South Carolina Can Deny Medicaid Patients Planned Parenthood Care, SCOTUS Rules
In a 6-3 decision, the court determined that Planned Parenthood clinics and patients in South Carolina may not sue the state for denying Medicaid funding to the reproductive care provider. The ruling overturns repeated lower court decisions that affirmed Medicaid recipients' rights to visit a provider of their choosing that accepts the program. It comes against the backdrop of looming federal cuts to Medicaid, which would further restrict health care access for millions of low-income Americans.
In South Carolina, abortion is already subjected to a near-total ban. State law prohibits abortion after six weeks with limited exceptions — which is often before someone would be aware that they're pregnant. Republican South Carolina Gov. Henry McMaster has been direct about wanting to target Planned Parenthood because the network of clinics is known as an abortion provider.
'South Carolina has made it clear that we value the right to life,' McMaster said in a February statement. 'Therefore, taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs.'
The idea that Medicaid is subsidizing abortion care in South Carolina is incredibly misleading, said Susanna Birdsong, general counsel and vice president of compliance at Planned Parenthood South Atlantic.
'Medicaid does not cover abortion except in very narrow circumstances of rape, incest in life of the pregnant person,' Birdsong said. 'That's been a federal rule since the 1970s.'
Planned Parenthood provides care for a host of other sexual and reproductive wellness concerns — meaning that low-income South Carolinians will lose access to 'health care that has nothing to do with abortion,' Birdsong said. She pointed to things like testing for sexually transmitted infections, cancer screening, and birth control.
In its ruling, the Court made clear that it was aware of the other services Planned Parenthood provides.
'Planned Parenthood South Atlantic operates two clinics in South Carolina, offering a wide range of services to Medicaid and non-Medicaid patients,' reads a summary of the decision. 'It also performs abortions.'
The Court noted that Planned Parenthood and a patient sued under the any-qualified-provider provision, which allows Medicaid patients to seek care from a provider of their choosing, but the majority determined they did not necessarily have an 'enforceable' right to do so.
Experts expect that this decision will open the floodgates for other states to pass similar bans, limiting access to the largest provider of reproductive and sexual health care in the United States for millions of lower-income Americans.
'Other states certainly have tried it before,' said Dr. Jamila Perritt, an OB-GYN and president of the nonprofit Physicians for Reproductive Health. 'Much in the same way that abortion bans really swept this country, I think we're going to see similar effects.'
The decision to limit where Medicaid patients can access care disproportionately affects women of color, said Perritt. As of 2023, the majority of people enrolled in Medicaid in South Carolina were nonwhite, and roughly 39 percent of Medicaid enrollees were Black, according to health policy research nonprofit KFF.
Even before the decision, access to health care — particularly reproductive and sexual health care — in South Carolina was a challenge for lower-income residents. Roughly 41 of the state's 46 counties are considered federally designated 'Health Professional Shortage Areas,' and Medicaid recipients are disproportionately likely to live in communities with provider shortages.
'We're talking about communities that are already marginalized from care, communities that already have disproportionately poor reproductive and sexual health outcomes,' said Perritt, who predicted the decision would have 'significant negative health consequences.'
Aside from having one of the strictest abortion bans in the country, South Carolina is one of only 10 states not to expand Medicaid coverage since the Affordable Care Act was passed in 2010. South Carolina also has the eighth-highest maternal mortality rate in the country, hovering around 47.2 pregnancy-related deaths per 100,000 live births, and some of the highest rates of sexually transmitted infections in the nation.
'It's really a state that should be investing more in its public health infrastructure and making sure that people who live in the state have access to the care that they need,' said Birdsong.
Jennifer Driver, senior director of reproductive rights for State Innovation Exchange, said, like the state's abortion ban, lower-income people in South Carolina will bear the brunt of the burden of this decision.
'It targets people who are already limited on resources to say, 'You know what? On top of that, you actually don't get to have a decision on the care that you get and the provider you get it from,' she said.
Read Our Complete Coverage
At the same time, the Trump administration and Congress are seeking to further restrict health coverage for low-income Americans. A Congressional Budget Office report found that the House of Representatives' version of the 'Big, Beautiful, Bill' would leave 16 million Americans without health insurance and kick 7.8 million people off of Medicaid. Senate Republicans are considering their own set of Medicaid cuts, though they've been snarled by political opposition.
'This is a clear and obvious attack on people with low income, people who rely on Planned Parenthood clinics to get life-saving health services,' said Perritt. She described the decision as part of the government's broader efforts 'to eliminate access to comprehensive health care for folks, really across the country. This has to also be understood as an attack that reaches far beyond the borders of South Carolina.'
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
19 minutes ago
- New York Post
NY Rep. Elise Stefanik demands to know if Gov. Hochul knew massive prison strike was brewing: ‘Why did she refuse to act?'
ALBANY – Upstate Rep. Elise Stefanik is calling on Gov. Kathy Hochul to come clean about this year's massive corrections workers strike and whether she knew about the brewing 'powder keg' in state prisons. The Republican North Country rep, in a statement first obtained by The Post, said Hochul 'must immediately address' a new report by the prison workers' union largely blaming the state for allegedly ignoring warning signs of the simmering crisis and strike threats. 'What did she know, when did she know it, and why did she refuse to act?,' Stefanik writes in the statement. 3 North Country Rep. Elise Stefanik is attacking Gov. Kathy Hochul over her handling of the illegal corrections officers strike earlier this year. Hans Pennink Thousands of corrections officers illegally walked off the job in February, requiring Hochul to deploy over 6,000 National Guard troops to supplement staffing shortages in the problem-plagued facilities. The memo from the state Correctional Officers & Police Benevolent Association issued last week alleged its leadership had showed a top Hochul aide a video of members threatening to strike at an annual meeting weeks earlier, and were told the issue would be raised to the governor. 'The deterioration of prison conditions statewide and the indifference of the State's elected leaders to cries for help from the rank-and-file pushed staff to the breaking point, and then they broke,' the union memo reads. Stefanik — who is widely believed to be mounting a Republican challenge to Hochul in next year's gubernatorial election — slammed the Democrat for allegedly failing to act to prevent the strike. 'The union representing Correction Officers stated they warned Kathy Hochul before their strike that prisons were a dangerous powder keg, a strike was imminent, and that lives of officers were at risk. Hochul did nothing,' Stefanik wrote. 3 Rep. Elise Stefanik says Hochul 'did nothing' to respond to a 'powder keg' in the state prisons pre-strike. AP While the Hochul administration declared an end to the strike in early March, upwards of 2,000 National Guard troops remain to backfill staffing holes at the facilities, which are 4,000 to 5,000 personnel short of the Department of Corrections and Community Supervisions' ideal staffing level, Commissioner Daniel Martuscello wrote in a recent court filing. The department was already suffering from staffing shortages even before the strike, a report from the state comptroller's office said last month. A spokesperson for Hochul, in response to Stefanik's statement, accused the congresswoman of condoning the illegal strike and called the corrections officers' demands 'unrealistic.' 'Unlike Congresswoman Stefanik, Governor Hochul does not condone breaking the law. Corrections officers who joined the illegal work stoppage earlier this year knowingly put both the incarcerated population and their fellow officers at risk. Walking off the job because an unrealistic list of demands isn't met is unacceptable and illegal,' a rep for Hochul's office wrote in a statement. 3 A spokesperson for Gov. Kathy Hochul called illegally striking corrections officers demands 'unrealistic'. Hans Pennink 'Instead of issuing empty statements, Governor Hochul will keep focusing on real reforms that improve conditions for everyone in DOCCS facilities, including incarcerated individuals and the employees who serve there,' the statement said. The Hochul rep emphasized that corrections workers have received a pay bump since the strike. The spokesperson also noted that the state tried to pause the requirements of a solitary confinement law that the agency claimed it was unable to implement considering its dire staffing levels, but a court ordered them to resume. A spokesperson for NYSCOPBA declined to comment saying the report speaks for itself. The union also declined to share the video it says showed the Hochul administration official in February. The union, which found itself at odds with its members during the illegal strike is up for contract negotiations with the state in May 2026, per its memo.
Boston Globe
19 minutes ago
- Boston Globe
Appeals court lets the White House suspend or end billions in foreign aid
After groups of grant recipients sued to challenge that order, U.S. District Judge Amir Ali ordered the administration to release the full amount of foreign assistance that Congress had appropriated for the 2024 budget year. Advertisement The appeal court's majority partially vacated Ali's order. Judges Karen LeCraft Henderson and Gregory Katsas concluded that the plaintiffs did not have a valid legal basis for the court to hear their claims. The ruling was not on the merits of whether the government unconstitutionally infringed on Congress' spending powers. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up 'The parties also dispute the scope of the district court's remedy but we need not resolve it ... because the grantees have failed to satisfy the requirements for a preliminary injunction in any event,' Henderson wrote. Judge Florence Pan, who dissented, said the Supreme Court has held 'in no uncertain terms' that the president does not have the authority to disobey laws for policy reasons. 'Yet that is what the majority enables today,' Pan wrote. 'The majority opinion thus misconstrues the separation-of-powers claim brought by the grantees, misapplies precedent, and allows Executive Branch officials to evade judicial review of constitutionally impermissible actions.' Advertisement The money at issue includes nearly $4 billion for USAID to spend on global health programs and more than $6 billion for HIV and AIDS programs. Trump has portrayed the foreign aid as wasteful spending that does not align with his foreign policy goals. Henderson was nominated to the court by Republican President George H.W. Bush. Katsas was nominated by Trump. Pan was nominated by Democratic President Joe Biden.
NBC News
20 minutes ago
- NBC News
Mother with cerebral palsy struggles to hire aides after private equity takeover
Renee Christian, a single mom with cerebral palsy, lives in Buffalo, New York, with her 12-year-old daughter. Although her condition forced her to spend most of her childhood at a nursing home, she has resided in her own home for years with the help of personal assistants she hires under a New York State Medicaid program. In April, however, Christian's life was upended when the state forced her and her assistants to work with a new company administering the nation's largest consumer-directed personal assistance program, called CDPAP. One by one, she lost nearly half her assistants because they said they did not receive the proper pay for their work, Christian said. She now fears for her future living at home where she needs help getting dressed, doing laundry and cooking meals. 'I'm trying to hire new staff, and I am very good at navigating technology,' Christian, 37, said. 'But it's hard when you have to tell your new hires, 'I can't guarantee you're going to get paid on time or get the appropriate amount of hours.'' Christian is not the only one affected by the state program's recent takeover. NBC News spoke with nineconsumers and personal assistants who described multiple problems since Public Partnerships LLC (PPL) won the $1 billion, five-year contract in 2024, replacing roughly 600 entities that had been administering the program. The issues range from assistants receiving checks for zero dollars to problems arranging for direct deposit, onboarding new workers and clocking hours worked. PPL, which has a staff of 1,400 on the New York program, is owned by two private equity firms. Its takeover as the program's sole administrator triggered an avalanche of complaints from consumers unable to reach anyone to answer questions and assistants unpaid for hours they worked and unhappy with reduced health insurance benefits, according to lawmakers, consumer advocates and the consumers and assistants interviewed by NBC News. Before the transition to PPL, roughly 280,000 consumers were participating in the CDPAP program, according to the New York Department of Health. Since PPL took over, some 80,000 have left the program, the department said. 'A lot of these folks need the services being provided by the program,' Gustavo Rivera, a New York state senator who represents constituents in the Bronx, told NBC News. 'It's likely they dropped out because of difficulties making the program work or they switched to programs that are more expensive.' Rivera has scheduled hearings in August about what he calls the botched transition to PPL. At a cost of $9 billion a year, New York's CDPAP is the largest personal assistance program in the nation. It allows consumers like Christian to directly hire the folks who help them pursue their lives rather than rely on a staffing agency. At-home programs like New York's are less costly than providing institutional care, research shows. In 2024, according to one analysis, a semi-private room in a nursing home cost an average $9,277 a month nationwide. That's 43% more than a home health aide costing on average $6,483 each month. Amanda Lothrop, chief operating officer for New York State's Medicaid program, told NBC News that the transition to PPL aimed to eliminate the former program's administrative inefficiencies while protecting taxpayers. She said fraud and abuse had marred the previous program, but the state has identified very few cases. A 2022 audit by the Office of Medicaid Inspector General in New York, for example, uncovered only $46,000 in overpayments in the program, a 99% accuracy rate. In response to questions from NBC News, PPL and the New York state health department said together they had identified 30 instances of home care workers under the previous system billing consumers who were hospitalized or dead, five cases of workers billing for work with consumers who were out of the country, one worker claiming to work for two people at the same time and another who claimed to be in two places simultaneously. More than 200,000 workers are in the CDPAP program. 'In partnership with PPL,' the department of health said in a statement, it 'is using enhanced data and monitoring tools to protect program integrity, support consumers, and take timely action when issues arise.' Meg Fitzgerald, a PPL spokeswoman, said in a statement that the company's 'systems and centralized control processes would have been able to identify and prevent these violations.' The contract New York State awarded to PPL is a recent example of private equity's increasing involvement in home health care, said Aditi Sen, managing director of research and campaigns at Americans for Financial Reform, a nonprofit nonpartisan organization that advocates for fairness in the U.S. financial system. Last month, Sen published a report detailing the industry's forays into home health care entitled, 'Wall Street on Your Doorstep: Protecting Home Care from Private Equity Abuses.' 'The private equity industry is looking for any streams of steady public funding,' Sen said in an interview. 'As advocates have secured more funding for home and community-based services, that has resulted in the private equity encroachment.' She said the next step for researchers is to analyze the quality of home care after private equity gets involved. Founded in 1999, PPL calls itself an industry leader 'in financial management services for consumer direction, serving consumers throughout the U.S.' As for the difficulties in the New York program, the PPL spokeswoman said in a statement: 'The transition to a single fiscal intermediary required a significant element of education and, in some cases, a change in practices for submitting and approving time. We have been committed to providing various methods of extensive education and resources to all stakeholders. Ultimately, we strive to provide the accountability this program deserves.' Three CEOs in five years Private equity firms have taken over wide swaths of the health care industry in recent years and ill effects on care have been well-documented in independent academic research. The firms typically acquire companies or doctors' practices using debt and hope to sell them within five to seven years at a profit. This requires the firms to improve the financial results of the companies they buy, often firing employees or cutting services to slash costs. The private equity firms bought PPL three years ago. Studies on hospitals and nursing homes have found significant deterioration in patient outcomes after private equity takes them over. Other research has found that prices rise significantly after private equity acquires a practice or operation. According to Sen, private equity firms have rolled up hundreds of small home health and home care chains into large companies like Comfort Keepers, Help at Home and Accentcare. Combined, private equity-owned companies offering home and community-based care services are second only in size to chains owned by insurers Humana and UnitedHealthcare, Sen found. Many acquisitions by private equity-owned chains have been in companies offering home and community-based services for people with physical, intellectual and developmental disabilities, Sen determined. Pediatric home care for children with disabilities is another area of interest as is the consumer self-directed care industry, PPL's focus. Private equity acquisitions are not always easy to track. PPL's website does not identify its owners, but a recent court ruling disclosed the two private equity firms that control it — DW Healthcare Partners of Toronto and Park City, UT, and Linden Capital Partners of Chicago. Although both the firms' websites list other companies they have invested in, neither lists PPL as an investment. After winning the New York State contract, PPL tried to keep its ownership secret. In a lawsuit filed last year against New York's Department of Health by a home care company over the transition to PPL, the company's private equity owners were identified in a document that PPL requested the judge keep under seal. If the information were made public, the company argued, it 'may put individuals in danger and/or allow them to become targets of violence.' Public disclosure would also increase the risk of 'unwanted attention and harassment,' PPL said. The company lost that battle and the document became public. Fitzgerald, PPL's spokeswoman, declined to elaborate on the company's desire for secrecy in its ownership. Neither DW Healthcare nor Linden Capital Partners responded to emails seeking comment for this story. PPL also objected to a 2024 Medicare rule affecting home care organizations. The rule mandated that at least 80% of Medicaid payments go to compensation for direct care workers, such as personal assistants, not a company's 'administrative overhead or profit.' Fitzgerald said the company's objections were not about worker compensation. Rather, she said, the company believed the rule would 'make it more difficult for states to initiate new self-directed programs and to maintain small self-directed programs.' Participants in the CDPAP program aren't the only ones experiencing upheaval in the transition to PPL. Recently, Vince Coppola, PPL's former chief executive, and Maria Perrin, its former president, departed unexpectedly. PPL has had three CEOs over the past five years, Fitzgerald said. Filling out forms for hours Tara Murphy said she enjoyed working as a personal assistant in the CDPAP program for 25 years. But when she tried to switch to PPL, she encountered multiple difficulties, she said. 'Their technology is so hard to navigate, it took me four and a half hours to fill out their forms,' she recalled. 'I uploaded them nine times before they were finally accepted in their system.' Murphy's hourly pay with PPL was 2% less than she had previously earned, she said, and she never received the correct pay under the new program. 'I ended up having to quit my job and leave my consumer,' she said. Rivera, the New York state senator, said he hopes to gain some answers from state officials on the PPL transition at the Aug. 21 hearings in New York City he co-sponsored with state Sen. James Skoufis. 'Last year, when it was pushed upon us in the budget process I said back then that I thought it was a bad idea,' Rivera said of the switch to PPL. 'Unfortunately, what I heard from my constituents is the transition was indeed bungled.' Meanwhile, Christian, the Buffalo mom who has lost five personal assistants since PPL took over, is especially worried about how it might impact her daughter. 'My daughter is 12 years old, she needs me here for her,' Christian told NBC News. 'If I have to go into a facility because I can't get care in my home, where is she going to go?'
