On Thursday, June 26, the Supreme Court issued a 6-3 decision in Medina v. Planned Parenthood South Atlantic, ruling that individuals do not have the right to sue under the “free choice of provider” clause of the Medicaid Act. This decision reversed lower court rulings and remanded the case back to district courts.
Medina v Planned Parenthood South Atlantic centers around the 2018 Executive Order by South Carolina’s governor, Henry McMaster, that blocked clinics that provide abortion services, including Planned Parenthood South Atlantic, from participating in the state’s Medicaid program.
Planned Parenthood South Atlantic is a Planned Parenthood affiliate that operates clinics in Charleston and Columbia, South Carolina. These clinics have worked under the strict abortion laws within the state, following the six-week ban. Besides from abortion services, the South Atlantic clinics also provide prenatal and postpartum care, physical exams, and cancer screenings.
Planned Parenthood South Atlantic, joined by patient Julie Edwards, argued that the order violated Medicaid’s “free choice of provider” provision. This clause, a core component of Medicaid legislation, guarantees beneficiaries the right to choose amongst qualified providers. McMaster’s order would deny Medicaid recipients from choosing Planned Parenthood services.
Lower courts had sided with Planned Parenthood previously, notably both a federal district judge and the US Court of Appeals for the 4th Circuit. These rulings have stalled McMaster’s order from taking effect.
The Supreme Court, however, did not directly answer the question of whether South Carolina could legally exclude Planned Parenthood from Medicaid. The Court did not deal with any discussion of abortions at all. Instead, it addressed a narrower question: Can Medicaid beneficiaries sue to enforce their provider choice under federal law?
Justice Neil Gorsuch wrote for the majority, stating that individuals do not possess the “enforceable right” to sue under free choice of provider. Reversing the decisions of lower courts, this decision remanded the case to district courts consistent with the Supreme Court ruling.
This ruling could have broad implications for Medicaid beneficiaries across the country. Several other states are likely to follow suit with South Carolina’s order. Texas, Arkansas, Indiana, and Missouri have already tried to keep Planned Parenthood out of their Medicaid networks. Although they were previously blocked, this ruling gives them a clear legal pathway toward achieving this goal.
Additionally, this ruling curtails low-income women’s ability to access reproductive care. Medicaid covers one in five women of reproductive age and is the largest source of coverage for low-income women. KFF research has found that Planned Parenthood offers a wider range of family care compared to non-specialized clinics who are unharmed by this ruling. Limiting access to these providers could disproportionately affect low-income women seeking care.
While the Court did not rule on abortion rights, this decision limits the ability of patients to challenge state decisions that affect access to reproductive and preventive health care. The long-term impact on provider networks and patient access remains to be seen.
