaid law, and whether individual patients have an unambiguous “right” to sue to see their provider of choice, under its specific language.

The Supreme Court split 6-3 in the opinion, with the three liberal justices dissenting.

Writing for the dissent, Justice Ketanji Brown Jackson called the approach taken by South Carolina and the Court’s majority “a narrow and ahistorical reading” of Section 1983.

“That venerable provision permits any citizen to obtain redress in federal court for ‘the deprivation of any rights, privileges, or immunities secured by the Constitution and laws’ of the United States,” Jackson wrote. “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.”

Federal law already prohibits Medicaid money from going to pay for abortions, with very limited exceptions. South Carolina bans almost all abortions around six weeks after conception, or when cardiac activity is detected, with limited exceptions.

In South Carolina, Medicaid patients often seek out Planned Parenthood because it accepts publicly funded insurance. Blocking the provider from Medicaid networks could effectively defund it.

There are just two Planned Parenthood clinics in South Carolina, but every year they take hundreds of low-income patients for reproductive healthcare, including contraception, cancer screenings and pregnancy testing, according to the Associated Press.

Planned Parenthood South Atlantic has argued that the case is not about abortion, but about access to general healthcare. 

Alliance Defending Freedom lawyer John Bursch, representing South Carolina, arrives to speak outside the U.S. Supreme Court on April 2, 2025.  (Kayla Bartkowski/Getty Images)

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The case stretches back to 2018, before the Supreme Court overturned Roe v Wade, when McMaster signed an executive order directing the South Carolina Department of Health and Human Services (DHHS) to remove abortion clinics, including Planned Parenthood South Atlantic (PPSAT), from the state’s Medicaid provider list. The governor said Medicaid money for the state’s two Planned Parenthood clinics amounted to taxpayers subsidizing abortions. 

The action essentially barred low-income patients from receiving other services from PPSAT in Columbia and Charleston, including gynecological exams, birth control, cancer screenings, and testing and treatment for sexually transmitted infections (STIs). Lower courts had put that order on hold, leading to the current case.

A pro-choice demonstrator holds a sign in front of the U.S. Supreme Court as Medina v. Planned Parenthood South Atlantic is heard, Wednesday, April 2, 2025.  (Tom Williams/CQ-Roll Call, Inc via Getty Images)

The conservative group Alliance Defending Freedom has argued that a win for South Carolina would still mean Medicaid patients could go to one of 200 other publicly funded healthcare clinics in the state. 

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The Fourth Circuit Court of Appeals previously sided with Planned Parenthood, ruling that Medicaid patients can sue over their legal right to choose their own qualified provider.

The Associated Press contributed to this report. 

This is a breaking story. Check back here for updates.