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WASHINGTON, D.C. — In a seismic shift for reproductive rights and federal health care policy, the U.S. Supreme Court ruled 6–3 on Thursday to allow states to block Medicaid funds from going to Planned Parenthood and similar providers. The decision, rooted in a challenge to a South Carolina law, marks a major victory for conservatives and a potentially devastating blow to reproductive health access for low-income Americans.
🏛️ The Ruling: No Private Right to Sue Under Medicaid
At the core of the case, Medina v. Planned Parenthood South Atlantic, was a simple but powerful question: Can individual patients or providers sue a state for violating the Medicaid law’s “free choice of provider” provision?
The Court’s conservative majority said no.
Writing for the court, Justice Neil Gorsuch declared that Medicaid is a federal-state contract, not a source of private civil rights. That means neither patients nor providers can take a state to court over which organizations receive funding.
“It generally belongs to the federal government to supervise compliance with its own spending programs,” Gorsuch wrote.
⚖️ Dissent: “A Blow to Civil Rights Protections”
In a blistering dissent, Justice Ketanji Brown Jackson argued that the ruling undermines decades of civil rights precedent, dating back to the Civil Rights Act of 1871.
“One of the conditions that the Medicaid Act imposes on participating States is the requirement that Medicaid recipients be able to choose their own healthcare providers,” she wrote. “That is a right, not a suggestion.”
Pro-choice advocates echoed Jackson’s concerns, saying the ruling enables ideological bans disguised as budget decisions.
💉 What It Means for Planned Parenthood and Patients
Planned Parenthood, which receives Medicaid reimbursements for services like birth control, STI testing, cancer screenings, and prenatal care, is likely to see funding slashed in any state that now chooses to follow South Carolina’s lead.
Roughly 1 in 5 American women use Medicaid for health coverage. With Planned Parenthood often being the only provider of reproductive health services in rural or underserved areas, the decision could have far-reaching consequences.
Pro-life groups celebrated the ruling as a long-overdue return of power to the states.
“No one should be forced to subsidize the abortion industry with their tax dollars,” said Carol Tobias, president of National Right to Life.
But pro-choice advocates warned of dire health outcomes.
“Extremists would rather let someone die of cancer than let them get a screening at Planned Parenthood,” said Nancy Northup, president of the Center for Reproductive Rights.
🧠 The Bigger Picture: Medicaid, Abortion, and Ideology
The Court's ruling aligns with broader conservative efforts to reshape Medicaid not just as a health program, but as a moral and ideological battleground. South Carolina’s law, enacted in 2018, was one of several state efforts to restrict funds to providers offering abortion services, even when the funds themselves aren’t used for abortions.
Though federal law (Hyde Amendment) already bars federal funds from covering most abortions, states like South Carolina argue that any money going to providers like Planned Parenthood frees up other funds for abortion-related services.
🗺️ What’s Next?
With the legal green light from the Supreme Court, other Republican-led states are expected to move swiftly to implement similar bans. Already, GOP lawmakers in Congress are seeking to codify these restrictions nationally via appropriations bills.
Meanwhile, Planned Parenthood and allied organizations are recalibrating their legal strategy. Without the ability to sue under Medicaid law, they’ll need to rely on public pressure, state constitutional challenges, or federal executive enforcement—none of which are guaranteed paths forward.