Republican-led states have sought to deprive abortion providers of public funds by restricting access to Medicaid.
The United States Supreme Court has cleared the way for South Carolina to strip the nonprofit healthcare provider Planned Parenthood of funding under Medicaid, a government insurance programme.
Thursday’s ruling was split along ideological lines, with the three liberal justices on the nine-member court dissenting.
The ruling overturned a lower court’s decision barring Republican-governed South Carolina from preventing Planned Parenthood South Atlantic, a regional branch, from participating in the state’s Medicaid programme.
Republican leaders in South Carolina have objected to Planned Parenthood because it provides abortions.
The Supreme Court’s decision bolsters efforts by Republican-led states to deprive the reproductive healthcare provider of public money.
The case centred on whether recipients of Medicaid may sue to enforce a requirement under US law that they may obtain medical assistance from any qualified and willing provider. Medicaid is administered jointly by the federal and state governments, and it is designed to provide healthcare coverage for low-income people.
Since the Supreme Court in 2022 overturned its landmark Roe v Wade ruling that legalised abortion nationwide, a number of Republican-led states have implemented near-total bans on the procedure. Some, like South Carolina, prohibit abortions after six weeks of pregnancy.
Planned Parenthood South Atlantic operates clinics in the South Carolina cities of Charleston and Columbia, where it serves hundreds of Medicaid patients each year, providing physical examinations, screenings for cancer and diabetes, pregnancy testing, contraception and other services.
The Planned Parenthood affiliate and a Medicaid patient named Julie Edwards sued the state in 2018. A year earlier, in 2017, Republican Governor Henry McMaster had ordered officials to end Planned Parenthood’s participation in the state Medicaid programme by deeming any abortion provider unqualified to provide family planning services.
The plaintiffs sued South Carolina under an 1871 law that helps people challenge illegal acts by state officials. They said the Medicaid law protects what they called a “deeply personal right” to choose one’s doctor.
The South Carolina Department of Health and Human Services, represented by the Alliance Defending Freedom conservative legal group and backed by President Donald Trump’s administration, said the disputed Medicaid provision in this case does not meet the “high bar for recognising private rights”.
A federal judge previously ruled in Planned Parenthood’s favour, finding that Medicaid recipients may sue under the 1871 law and that the state’s move to defund the organisation violated Edwards’s right to freely choose a qualified medical provider.
In 2024, the 4th US Circuit Court of Appeals, based in Richmond, Virginia, also sided with the plaintiffs.
The Supreme Court heard arguments in the case on April 2.
The dispute has reached the Supreme Court three times. The court in 2020 rejected South Carolina’s appeal at an earlier stage of the case. In 2023, it ordered a lower court to reconsider South Carolina’s arguments in light of a ruling the justices issued involving the rights of nursing home residents.
That decision explained that laws like Medicaid must unambiguously give individuals the right to sue.
