The Supreme Court has issued a significant ruling that opens the door for states to exclude Planned Parenthood health centers from their Medicaid provider networks. In a 6-3 decision handed down on Thursday, June 26, 2025, the Court’s conservative majority ruled that individuals cannot use the federal Medicaid Act to file civil rights lawsuits challenging a state’s termination of a specific healthcare provider from its network.
Authored by Justice Neil Gorsuch, the decision in Medina v. Planned Parenthood South Atlantic marks a substantial blow to reproductive healthcare access advocates. It’s also a notable victory for the Alliance Defending Freedom (ADF), a conservative legal organization that represented the state in the case and was instrumental in the Dobbs decision that overturned Roe v. Wade.
For years, supporters of Planned Parenthood have warned that this case could empower states nationwide to remove the organization, which is the largest provider of women’s health care in the U.S., from their Medicaid programs. The Supreme Court’s ruling makes this a clear and present danger.
The South Carolina Origin Story
The case originated in South Carolina in 2018. Republican Governor Henry McMaster issued an executive order instructing the state’s Medicaid agency to find ways to prevent Planned Parenthood from receiving public funds. McMaster argued that “Taxpayer dollars must not directly or indirectly subsidize abortion providers.”
However, federal law already prohibits Medicaid funding for abortion services except in limited circumstances, and abortion is now largely banned in South Carolina after six weeks with few exceptions. Despite these facts, McMaster continued his efforts even after initial court setbacks.
Planned Parenthood operates two health centers in South Carolina, serving an estimated 6,000 patients annually. These centers provide essential services such as birth control, STI testing, and cancer screenings, in addition to abortion care.
In response to McMaster’s order, a South Carolina woman and Medicaid recipient named Julie Edwards, who relied on Planned Parenthood for her healthcare, sued. She argued that the order violated her right under the federal Medicaid Act to choose her qualified healthcare provider. Edwards initially won her case in 2020. This victory was upheld by the Fourth Circuit Court of Appeals upon re-examination, which agreed that the Medicaid Act grants patients the right to choose any qualified provider and that the state could not arbitrarily deny a patient like Edwards her choice. Planned Parenthood representatives noted they had won at every stage of the litigation prior to reaching the Supreme Court.
However, the Supreme Court’s decision reversed these lower court rulings, extinguishing this specific path for patients to challenge such state actions.
Dissenting Voices Warn of Harm
The Court’s three liberal justices sharply dissented. Justice Ketanji Brown Jackson, joined by Justices Elena Kagan and Sonia Sotomayor, wrote that the decision is “likely to result in tangible harm to real people.”
Jackson emphasized that the ruling strips Medicaid recipients of their most effective way to enforce a right granted by Congress. More broadly, she stated, it deprives them of a deeply personal freedom: “the ‘ability to decide who treats us at our most vulnerable.’”
Reactions and Potential Impacts
Planned Parenthood South Atlantic stated they were “deeply disappointed” but are “looking at all of our options” – legal and otherwise – to continue fighting for their patients. They believe the Court wrongly decided the Medicaid Act issue but see other potential avenues for challenge.
Reproductive rights advocates swiftly condemned the ruling. Destiny Lopez, CEO of the Guttmacher Foundation, labeled it a “grave injustice.” She highlighted that the decision compromises access to affordable, high-quality care, noting Guttmacher data showing one in three patients seeking birth control in 2020 received it from Planned Parenthood.
Nancy Northup, president and CEO of the Center for Reproductive Rights, stated the decision fuels campaigns seeking to deny Medicaid patients access to Planned Parenthood for non-abortion services like contraceptives and STI testing. She also warned that Congress is attempting to implement similar bans nationwide, prioritizing politics over patient health.
Planned Parenthood had previously estimated that a ruling favoring South Carolina could threaten the closure of nearly 200 of its health centers across 24 states. A significant majority—90 percent—of these potential closures could occur in states where abortion remains legal, underscoring the impact on services like cancer screenings and birth control.
Experience from states that have already removed Planned Parenthood from their Medicaid or family planning programs provides a preview of potential consequences. In Texas, where Planned Parenthood was excluded from both publicly-funded family planning and Medicaid networks, program access for enrollees dropped from 90 percent in 2011 to 59 percent in 2023. Over the same period, the use of birth control accessed through the program declined by 56 percent.
The Supreme Court’s decision significantly alters the legal landscape, removing a key tool patients previously had to protect their access to care at Planned Parenthood through state Medicaid programs. The fight over patient choice and provider access is expected to continue through other legal and political channels.
