Supreme Court Rules States Can Block Medicaid Patients From Accessing Planned Parenthood

The Supreme Court effectively ruled on Thursday morning that South Carolina can exclude Planned Parenthood from their Medicaid programs because the national health care organization also offers abortion care. The decision will deny hundreds of thousands of low-income patients their only health care option and paves a path for other states to do the same.

It’s the high court’s first ruling on abortion since the return of President Donald Trump, whose administration in February joined the case alongside South Carolina. The decision is a win for the Trump administration, which has made it a priority to actualize the GOP’s long-held goal of defunding Planned Parenthood.

The 6-3 ruling in Medina v. Planned Parenthood South Atlantic focused on the technical question of whether Medicaid-covered patients could sue in order to claim the right to use Planned Parenthood as a health care provider. Federal Medicaid rules allow patients to access care from any provider who is both qualified to provide the care and willing to provide the care, a provision known as “free choice of provider.”

Now, the court has ruled, South Carolina’s Medicaid recipients do not have the right to sue a state if it terminates their chosen provider from the Medicaid program for reasons unrelated to competence, opening the door for providers to be barred from the program for political reasons. 

The decision stems from a 2018 case in which a Medicaid beneficiary sued South Carolina Gov. Henry McMaster (R) after he issued an executive order to terminate Medicaid coverage for all abortion providers in the state. “Taxpayer dollars must not directly or indirectly subsidize abortion providers like Planned Parenthood,” McMaster said at the time. In doing so, he also cut off Medicaid-covered patients from using the numerous other non-abortion services provided by clinics like Planned Parenthood, which include sexually transmitted infection screenings and treatment, contraceptive care, and wellness exams.

Medicaid already generally cannot be used for abortion care. The Hyde Amendment bans the use of federal funds, including Medicaid, from covering abortion unless it’s in cases of rape, of incest or where the pregnant person’s life is in danger. The right-wing argument that federal dollars are going toward abortion care is inaccurate and used as a backdoor way to defund Planned Parenthood. 

There are two Planned Parenthood health centers in South Carolina, one in Columbia and one in Charleston, that provide basic health care services including contraception, STI treatment and cancer screenings. The clinics also provide abortion care, but the state currently has an abortion restriction in place, banning care after about six weeks of pregnancy. Over 60% of Medicaid recipients in South Carolina are women, and 20% of all women of reproductive age in the state are covered by Medicaid.  

In 14 of South Carolina’s 46 counties, there are zero practicing OB-GYN physicians, and five other rural counties have just one, Dr. Katherine Farris, a family physician and the chief medical officer of Planned Parenthood South Atlantic told reporters ahead of oral arguments in April. 

Medicaid is the largest payer of reproductive health care in the U.S., subsidizing 75% of all publicly funded family planning services ranging from Pap smears to high blood pressure treatment and screenings for anxiety and depression. As Farris told reporters earlier this year, Medicaid reimbursements for providers are extremely low, disincentivizing clinics from accepting Medicaid patients and making it really hard for patients to find a provider that accepts their insurance coverage. 

“Even [those clinics] listed as a Medicaid provider, they may not currently be accepting new Medicaid patients, or they may have a wait list, that is, days, weeks or even months long,” Farris said, noting that Planned Parenthood does not cap the number of Medicaid patients it accepts. 

The decision paves the way for more states to follow in South Carolina’s footsteps — and it’s likely they will. The strategy to defund Planned Parenthood through state Medicaid plans comes straight out of the far-right Project 2025 playbook, which calls on the Department of Health and Human Services to do exactly what South Carolina did but on the federal level. 

Republicans have been trying to defund Planned Parenthood for decades, and the Trump administration has made it clear that one of its top priorities is to slash federal funding for the group. The administration cut millions in Title X family planning grants to the national reproductive health organization.

Trump’s domestic policy agenda, or the so-called Big Beautiful Bill, includes funding cuts that single out Planned Parenthood. The reproductive health organization says the federal funding cuts, if successful, would serve as a backdoor nationwide abortion ban, shutting down 1 in 4 Planned Parenthood health centers that provide abortion care across the country. Around 90% of those closures would be in states where abortion is currently legal.