Justices Lean Toward Planned Parenthood in Medicaid Row Case (1)

A majority on the US Supreme Court seemed to doubt South Carolina’s claim that Medicaid recipients can’t sue over the state’s decision to exclude a Planned Parenthood affiliate from its program.

In their questions during arguments Wednesday, Chief Justice John Roberts and Justice Amy Coney Barrett appeared concerned that people on Medicaid wouldn’t have any other way to challenge a state’s decision to nix their preferred health-care provider.

Roberts said one of the benefits provided by the Medicaid Act is recipients may choose their own doctor.

“If the person thinks that’s not being provided, what remedies do they have?” he asked

Barrett raised a similar question.

“There’s no mechanism, am I right, for the beneficiary to say ‘well, you’re depriving me of my ability,’ I won’t call it ‘right’ and use the loaded word, ‘of my ability to see the provider of my choice,’” she said.

At issue is the “any-qualified-provider” provision in the Medicaid Act, which says any recipient “may obtain” care from any qualified and willing provider. The question for the court is whether that language gives Medicaid recipients the right to enforce it in court.

The court’s liberal wing suggested they resoundingly agree it does.

Justice Elena Kagan said she doesn’t know how to say the state has an obligation to ensure a person has a right to choose their doctor without saying the word “right.”

“That’s what this provision is,” she said. “It’s impossible to even say the thing without using the word ‘right’”

The case, which stems from Republican official’s decision to withdraw funding from abortion providers in 2018, raises a technical question of how to interpret language in one provision of federal spending legislation.

South Carolina’s Health and Human Services director and the federal government say a ruling for the Medicaid recipient here could raise questions about who can enforce other federal-state programs and lead to an influx in litigation. Ruling against her could allow states to strip Medicaid recipients of the ability to choose their own doctor, public health organizations told the court in a brief.

Abortion Related

The case isn’t about abortion rights, but it stems from South Carolina Gov. Henry Dargan McMaster’s (R) decision to remove a health-care provider from its Medicaid program because it performs abortions. Although Planned Parenthood South Atlantic said it doesn’t accept Medicaid for those procedures, the state said they were being indirectly subsidized by the program.

Julie Edwards, who’s insured through Medicaid, said removing the Planned Parenthood affiliate from the state’s program violated her right to choose her own doctor and sued the state along with Planned Parenthood South Atlantic.

“I mean, this is a very individual choice that Congress was trying to protect,” said their attorney Nicole Saharsky, of Mayer Brown LLP. “It’s individuals who are hurt.”

The state argues the “may obtain” in the “any-qualified-provider” provision isn’t clear language that gives individuals on Medicaid the right to sue in court to pick the doctor of their choosing.

“Certainly, a state would understand it has to provide a benefit, but absent clear rights-creating language, it wouldn’t know that it had to honor a right,” said John Bursch, who represented the state’s Health and Human Services secretary.

Bursch is senior counsel and vice president of appellate advocacy at Alliance Defending Freedom, a Christian legal group that helped Mississippi write and defend an anti-abortion law that led to the Supreme Court overturning the constitutional right to abortion in 2022.

He argued Congress could have said “for example, a beneficiary has a right to designate her provider.”

Justice Brett Kavanaugh said he’s “not allergic to magic words because magic words, if they represent the principle, will provide the clarity that will avoid the litigation that is a huge waste of resources for states, courts, providers, beneficiaries, and Congress.”

The US Court of Appeals for the Fourth Circuit said the provision unambiguously gives Medicaid-eligible patients an individual right to choose their own provider, which they can enforce through litigation.

Planned Parenthood has received funding from Bloomberg Philanthropies, the charitable organization founded by Michael Bloomberg. Bloomberg Law is operated by entities controlled by Michael Bloomberg.

Medina v. Planned Parenthood South Atlantic, U.S., No. 23-1275, arguments 4/2/25