Supreme Court rules Planned Parenthood cannot sue over South Carolina defunding effort

Boston Globe

26-06-2025

But abortion was mentioned only in passing in the decision, and the patient in the case had sought access to contraception, not an abortion.
Instead, the justices focused on whether the plaintiffs were entitled to sue to enforce part of the Medicaid law, which gives federal money to states to provide medical care for poor people.
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Still, in shutting down such suits in federal court, the majority made it easier for states to deny funding to Planned Parenthood, particularly given the current administration's hostility to abortion rights.
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Medicaid provides federal money to states, but it sets some conditions. One is that eligible participants may receive assistance from any provider qualified to perform the required services. At issue in the case was whether a patient could sue to enforce that provision and obtain Planned Parenthood services for medical treatment other than abortions.
Abortions are banned in South Carolina after six weeks of pregnancy. Even then, federal law prohibits the use of Medicaid funding for abortion except in life-threatening circumstances or in cases of rape or incest. But Planned Parenthood clinics in Charleston and Columbia, S.C., provide services unrelated to abortion, including counseling, physical exams, contraception, and screenings for cancer and sexually transmitted infections.
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Justice Neil Gorsuch, writing for the majority, said private suits to enforce federal statutes are rarely permissible and require clear congressional authorization.
'After all, the decision whether to let private plaintiffs enforce a new statutory right poses delicate questions of public policy,' he wrote, adding that those questions should be resolved by 'the people's elected representatives, not unelected judges.'
Gorsuch wrote that there are other ways to enforce the statute. The federal government can cut off Medicaid money, he wrote, and South Carolina has an administrative process in which medical providers can challenge their exclusion from the state's Medicaid program.
In dissent, Justice Ketanji Brown Jackson, joined by Justices Sonia Sotomayor and Elena Kagan, said the law in question directly authorized the suit.
She added that Gorsuch's proposed alternatives were unrealistic. 'In practice,' she wrote, the federal government 'rarely invokes its authority to withhold funding because doing so would inevitably harm the program's beneficiaries.'
Jackson concluded her dissent by predicting that grave consequences would flow from the majority's approach.
'Today's decision is likely to result in tangible harm to real people,' she wrote. '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. 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.''
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John J. Bursch, a lawyer with the Alliance Defending Freedom, a conservative Christian group that represented South Carolina, welcomed the ruling.
'The American people don't want their tax dollars propping up the abortion industry,' he said in a statement. 'The Supreme Court rightly restored the ability of states like South Carolina to steward limited public resources to best serve their citizens.'
Paige Johnson, president of Planned Parenthood South Atlantic, which brought the suit, said in a statement: 'Today's decision is a grave injustice that strikes at the very bedrock of American freedom and promises to send South Carolina deeper into a health care crisis.'
She added that the South Carolina law was an effort to 'weaponize anti-abortion sentiment to deprive communities with low incomes of basic health care.'
A federal trial judge blocked the South Carolina directive, saying that it ran afoul of Medicaid's requirement that patients may choose any qualified provider.
The litigation that followed was convoluted and circuitous, focusing largely on whether Medicaid's provision created a right that individuals could enforce by filing lawsuits. The Supreme Court has said that federal laws like Medicaid, which give money to states if they accept certain conditions, must 'unambiguously confer individual federal rights' to give affected individuals the right to sue.
That is a hard test to meet, and the court has only rarely ruled that it has been satisfied, most recently in 2023 in Health and Hospital Corporation of Marion County v. Talevski, a case concerning nursing homes. The statute at issue in that case repeatedly referred to 'rights' as such, while the Medicaid provision in the new case, Medina v. Planned Parenthood South Atlantic, uses different language.
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That law says that people seeking medical services 'may obtain such assistance from any institution' that is 'qualified to perform the service or services required.'
Last year, a unanimous three-judge panel of the Fourth US Circuit Court of Appeals, in Richmond, Va., ruled that the suit could proceed.
'This case is, and always has been, about whether Congress conferred an individually enforceable right for Medicaid beneficiaries to freely choose their health care provider,' Judge J. Harvie Wilkinson III wrote for the panel. 'Preserving access to Planned Parenthood and other providers means preserving an affordable choice and quality care for an untold number of mothers and infants in South Carolina.'
He added that 'this decision is not about funding or providing abortions.'
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