Planned Parenthood faces key Supreme Court test over Medicaid access

Axios

01-04-2025

The Supreme Court on Wednesday is due to hear a high-profile case blending patients' rights with reproductive care access, stemming from South Carolina's move to block Medicaid recipients from getting care at Planned Parenthood clinics in the state.
Why it matters: At issue is whether Medicaid patients can freely choose their provider for any service — not just reproductive care. But the case has major implications for Planned Parenthood, which derives a significant chunk of its funding from the safety net program and is the biggest provider of abortion services in the country.
It's the first abortion-adjacent case since President Trump's second-term inauguration, and his administration will play a prominent role, arguing along with South Carolina for the state's position.
The case is being heard by the Supreme Court amid other efforts to defund Planned Parenthood, including freezing Title X family planning funds.
What they're saying: The case is "a political lightning rod, because it's Planned Parenthood," said Elizabeth Taylor, executive director of the National Health Law Program, which has written a brief in support of Planned Parenthood in the case.
At its core, though, the case is about the rights of Medicaid enrollees, she said.
"If Medicaid enrollees can't enforce the rights that the Medicaid statute creates, then those rights, you know, they're not real rights," she said. "It is essential to the effective working of the Medicaid program ... that when they aren't getting what they're legally entitled to, they can go into court and enforce those rights."
On the other hand, South Carolina and its allies argue that Medicaid enrollees don't have the privilege to sue to enforce their rights as the law currently stands.
The big picture: A decision in favor of South Carolina could embolden more states to remove Planned Parenthood from their Medicaid networks. Texas, Arkansas and Missouri have already done so.
Nearly half of patients who use Planned Parenthood health services have Medicaid coverage, according to the Planned Parenthood Action Fund. Shutting the provider out of Medicaid networks could effectively defund it — a longtime priority of conservative politicians and an explicit goal of Project 2025.
Defunding Planned Parenthood would not only further curtail abortion access. It would also diminish the availability of primary care services provided by the clinics, including STI and cancer screening, birth control prescriptions, vaccines and mental health help.
If the high court sides with South Carolina, it could pave the way for states to stop allowing hospitals that provide gender-affirming care to transgender patients to be paid by Medicaid, said Sara Rosenbaum, professor emerita of health law and policy at George Washington University.
Catch up quick: In 2018, South Carolina prohibited abortion clinics, including Planned Parenthood, from getting paid by the state's Medicaid program.
Medicaid already cannot cover abortion care in most cases, but South Carolina's move stopped beneficiaries in the state from going to Planned Parenthood for birth control and other non-abortion health care services.
Planned Parenthood South Atlantic and Medicaid enrollee Julie Edwards later sued the state in federal court. They argued that South Carolina's policy violates Medicaid enrollees' right to choose any qualified provider for their health care.
Zoom in: South Carolina is arguing that Medicaid enrollees don't have the right to sue their state in order to enforce their ability to see their preferred health provider.
But Planned Parenthood posits that federal Medicaid law "unambiguously" allows enrollees to use the courts to enforce their right to choose a health provider.
Nine health care provider trade groups, in a brief to the court supporting Planned Parenthood, said the freedom to choose a provider "can be pivotal in shaping the patient's treatment, overall well-being, and quality of life."