US Supreme Court says SC can block Medicaid payments to Planned Parenthood
In a blow to one the state’s two abortion providers, South Carolina can refuse to pay Planned Parenthood through the state’s Medicaid program, the U.S. Supreme Court ruled in a 6-3 decision Thursday. The court reversed a lower court’s decision and also sent it back for further proceedings.
At issue in the case was whether Medicaid recipients in South Carolina have the right to seek care from a specific provider, if the provider is willing and qualified.
In the decision, written by Associate Justice Neil Gorsuch, the majority of justices found that when Congress passed the Medicaid statute they didn’t intend to create a right to select a provider. “The Medicaid provision never uses ‘guarantee’ or ‘free choice,’ ” the decision said.
Another question in the case was whether a person on Medicaid can sue over whether a provider is excluded.
“If existing remedies prove insufficient, Congress can create new ones. But balancing enforcement costs and benefits is a policy question for Congress, not courts,” the ruling said. The ruling leaves enforcement of the Medicaid act to the federal branch, leaving it effectively toothless under the current administration, say Planned Parenthood’s lawyers.
Thursday’s ruling allows the state to deny payment to Planned Parenthood through the state’s health care coverage program that primarily serves low-income families and people with disabilities. While the court’s ruling is limited to South Carolina, representatives of Planned Parenthood warn that it could give other states the “greenlight” to begin imposing their own restrictions on the use of Medicaid dollars.
In 2018, Gov. Henry McMaster issued an executive order to prevent the state’s Medicaid program from paying Planned Parenthood South Atlantic, one the state’s two abortion providers. His order was stayed by lower federal courts, which allowed Planned Parenthood to continue receiving Medicaid money for its patients.
“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,” McMaster said in a statement Thursday.
The ruling comes as another blow to Planned Parenthood, the nation’s largest provider of reproductive and sexual healthcare, including abortions. As the Supreme Court has tilted rightward since the first Trump administration, states have seen increasing success in challenging abortion rights.
“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. Twice, justices of this Court denied to even hear this case because Gov. McMaster’s intent is clear: Weaponize anti-abortion sentiment to deprive communities with low incomes of basic health care,” said Paige Johnson, president and CEO of Planned Parenthood South Atlantic in a statement.
The state of South Carolina will now have to go to a federal district court in order to lift the injunction currently preventing the state from withholding Medicaid reimbursement from Planned Parenthood. At a news conference Thursday morning, representatives of Planned Parenthood say they are continuing to explore legal options. In the meantime, there will be no immediate effects and Planned Parenthood will continue to operate and provide care for Medicaid recipients in South Carolina for as long as possible, said Katherine Ferris, Chief Medical Officer for Planned Parenthood South Atlantic.
Planned Parenthood South Atlantic currently operates just two facilities in South Carolina, in Columbia and Charleston, and accepts Medicaid for a range of non-reproductive health care services.
The state’s only other abortion provider, Greenville Women’s Clinic, does not accept Medicaid for reproductive health services.
Federal law prohibits Medicaid dollars from paying for abortions, and Planned Parenthood has said that no state money is used to pay for procedures in South Carolina. Rather, the national reproductive health provider has said that the governor’s executive order was intended to block reimbursements for services covered by Medicaid, like cancer screenings and STD tests, simply because the organization also provide abortions.
“Where are those Medicaid patients going to go?” said Matthew Butler, an Advocacy Strategist with ACLU South Carolina. “This is another unpaid hospital bill, another unpaid doctors visit bill the many poor people of South Carolina are going to have to take into consideration among all the other extremely high bills they have to pay.”
Medicaid is a reimbursement system — meaning that Planned Parenthood provides care and is reimbursed afterwards by Medicaid for that specific appointment or procedure.
By preventing Medicaid recipients from obtaining reimbursements for Planned Parenthood’s services, South Carolina was in violation of the federal Medicaid Act, said the nonprofit’s lawyers. The act says that any Medicaid recipient “may obtain” healthcare from any qualified provider that accepts reimbursement through the program.
The Supreme Court made no finding that Planned Parenthood was not a qualified provider.
With the ruling, “if (South Carolinians) fall on hard financial times, they are fundamentally less free. They have fewer rights today than they did when they went to sleep last night,” Ferris said.
So far in 2025, just 3.5% of Planned Parenthood’s patients in South Carolina received care through Medicaid. This is significantly lower than other states, where that number is closer to 50%, because South Carolina has not expanded Medicaid. It’s also a relatively small amount of money — over the past seven years the organization has received less than $100,000 a year in Medicaid reimbursement, Planned Parenthood said at a news conference in front of the state house Thursday afternoon.
Sen. Tameika Isaac Devine, D-Richland, called the decision to stop reimbursements “a chilling message that poor people in South Carolina don’t have the same right to choose health care providers that others do.”
Lawyers for the state of South Carolina have argued that the language of the federal law isn’t clear enough to say that the state infringed on anyone’s rights.
Abortion opponents argue that the Medicaid dollars subsidizes Planned Parenthood’s operations, enabling the organization to perform abortions.
“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,” said state Senate Majority Leader Shane Massey in a statement.
Planned Parenthood said the Medicaid reimbursements it receives is less than other insurance coverage and doesn’t cover the full costs of the services its meant to pay for — health screenings and contraception.
South Carolina bans abortions after a fetal heartbeat can be detected, which is usually around the six-week mark of a pregnancy. A woman may not even know she is pregnant at that point. The state’s law has exceptions in cases of rape and incest or the life of the mother is in danger.
Lawmakers in the Republican-controlled General Assembly even included a provision in the new state budget that explicitly orders the director of Health and Human Services to “withhold funding to abortion providers to the fullest extent allowed under the law.”
This developing story will be updated.
This story was originally published June 26, 2025 at 11:00 AM.
