The Supreme Court’s 6-3 ruling empowers South Carolina and potentially all states to cut Medicaid funding to Planned Parenthood, delivering a major victory for pro-life advocates while stripping abortion providers of millions in taxpayer dollars.
Key Takeaways
- The Supreme Court ruled 6-3 that South Carolina can exclude Planned Parenthood from its Medicaid program, potentially allowing other states to follow suit.
- Justice Neil Gorsuch’s majority opinion stated that federal law does not permit Medicaid enrollees to sue states over provider choice violations.
- The ruling prevents Medicaid patients from enforcing their right to choose medical providers through lawsuits.
- Planned Parenthood claims the decision could lead to the closure of nearly 200 health centers across 24 states.
- South Carolina Governor Henry McMaster celebrated the ruling as a victory for “the sanctity of life” and state authority.
Supreme Court Delivers Major Victory for States’ Rights
In a landmark decision that reinforces states’ authority over healthcare funding, the Supreme Court has ruled in favor of South Carolina’s efforts to exclude Planned Parenthood from its Medicaid program. The 6-3 ruling, split along ideological lines, overturns lower court decisions that had previously blocked Governor Henry McMaster’s 2018 executive order cutting off Medicaid reimbursements to abortion providers. This decision represents a significant win for conservative states seeking greater control over how their taxpayer dollars are allocated in healthcare.
“Seven years ago, we took a stand to protect the sanctity of life and defend South Carolina’s authority and values – and today, we are finally victorious,” said Henry McMaster, Governor of South Carolina.
Writing for the majority, Justice Neil Gorsuch emphasized that while Medicaid’s “free choice of provider” provision does impose requirements on states, it does not create a right for individuals to sue states for violations. “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,” Gorsuch wrote, adding simply, “that is not the law we have.”
Implications for Planned Parenthood and Women’s Healthcare
The ruling delivers a significant financial blow to Planned Parenthood, which receives approximately one-third of its revenue from state and federal funding, including Medicaid. According to court documents, nearly half of Planned Parenthood’s patients nationwide receive care through Medicaid. The organization warns that this decision could lead to the closure of nearly 200 health centers across 24 states, potentially leaving many low-income women without access to services such as cancer screenings, STI testing, and other preventative care.
“Today’s decision is a grave injustice that strikes at the very bedrock of American freedom and promises to send South Carolina deeper into a health care crisis,” said Paige Johnson, CEO of Planned Parenthood South Atlantic.
The ruling is particularly significant in South Carolina, a state with a documented shortage of primary care providers, where Planned Parenthood facilities have been providing essential healthcare services to underserved communities. Critics argue that while Medicaid funds do not cover abortion services directly, the decision effectively limits access to comprehensive healthcare for low-income women who rely on Planned Parenthood for a range of medical services.
Dissenting Opinion and Future Implications
Justice Ketanji Brown Jackson issued a strong dissent, joined by Justices Elena Kagan and Sonia Sotomayor, arguing that the majority’s decision undermines civil rights protections and could result in “tangible harm to real people.” Jackson wrote that “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.”
“Taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs,” said Gov. Henry McMaster, emphasizing his longstanding position on the issue.
The ruling sets a precedent that could extend beyond the abortion debate. Legal experts note that states might now exclude providers from Medicaid for reasons entirely unrelated to abortion, potentially reshaping how states administer their Medicaid programs across the healthcare spectrum. Meanwhile, congressional Republicans have already included provisions in a House spending bill to bar Medicaid from funding Planned Parenthood nationwide, though its future in the Senate remains uncertain.
A Victory for State Authority
This decision follows South Carolina’s implementation of a six-week abortion ban and comes in the wake of the Supreme Court’s historic overturning of Roe v. Wade in 2022. For conservative states, the ruling represents a significant affirmation of their authority to direct public funds according to their citizens’ values. The decision aligns with the Trump administration’s previous support for South Carolina’s position, contrasting sharply with the Biden administration’s stance that individuals should retain the right to sue states over Medicaid provider choices.
“Though it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so,” Justice Neil Gorsuch wrote in the majority opinion, emphasizing the court’s view that Congress did not clearly establish an individual right to sue under the relevant Medicaid provisions.
With Medicaid serving approximately 80 million beneficiaries nationwide, primarily low-income Americans, this ruling stands to reshape the landscape of healthcare funding and access across the country, particularly in conservative states that may now move to exclude Planned Parenthood and potentially other providers from their Medicaid programs.
