Supreme Court hears arguments in case against South Carolina removing Planned Parenthood from Medicaid program

The Supreme Court heard arguments on Wednesday in a case out of South Carolina stemming from an executive order signed by Governor Henry McMaster directing the state’s Department of Health and Human Services to remove abortion clinics like Planned Parenthood from the state’s Medicaid provider list.

While federal law prohibits Medicaid funding from going toward paying for abortions, many Medicaid patients in the state seek out the clinic for care such as cancer screenings, pregnancy testing, and contraceptives, per the Associated Press. In South Carolina, there are just two Planned Parenthood clinics. 

An attorney for the state argued that Congress "did not use clear rights-creating language in any qualified provider provision" in the Medicaid Act’s any-qualified-provider provision and that it did not use the word "right or its functional equivalent, nor does it use words with a deeply rooted rights-creating pedigree."

"The provision speaks merely of obtaining a benefit from a third party, unlike traditional rights-creating language which confers a right directly," he said. 

The attorney’s claim about "rights-creating language" was heavily questioned by the justices. "The state has an obligation to provide this particular thing right, which is the state has an obligation to ensure that a person, I don't even know how to say this line without saying right, has a right to choose their doctor. That's what this provision is. It's impossible to even say the thing without using the word right," Justice Elena Kagan said.

The attorney responded, "Well, that language that you're focused on—'may obtain'—is not clear rights-creating language for four reasons." to which Kagan replied, "I don't want four reasons. I want you to answer my question." He replied, "I won't go through my list. There's many reasons why that analysis is wrong, but simply because we understand colloquially that something might be a right doesn't mean that Congress has put a state on clear notice that it could be sued in federal court under 1983 and subjected to liability and attorney fee shifting if it doesn't follow that provision, particularly in a substantial compliance reason."

After McMaster signed the executive order, Julie Edwards, a Planned Parenthood patient, and the organization sued the state, per CBS News. A federal district court blocked South Carolina from removing Planned Parenthood from its Medicaid program, and a US appeals court upheld the decision. 

The high court ordered in 2024 additional proceedings in the case after is ruled in a separate case that nursing home residents could sue state-owned healthcare facilities over alleged violations of civil rights. The three-judge appeals court panel ruled unanimously in March, after weighing its earlier decision, that Edwards’ lawsuit could move forward. 

Judge Harvie Wilkinson wrote for the US Court of Appeals for the 4th Circuit, "This case is, and always has been, about whether Congress conferred an individually enforceable right for Medicaid beneficiaries to freely choose their healthcare provider. 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."

South Carolina requested that the Supreme Court review the decision, making it the third time the case has been before the justices. They agreed to take up the question of whether "the Medicaid Act's any-qualified provider provision unambiguously confers a private right upon a Medicaid beneficiary to choose a specific provider."