The rules of the Supreme Court according to which states can refuse people covered by Medicaid the freedom to choose Planned Parenthood as a health care provider

Having the freedom to choose your own health care provider is something that many Americans hold for granted. But the conservative supermajure conservative of the United States Supreme Court ruled on June 25, 2025, in a 6-3 decision that People who count on Medicaid For their health insurance, I have no right.

The case, Medina v. Planned Parenthood South Atlanticis focused on a technical legal issue: if people covered by Medicaid have the right to pursue state officials to have prevented them from choosing their health care provider. In his majority opinion, judge Neil Gorsuch wrote that they did not do so because the status of Medicaid did not “clearly and without ambiguity” the individuals.

As law teachers who Teach health courses And Poverty law as well as reproductive justiceWe believe that this decision could restrict access to health care for the most than 78 million Americans who get their health insurance coverage as part of the Medicaid program.

Excluding Planned Parenthood

The case began with a difficult situation for the resident of South Carolina, Julie Edwards, who is registered in Medicaid. After Edwards was struggling to obtain contraceptive servicesShe was able to receive care from a southern Atlantic clinic of Planned Parenthood in Columbia, South Carolina.

Planned Parenthood, a Range of non -profit organizations With roots that date Back more than a centuryThis is one of the main reproductive service providers in the country. It operates two clinics in South Carolina, where patients can get physical exams, cancer screening, contraception and other services. He too Provides appointments on the day and keep long hours.

In July 2018, however, South Carolina Governor Henry McMaster issued an executive decree which prohibited Medicaid the reimbursement of health care providers in the state which offers abortion care.

This meant Planned Parenthood, a longtime target of the anger of the conservativeswould no longer be reimbursed for any type of care for Medicaid patients, preventing Edwards from transferring all his gynecological care This office as she had hoped to do.

Planned Parenthood and Edwards continued South Carolina. They argued that the state violated the federal Medicare and Medicaid actthat the congress adopted in 1965, by not leaving Edwards to obtain care from the supplier of his choice.

A requirement for “free law”

Medicaid, which mainly covers low -income people, their children and disabled people, operates as a partnership between the federal government and the States. The Congress adopted the law which led to its creation according to its power under the expense clause of the Constitution, which allows the congress of Subject of federal funds to certain requirements.

Two years later, due to the concerns that states restricted suppliers that the beneficiaries of Medicaid could choose, the Congress added a “free-to-go“Requirement on the program. He stipulates that people registered in Medicaid “can obtain this assistance from any institution, agency, community pharmacy or person, qualified to perform the service or services required. »»

Although the status of Medicaid does not authorize the people registered with this program for himself to enforce this free choice clause, the question at the heart of this case was whether another federal law, Known as section 1983gave them the right to continue.

The Supreme Court has long recognized that article 1983 protects an individual’s ability to continue when his rights under a federal law have been violated. Actually, in 2023,, He found such a right under the law on the reform of nursing houses in Medicaid. The court judged that article 1983 gives the right to continue during the provisions of a law “confer without ambiguity of individual federal rights. “”

In Medina, however, the court concluded that there was no right to continue. Instead, the court stressed that “the typical remedy” is that the federal government cuts the Medicaid funds to a state if a state does not comply with the status of Medicaid.

The decision Decisions of the lower land canceled in favor of Edwards. He also expressly rejected the previous decisions of the Supreme Court, which the majority criticized as admiring a “more extensive vision of his power to involve private action causes to enforce federal laws”.

Restrict Medicaid funds

This dispute is only a chapter of the long fight against access to abortion in the United States in addition to the question of whether it should be legal, supporters and opponents of abortion rights have fought to find out if the government should pay for this – Even if this funding occurs indirectly.

Thanks to a federal law known as Hyde amendmentMedicaid cannot reimburse health care providers for the cost of abortions, with a few exceptions: when a patient’s life is at risk, or his pregnancy is due to rape or incest. Some states cover abortion when their laws allow itwithout using federal funds.

Consequently, Planned Parenthood Obtains federal funds from Medicaid for abortions.

McMaster explained that he had removed the “abortion clinics”, notably Planned Parenthood, of the South Carolina Medicaid program Because he didn’t want public funds indirectly subsidize the abortions.

After the Supreme Court ruled on this case, McMaster said he had taken “A position to protect the sacred character of life and defend the authority and values ​​of South Carolina – and today, we are finally victorious.”

But only about 4% of Planned parents National services were linked to abortionfrom 2022. Its most common service is Sexually transmitted disease test. Across the country, Planned Parenthood provides health care to more than 2 million patients per yearmost of which have low incomes.

Consequences beyond the South Carolina

The consequences of this decision are not limited to access to Medicaid in South Carolina.

It can make it more difficult for individuals to use the 1983 article to make complaints under any federal law. While judge Ketanji Brown Jackson, joined by judges Sonia Sotomayor and Elena Kagan, wrote in his dissent, the court “continues the project to suffocate one of the major laws on the country’s civil rights”.

Promulgated in 1871the civil rights law has been invoked to challenge violations of the rights of state officials against individuals. Jackson wrote that the Tribunal now limits the possibility of using article 1983 to justify personal rights if the statutes use correct “magic words”.

Dissent also criticized the majority decision as probably “To cause tangible damage to real people. “Not only will this potentially deprive” the beneficiaries of Medicaid in South Carolina in their only significant way to apply a right that Congress expressly granted them “, wrote Jackson, but this could also” strip these South Carolinians – and countless other beneficiaries of Medicaid through the country – of deep and personal freedom: the “ability to decide that deals with us.

The decision could also have great -reaching consequences. Arkansas, Missouri and Texas have already prohibited Planned Parenthood to be reimbursed by Medicaid for any type of health care. More states could follow the plunge.

In addition, given the role of Planned Parenthood in the provision of contraceptive care, the disqualifying of Medicaid could restrict access to health care and increase The already involuntary pregnancy rate in America.

States could also try to exclude suppliers according to other characteristics, such as If their employees belong to unions or if they provide their patients stupid careto further restrict patient choices.

With this decision, the court authorizes a patchwork of Planned Parenthood’s state exclusions and other medical suppliers of the Medicaid program which could soon look like the patchwork already seen with access to abortion.

Parties of this article appeared for the first time in another article Posted on April 2, 2025.