The Supreme Court appeared to have been split on Wednesday on whether the state could block Medicaid funds for planned parent-child clinics.
In almost two hours of verbal discussion, the court’s conservative majority provided measured support for South Carolina’s position.
The specific question is whether low-income Medicaid patients can sue to select their qualified healthcare provider. The Federal State Program shares funding and management responsibilities through private healthcare providers.
While federal law prohibits taxpayer funding from funding almost all abortions, Planned Parenthood also offers a range of other health services, including gynecological care and cancer screening, with or without Medicaid subsidies.
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Medinav, Washington, DC. When verbal debate is heard at Planned Parenthood (Kayla Bartkowski/Getty Images), activists protest outside the Supreme Court building.
Blocking a provider from the Medicaid network could effectively refund it. Given the fundamental divisive issues of abortion, groups on both sides gathered outside the High Court prior to discussion.
The 2018 South Carolina governor signed an executive order blocking Medicaid funding at two of the state’s planned parent-child clinics, saying it amounted to taxpayers subsidizing abortions.
The court has pending the order, leading to the current lawsuit.
South Carolina currently bans abortions when cardiac activity is detected, about six weeks of pregnancy, or with limited exceptions.
An important provision in the Medicaid Act of 1965 ensures patients are willing to qualify for “free choice of providers.”
Many court sessions deal with whether Planned Parenthood is a “qualified provider” under Medicaid law, and whether individual patients have a clear “right” to sue to see the providers they have chosen under a particular language.
“It seems a little odd to think that the issue that motivated Congress to pass this provision is that the state is limiting the choices people had,” Judge Sonia Sotomayor said. “It seems difficult to understand that states didn’t understand that individuals had to give the right to choose a provider.”
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When the court hears oral debate on planned custody in Medina and Washington, DC, pro-life demonstrators gather in front of the Supreme Court building (Kayla Bartkowski/Getty Images)
“The state has an obligation to ensure that a person has the right to choose a doctor,” added Judge Elena Kagan. “It’s impossible to say things without using the word “right.” ”
However, some conservative justice have questioned how to interpret regulations that do not include the word “right.”
“For patients, we can imagine laws written as individual interests that are not essential to the state but not correct,” Judge Neil Golsch said. “I mean, that’s an imaginable scenario.”
Judge Samuel Alito added that giving an individual the right to sue under the expenditure clause of the constitution is “very extraordinary.”
The votes of Judges John Roberts and Judge Amy Coney Barrett could be key. They asked both sides harsh questions.
Barrett offered a hypothesis of the rights of patients to go to court through a doctor accused of medical malpractice. “Does that make sense in that situation that Congress wants the plaintiffs to sue?” she asked.
Planned Parenthood says its future is at stake, with around $700 million (about a third of national revenue) attributing Medicaid rebates and government grants and contracts.
However, the group notes that just $90,000 in Medicaid funding is given to planned parent-child facilities in South Carolina each year, and is relatively low with the state’s total Medicaid spending.
South Carolina resident Julie Edwards sued along with the planned parent-child South Atlantic, which operates two clinics in Columbia and Charleston. She has medical complications associated with type 1 diabetes and wanted to choose Columbia Clinic for a variety of services, including reproductive care.
The federal court of appeals ruled against the state in 2024, concluded that the “free choice of provider” provision “designates the qualifications granted to each Medicaid beneficiary.”
In the 2023 Supreme Court opinion, which involves caring for nursing home residents, the judiciary concluded that another law with Medicaid gives individuals the right to appeal.
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Several states, including Texas, Missouri and Arkansas, have already done what South Carolina wants to do by cutting Medicaid funds to planned parent-child relationships, and could continue further if South Carolina wins.
“The people in this state don’t want their taxes to go to that organization,” Republican South Carolina Gov. Henry McMaster attended the oral discussion. “I believe this court’s decision is that the people of South Carolina have the right to make this decision for our state. Other states may make another decision, but it is not ours. South Carolina represents the right to life.
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The Trump Justice Department is helping South Carolina in its decision to fund planned custody. (Valerie Plesch/Picture Alliance by Getty Images)
The Trump Justice Department supports the state, and abortion rights groups say the issue is about patient choice.
“Our health centers play an irreplaceable role in the state’s health care system and provide birth control and cancer screening to those who cannot afford these services anywhere else,” said Paige Johnson, president and CEO of Planned Parenthood South Atlantic. “Government officials should not block people from accessing medical care or decide which doctors they can or cannot see.”
One concern raised by healthcare advocates is finding gynecological and family planning services in states where facilities are limited. Low-income women often find it difficult to travel long distances to get such quality care, a requirement for Medicaid providers.
Judge Brett Kavanaugh said his mission would be to bring his mission when he called the 45-year “Odyssey” when patients can go to court.
Much of the public’s argument dealt with whether the “right” to appeal is a magical word that automatically determines the problem.
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“I’m not allergic to magical words because, if they represent principles, they provide clarity to avoid lawsuits that are a major waste of resources for states, courts, healthcare providers and beneficiaries,” Kavanaugh said.
The case is Medina (SC DOH) v. Plannad Parent-Child Relationship South Atlantic Ocean (23-1275). The ruling is likely to be early summer.
Shannon Bream is currently serving as an anchor for Fox News Sunday. She joined the network in 2007 as a Washington, D.C.-based correspondent covering the Supreme Court.
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