In a win for advocates of limited government and state autonomy, the Supreme Court ruled Thursday that South Carolina can legally block Medicaid funding to Planned Parenthood clinics.
According to Fox News, the decision came in a 6-3 ruling that addressed whether Medicaid patients could sue to access specific healthcare providers using a provision from the Civil Rights Act of 1871.
The case, Medina v. Planned Parenthood South Atlantic, began after South Carolina Governor Henry McMaster directed the state's Department of Health to exclude abortion clinics, including Planned Parenthood, from the Medicaid network. This executive action aimed to prevent taxpayer funds from indirectly supporting abortion providers.
Justice Neil Gorsuch, writing for the majority, emphasized that enforcement of Medicaid-related statutes should come through federal administrative channels, not lawsuits from individual patients. He noted that the law in question does not clearly give individuals a right to sue the state.
Gorsuch warned against the judiciary creating new rights outside the legislative process, saying that such decisions belong to elected representatives. "New rights for some mean new duties for others," he wrote, reminding the public that courts exist to apply law, not reshape it.
The opinion underscored a fundamental constitutional point: even if a statute is passed using federal spending power, it does not automatically authorize private lawsuits unless it explicitly states so. This was not the case here.
In a dissent joined by Justices Sotomayor and Kagan, Justice Ketanji Brown Jackson argued the ruling restricts patients' ability to seek redress when they feel their healthcare rights are violated under Medicaid. She called the majority's reading of the Civil Rights Act "narrow and ahistorical."
Jackson accused South Carolina of trying to sidestep accountability for defunding Medicaid access to clinics chosen by low-income patients. However, the majority viewed the issue as strictly statutory and not about patients’ preferences or healthcare outcomes.
While Planned Parenthood framed the lawsuit around general healthcare access, the underlying tension—state support for organizations linked to abortion—was impossible to ignore in the courtroom and public square alike.
The case dates back to 2018, before Roe v. Wade was overturned, when Gov. McMaster issued an executive order to remove abortion providers from the Medicaid program. He argued that even if federal dollars couldn’t be used directly for abortion, allowing funds to flow to such clinics effectively subsidized abortion-related infrastructure.
South Carolina law bans nearly all abortions around six weeks of pregnancy, reflecting the pro-life sentiment among many residents. The move to cut off Medicaid funding for Planned Parenthood aligned with these broader legislative goals.
Two clinics in the state—located in Columbia and Charleston—were impacted. Though they offer a range of reproductive services, including contraception and cancer screenings, their ties to abortion services made them a target of budgetary scrutiny.
Planned Parenthood South Atlantic argued the case wasn’t about abortion but about access to vital healthcare for low-income women. However, South Carolina maintained that patients still had options, citing over 200 other publicly funded clinics across the state.
Alliance Defending Freedom, the legal group supporting the state, emphasized that the ruling wouldn’t strip patients of care—it merely affirmed the state’s right to determine which providers qualify for taxpayer support.
The Fourth Circuit Court of Appeals had previously sided with Planned Parenthood, allowing lawsuits by Medicaid patients to proceed, but that view has now been decisively reversed by the nation’s highest court.
