SCOTUS Allows States To Defund Planned Parenthood

This article is part of TPM Cafe, the House of TPM for the opinion and the analysis of the news. It was initially published during the conversation.

Having the freedom to choose your own health care provider is something that many Americans hold for granted. But the conservative supermajure of the United States Supreme Court ruled on June 25, 2025, in a 6-3 decision that people who count on Medicaid for their health insurance do not have this right.

The case, Medina v. Planned Parenthood South Atlantic, focuses on a technical legal issue: if people covered by Medicaid have the right to pursue state officials to have prevented them from choosing their health care provider. In his majority opinion, judge Neil Gorsuch wrote that they did not do so because the status of Medicaid did not “clearly and without ambiguity” the individuals.

As law teachers who teach courses on health and poverty law as well as on reproductive justice, we believe that this decision could restrict access to health care for more than 78 million Americans who obtain their health insurance coverage thanks to the Medicaid program.

Excluding Planned Parenthood

The case began with a difficult situation for the resident of South Carolina, Julie Edwards, who is registered in Medicaid. After Edwards had trouble obtaining contraceptive services, she was able to receive care from a Planned Parenthood South Atlantic clinic in Columbia, South Carolina.

Planned Parenthood, a range of non -profit organizations with roots that go back more than a century, is one of the country’s main reproductive service providers. It operates two clinics in South Carolina, where patients can take physical exams, cancer screening, contraception and other services. It also offers meetings the same day and keeps long hours.

In July 2018, however, the Governor of South Carolina Henry McMaster published an executive decree which prohibited Medicaid with the reimbursement of health care providers in the state which offers abortion care.

This meant that Planned Parenthood, a long -standing target of the anger of the Conservatives, would no longer be reimbursed for any type of care for Medicaid patients, preventing Edwards from transferring all her gynecological care to this office as she had hoped.

Planned Parenthood and Edwards continued South Carolina. They argued that the state violated the Federal Medicare and Medicaid law, which the Congress adopted in 1965, by not letting Edwards obtain care from the supplier of his choice.

A requirement for “free law”

Medicaid, which mainly covers low -income people, their children and disabled people, operates as a partnership between the federal government and the States. The congress adopted the law which led to its creation according to its power under the expense clause of the Constitution, which allows the congress to submit federal funds to certain requirements.

Two years later, due to the concerns that states restrict providers that the beneficiaries of Medicaid could choose, the congress added a requirement of “free-law” to the program. He stipulates that people registered in Medicaid “can obtain this assistance from any institution, agency, community pharmacy or person, qualified to perform the service or services required.”

Although the status of Medicaid does not allow themselves in itself, the people registered with this program to enforce this free choice clause, the question at the heart of this case was whether another federal law, known as the 1983 section, gave them the right to continue.

The Supreme Court has long recognized that article 1983 protects an individual’s ability to continue when his rights under a federal law have been violated. In fact, in 2023, he found such a right under the Medicaid Nursing Reform Act. The court judged that article 1983 confers the right to continue when the provisions of a law “unambiguously spending individual federal rights”.

In Medina, however, the court concluded that there was no right to continue. Instead, the court stressed that “the typical remedy” is that the federal government cuts the Medicaid funds to a state if a state does not comply with the status of Medicaid.

The decision canceled the decisions of the lower field in favor of Edwards. He also expressly rejected the previous decisions of the Supreme Court, which the majority criticized as admiring a “larger vision of his power to involve private action causes to apply federal laws”.

Restrict Medicaid funds

This dispute is only a chapter of the long struggle concerning access to abortion in the United States in addition to the question of whether it should be legal, supporters and opponents of abortion rights have fought to know if the government should pay for this – even if this funding occurs indirectly.

Thanks to a federal law known as Hyde amendment, Medicaid cannot reimburse health care providers for the cost of abortions, with a few exceptions: when a patient’s life is in danger, or that his pregnancy is due to rape or incest. Some states cover abortion when their laws allow, without using federal funds.

As a result, Planned Parenthood rarely gets Federal Medicaid funds for abortions.

McMaster explained that he had removed the “abortion clinics”, notably Planned Parenthood, from the South Medicaid Carolina program because he did not want public funds to indirectly subsidize.

After the Supreme Court ruled on this case, McMaster said that he had taken a position to “protect the sacred nature of life and defend the authority and values ​​of South Carolina – and today, we are finally victorious”.

But only about 4% of Planned Parenthood services at the national level were linked to abortion, from 2022. Its most common service is to test sexually transmitted diseases. Throughout the country, Planned Parenthood provides health care to more than 2 million patients per year, most of whom have low incomes.

Consequences beyond the South Carolina

The consequences of this decision are not limited to access to Medicaid in South Carolina.

It can make it more difficult for individuals to use the 1983 article to make complaints under any federal law. While judge Ketanji Brown Jackson, joined by judges Sonia Sotomayor and Elena Kagan, wrote in his dissent, the court “continues the project to suffocate one of the major laws on the country’s civil rights”.

Friends in 1871, the Civil Rights Act was invoked to challenge violations of rights by state officials against individuals. Jackson wrote that the Tribunal now limits the possibility of using article 1983 to justify personal rights if the statutes use correct “magic words”.

Dissent has also criticized the majority decision as probably “to affect tangible damages for real people”. Not only will this potentially deprive “the beneficiaries of Medicaid in South Carolina in their only significant way of applying a right that Congress expressly granted them”, wrote Jackson, but this could also “strip these South Carolinians – and countless other beneficiaries of Medicaid through the country – of deep and personal freedom: the” ability to decide that deals with us.

The decision could also have great -reaching consequences. Arkansas, Missouri and Texas have already prohibited Planned Parenthood from being reimbursed by Medicaid for any type of health care. More states could follow the plunge.

In addition, given the role of Planned Parenthood in the provision of contraceptive care, the disqualification of Medicaid could restrict access to health care and increase the rate of pregnancy already involuntary in America.

States could also try to exclude providers according to other characteristics, such as their employees belong to unions or if they provide their patients with stupid care, more restricting patient choices.

With this decision, the court authorizes a patchwork of Planned Parenthood’s state exclusions and other medical suppliers of the Medicaid program which could soon look like the patchwork already seen with access to abortion.

Parties of this article appeared for the first time in another article published on April 2, 2025. This article is republished from the conversation under a Creative Commons license. Read the original article.