Supreme Court clears way for states to kick Planned Parenthood out of Medicaid
Patients do not have legal standing to sue if a state denies their right to see their preferred medical provider, the court said in a 6-3 ruling.
By Alice Miranda Ollstein, Josh Gerstein and Lauren Gardner
Updated:
The Supreme Court on Thursday cleared the way for states to exclude Planned Parenthood from their Medicaid programs.
In a 6-3 decision divided along ideological lines, the court’s majority concluded that federal law doesn’t allow health care providers or patients to sue if a state violates a provision of federal law guaranteeing that Medicaid patients can visit their preferred provider.
The decision rejected a challenge to South Carolina’s 2018 expulsion of Planned Parenthood from its Medicaid program. It will likely allow other conservative states to similarly expel reproductive and sexual health clinics — shrinking the already narrow network of providers available in the health insurance program for low-income Americans.
“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,” South Carolina Gov. Henry McMaster, a Republican, said in a statement.
“Defunding” Planned Parenthood is a goal of many conservatives, who object to its abortion services. Federal law has long banned federal money from being used for abortions. But Planned Parenthood clinics provide many other health care services that are typically eligible for payment under Medicaid.
Thursday’s ruling will make it easier for states to deprive Planned Parenthood — and other clinics that provide abortions — from receiving Medicaid payments for any of their non-abortion-related 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,” Paige Johnson, president and CEO of Planned Parenthood South Atlantic, said in a statement.
The group said the decision doesn’t immediately affect Medicaid beneficiaries in the state that use its services, though they couldn’t predict when changes would kick in. The federal program has covered care for 3.5 percent of PPSA’s South Carolina patients so far this year, spokesperson Molly Rivera said, a figure much lower than the national average because the state declined to expand Medicaid under the Affordable Care Act.
The Supreme Court’s conservative majority ruled that while the Medicaid statute guarantees beneficiaries the ability to see any qualified provider that is willing to participate in Medicaid, federal law doesn’t grant a legal right to sue if a state denies access to certain providers.
Writing for the majority, Justice Neil Gorsuch said the provision guaranteeing access to qualified and willing providers “looks nothing like” language in other statutes that the court has found in the past to authorize lawsuits by benefit recipients.
“Doubtless, this language speaks to what a State must do to participate in Medicaid, and a State that fails to fulfill its duty might lose federal funding. Doubtless, too, this provision seeks to benefit both providers and patients,” Gorsuch wrote. But he said the provision lacked “unambiguous ‘rights-creating language’” that would allow patients to sue in federal court.
Gorsuch suggested the federal government could penalize a state for violating the guarantee that Medicaid patients can visit any qualified and willing provider. The Trump administration seems unlikely to do that, but a future administration might.
Gorsuch, a Trump appointee, also said Planned Parenthood could attempt to challenge the ban directly under state law, rather than trying to sue under a federal civil rights statute, as it did in this case. That statute, passed in 1871, allows people to sue state officials who violate the “rights, privileges or immunities” guaranteed by law or the Constitution.
All three of the court’s liberal justices dissented. Justice Ketanji Brown Jackson, joined by Justices Sonia Sotomayor and Elena Kagan, painted the majority’s decision as part of a century-and-a-half-long “project of stymying one of the country’s great civil rights laws.”
Jackson, a Biden appointee, accused her conservative colleagues of adopting “a narrow and ahistorical reading” of the civil rights law and of resisting “the natural and obvious … reading” of the Medicaid statute.
“Today’s decision is likely to result in tangible harm to real people,” Jackson warned, dismissing Gorsuch’s suggestions that bans on Planned Parenthood or other providers could be challenged by other means. “It will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them.”
During oral arguments in the case in April, Kagan and Planned Parenthood’s attorney warned that a ruling like the one the court delivered Thursday could empower states to boot providers from Medicaid for a wide range of reasons unrelated to abortion, such as providers’ support for LGBTQ+ patients or because they offer contraception.
While the Biden administration had defended individuals’ right to sue as the case moved through lower courts, the Trump administration switched sides and argued in support of South Carolina.
Abortion — South Carolina’s stated reason for labeling Planned Parenthood unqualified to participate in Medicaid — was barely mentioned during oral arguments, but the issue loomed over the case as anti-abortion groups and their allies in government pursue other lawsuits, executive actions and legislation to strip taxpayer support from Planned Parenthood.
The massive spending bill House Republicans passed last month, dubbed the “One Big Beautiful Bill” by President Donald Trump, would bar Medicaid from funding Planned Parenthood nationwide — even in states where the organization can’t provide abortion because it is illegal. It is not clear whether that provision will survive the Senate.