by Skylar Laird, Florida Phoenix
June 27, 2025

Medicaid patients don’t have the right to sue to see their doctor of choice, allowing South Carolina to exclude clinics that also provide abortions from its government health care program, the U.S. Supreme Court decided Thursday.

The South Carolina case that led to the 6-3 ruling began with Gov. Henry McMaster’s July 2018 executive order directing the state’s Medicaid agency to remove abortion clinics from its list of providers that patients can choose for coverage of non-abortion health care services.

The case is not about abortion — not directly, anyway — but whether South Carolinians can use their Medicaid health coverage at Planned Parenthood for services such as breast and cervical cancer screenings, birth control, and testing and treatment for sexually transmitted infections.

McMaster’s directive was quickly blocked by the federal courts, as Planned Parenthood sued on behalf of a patient who said she wanted to get all of her gynecological care at one of the provider’s two clinics in South Carolina but couldn’t unless Medicaid paid.

The case has been decided and appealed multiple times as it bounced back and forth.

Ultimately, six justices on the nation’s highest court decided nothing in the federal Medicaid laws provided the patient a constitutional right to sue. Three of the justices considered more liberal dissented.

“Though it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so,” Justice Neil Gorsuch wrote for the majority in his 24-page opinion. Justice Clarence Thomas wrote a separate concurring opinion.

McMaster declared victory.

“Seven years ago, we took a stand to protect the sanctity of life and defend South Carolina’s authority and values — and today, we are finally victorious,” the governor said in a statement Thursday.

However, nothing changes immediately.

Before South Carolina can officially remove Planned Parenthood from its Medicaid rolls, it needs another court order, said Katherine Farris, chief medical officer for Planned Parenthood South Atlantic.

That’s because justices’ decision on the patient’s right to sue sent the case back to a lower court.

Until the state gets the still-necessary permission, Planned Parenthood will continue providing services to Medicaid patients, Farris said.

“The state never claimed that we do not provide excellent care to Medicaid patients,” Farris said. “Rather, this is a purely political decision to deny patients the right to come to our offices because the name Planned Parenthood is on the door.”

Farris also noted that Wednesday’s ruling applies only to South Carolina.

However, it opens the door for other states to begin deciding which health care providers to approve or not approve to receive Medicaid funding, Farris said.

“The long-term consequences of that decision are devastating,” Farris said.

South Carolinians already can’t use Medicaid to pay for abortions, except in cases of rape, incest, or to save a patient’s life, as per a federal provision the state follows.

Planned Parenthood’s clinics in Columbia and Charleston receive a small fraction of the state’s total Medicaid dollars.

Of the $35 million total spent on South Carolinians’ Medicaid-covered family planning services in 2022-23, Planned Parenthood received $88,464, or 0.2%, according to the latest data from the state’s Medicaid agency.

What the justices said

The arguments primarily centered around two words in the federal Medicaid law.

Medicaid patients “may obtain” care from any provider “qualified to perform the service,” according to one of the qualifications states must meet in order to receive federal Medicaid funding.

Planned Parenthood’s attorneys argued the words “may obtain” meant patients had a right to visit the doctor of their choosing, and they could sue if the state tried to bar them from exercising that right.

But that is not a “rights-creating term,” such as specifically calling the decision a “right,” “privilege,” “entitlement” or “immunity,” attorneys for the state contended. If Congress had wanted to be sure patients were guaranteed the ability to choose their doctors, it would have explicitly said so, the attorneys argued.

The nation’s highest court agreed.

Deciding otherwise “would risk obliterating the longstanding line between mere benefits and enforceable rights,” Gorsuch wrote.

If a state is found to be violating the law, the federal government could cut off its funding, Gorsuch wrote. And states, including South Carolina, have an appeals process allowing providers who have been removed from the provider list to protest, he wrote.

Whether people can sue to resolve such questions should be left to lawmakers, not judges, Gorsuch wrote.

“New rights for some mean new duties for others,” the opinion reads. “And private enforcement actions, meritorious or not, can force governments to direct money away from public services and spend it instead on litigation.”

In the dissenting opinion, Justice Ketanji Brown Jackson wrote the majority’s reading of the law was “narrow and ahistorical.”

“The fact that the provision does not specifically use the word ‘right’ is not dispositive,” Jackson wrote. “We have never required Congress to use specific verbiage to establish individual rights.”

Gorsuch’s concern that the decision could open the floodgates to other lawsuits based on different parts of the Medicaid law is unfounded, considering that didn’t happen after the federal appeals courts previously ruled against South Carolina, Jackson wrote.

She warned that the ruling will weaken the Reconstruction-era law allowing people to sue in order to protect their rights and “is likely to result in tangible harm to real people.”

“At a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them,” Jackson wrote. “And, more concretely, it will strip those South Carolinians — and countless other Medicaid recipients around the country — of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.’”

Reaction from lawmakers

Republican lawmakers celebrated the opinion as another strike against abortions in the state. The federal ruling follows decisions by the state’s highest court upholding the state’s so-called “fetal heartbeat” law as a six-week abortion ban.

“Planned Parenthood has sued South Carolina over and over again, and over and over again, the abortion-giant keeps losing,” state Senate Majority Leader Shane Massey, R-Edgefield, said in a statement. “Today’s ruling is a win for all South Carolina taxpayers, and most of all, this pro-life generation looking forward to the day when Planned Parenthood’s doors close for good.”

The opinion allows the state to determine how it spends its money without interference from outside groups, Attorney General Alan Wilson said in a statement.

“The Supreme Court just slammed the door on Planned Parenthood’s latest attempt to force its radical agenda through the courts on our state,” Wilson said. “South Carolina, not federal judges or D.C. activist groups, gets to decide how we run our Medicaid program.”

The decision will disproportionately affect low-income women who relied on Planned Parenthood’s services, Sens. Margie Bright Matthews and Tameika Isaac Devine said in a joint statement.

“The real price of this decision will be paid by patients, especially Black, brown and rural women who now face fewer options and greater barriers to care,” the Walterboro and Columbia Democrats said.

This story first appeared in the South Carolina Daily Gazette, a member with the Phoenix in the nonprofit States Newsroom.

Florida Phoenix is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Florida Phoenix maintains editorial independence. Contact Editor Michael Moline for questions: info@floridaphoenix.com.

The post US Supreme Court allows SC to remove Planned Parenthood from list of Medicaid providers appeared first on floridaphoenix.com

Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This article presents the Supreme Court ruling in a factual manner but frames the issue with a focus on the impact on Medicaid patients, particularly low-income and minority women, highlighting concerns voiced by Planned Parenthood and Democratic lawmakers. It includes critical perspectives on the ruling’s consequences and underscores opposition from pro-choice advocates, while also providing the viewpoints of conservative officials celebrating the decision. The coverage leans slightly left by emphasizing the potential healthcare access limitations and political motivations behind the ruling without overtly endorsing a partisan position.