Supreme Court allows states to exclude abortion providers from Medicaid
By Easton Martin
WASHINGTON —In a major win for the pro-life movement, The Supreme Court ruled Thursday that South Carolina can legally remove abortion providers from its Medicaid program. The court delivered a 6 to 3 decision that limits patients’ ability to challenge such exclusions in federal court.
Majority Opinion
Justice Neil Gorsuch, writing for the majority, stated that Medicaid recipients do not have a private right to sue under federal civil rights law to enforce the Medicaid Act’s requirement that states allow access to any qualified and willing provider.
“Private enforcement does not always benefit the public,” Gorsuch wrote. “Balancing those costs and benefits belongs to the people’s elected representatives, not unelected judges.”
The Court concluded that the appropriate mechanism for enforcing Medicaid rules lies with federal oversight through funding penalties, rather than individual lawsuits filed under 42 U.S.C. § 1983.
Dissenting Views
Justice Ketanji Brown Jackson authored the dissent, whose vote was joined by Justices Sonia Sotomayor and Elena Kagan. Jackson argued that the decision strips low-income patients of a meaningful choice in their health care providers.
“This Court’s decision today will make a difference in real people’s lives,” Jackson wrote. “Specifically, it will strip poor and vulnerable patients of their ability to vindicate the right that Congress conferred.”
The dissent claims that the ruling undermines the intent of the Medicaid Act and places undue power in the hands of state governments to exclude providers for political reasons.
Case Background
The case centered on South Carolina’s 2018 directive to exclude Planned Parenthood South Atlantic from the state’s Medicaid program. The state argued that the organization did not meet its standards due to its provision of abortion services, although Medicaid funds do not cover abortions in most cases.
A Medicaid patient and Planned Parenthood challenged the exclusion, arguing it violated their rights under the Medicaid Act. Lower courts agreed, but the Supreme Court reversed those decisions.
National Impact
Legal analysts say the ruling will likely encourage other conservative-led states to take similar steps to cut ties with abortion providers through Medicaid. Health care advocates warn that this may also impact access to non-abortion services, such as cancer screenings and contraception, particularly for low-income communities.
The decision represents a significant shift in the Court’s approach to federal health care programs, signaling that enforcement of patient access provisions now rests with administrative agencies rather than the judiciary.
TPUSA founder Charlie Kirk posted on X regarding the decision, calling it a “Huge breakthrough for the cause of life”:
