Human Rights at Risk as Supreme Court Backs Medicaid Cuts to Abortion Providers

The U.S. Supreme Court on Thursday delivered a significant ruling backing South Carolina’s effort to exclude Planned Parenthood from its Medicaid program, marking a victory for Republican-led states seeking to restrict public funding for abortion providers.

In a 6–3 decision split along ideological lines, the Court overturned a lower court’s decision that had blocked the state’s policy. The ruling enables South Carolina officials to cut off Medicaid reimbursements to Planned Parenthood South Atlantic, which operates clinics in Charleston and Columbia and provides preventive and reproductive healthcare to hundreds of low-income patients each year.

The case centered on whether Medicaid recipients have the legal right to sue to enforce the program’s guarantee that beneficiaries can receive care from any “qualified and willing” provider. Planned Parenthood and patient Julie Edwards filed suit in 2018 under a Reconstruction-era civil rights statute, arguing that the state’s actions violated that provision.

Lower federal courts repeatedly agreed, finding that South Carolina’s move infringed on Medicaid patients’ ability to choose their healthcare providers. But in Thursday’s decision, the Supreme Court concluded that Medicaid’s language does not establish a private right of action enforceable through litigation.

“This ruling empowers states to exclude qualified healthcare providers from Medicaid without fear of legal challenge by patients,” said Alexis McGill Johnson, president of Planned Parenthood Federation of America, who warned the decision could limit access to essential care.

Republican Governor Henry McMaster ordered the defunding measure in 2017, asserting that any organization providing abortions, regardless of whether Medicaid pays directly for those services, should be deemed unqualified to participate in the program.

The dispute has been ongoing for years. In 2020, the Supreme Court declined to intervene at an earlier stage. In 2023, however, the justices instructed lower courts to reconsider South Carolina’s arguments after issuing a separate decision about enforcement rights under federal law.

Since the Supreme Court overturned Roe v. Wade in 2022, many Republican-led states have passed sweeping abortion restrictions. South Carolina now prohibits most abortions after six weeks of pregnancy.

While Thursday’s ruling does not close Planned Parenthood’s clinics, it removes a critical source of funding that supports a wide range of services, including cancer screenings, contraception, and testing for sexually transmitted infections.

Legal analysts say the decision is likely to embolden other states to pursue similar defunding strategies, deepening national divisions over reproductive rights and access to care for low-income patients.