Supreme Court Hears Red State Attempt To Block Poor People From Planned Parenthood

The Supreme Court heard South Carolina’s big swing to knock Planned Parenthood off of Medicaid Wednesday — not because the provider is unqualified, but because the state just doesn’t want it to be an option. 

A Medicaid beneficiary sued when South Carolina Governor Henry McMaster (R) directed the state Health and Human Services department in 2018 to terminate “abortion clinics” from the Medicaid program because, among other reasons, “the payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life.”

On Wednesday, that move ran headlong into Medicaid’s “free choice of provider” guarantee, enshrined in federal law, which states that beneficiaries can pick the provider of their choice as long as she is willing and qualified. 

Justice Elena Kagan made the slippery slope argument, that if South Carolina gets to deem providers “unqualified” due not to any professional standard but to political preference, other states could do the same.

“It could be people who do provide abortions, people who don’t provide abortions, people who do provide contraception, people who don’t provide contraception, people who do do gender transition treatment, people who don’t,” she said. “Every state could split up the world by providers like that,” giving beneficiaries “no ability to come back and say that’s wrong, I’m entitled to see my provider of choice.”  

Red states have often gone after Planned Parenthood through Medicaid, despite the fact that the Hyde Amendment prevents federal funds from being used for abortion. In this case, South Carolina tries to elide that fact by arguing that any money given to Planned Parenthood could be used to pay for abortions indirectly, perhaps by freeing up funds from other areas. The provider shot down that attempt in its brief. 

“South Carolina’s Medicaid reimbursement rates are so low that they ‘do not even fully cover the cost of the Medicaid services [Planned Parenthood] provides,’” its lawyers wrote. 

The Trump administration joined the case as an amicus, siding with South Carolina. 

The case is closely related to one the Court decided in 2023, when the Court upheld Medicaid beneficiaries’ ability to sue if states violate their rights. Activists and experts worried that the right-wing Court would use it to hobble the program — one warning that the case could be to Medicaid what Dobbs was to abortion — but only Justices Samuel Alito and Clarence Thomas ultimately dissented.