Supreme Court Frees States to Put Health Over Abortion Politics

In a landmark decision on June 26, the US Supreme Court affirmed a simple but vital principle: States have the freedom to decide which health-care providers qualify for Medicaid funding without being sued in federal court.

That means states can stop sending taxpayer dollars to abortion giants such as Planned Parenthood and instead prioritize providers that offer real, comprehensive, life-affirming health care to women and families. This is a victory for the rule of law—and for those who believe our tax dollars shouldn’t be used to prop up the abortion industry.

South Carolina made the right call in determining that Planned Parenthood—with its narrow focus on abortion and contraception—failed to provide holistic care. So the state chose to redirect limited Medicaid funds to more of the nearly 200 publicly funded health care clinics that offer a broad range of services, such as full prenatal care, high-risk pregnancy care, mammograms, and treatment for conditions that Planned Parenthood isn’t equipped to treat.

Predictably, Planned Parenthood sued. It wanted the federal courts to force South Carolina to keep writing checks. The federal courts first ruled in Planned Parenthood’s favor, as they have in states and federal courts across the country for decades.

But in its decision last week, the Supreme Court disagreed, confirming that states should decide who qualifies for Medicaid funding. That’s exactly how Congress designed the program. States know best how to ensure their own residents get the high-quality health care they deserve, and now they’re finally free to do that.

As Justice Neil Gorsuch wrote for the majority, “Private enforcement actions, meritorious or not, can force governments to direct money away from public services and spend it instead on litigation. The job of resolving how best to weigh those competing costs and benefits belongs to the people’s elected representatives, not unelected judges charged with applying the law as they find it.”

This win has national significance. To begin with, it means fewer federal lawsuits against states when they administer federal spending programs—it’s a victory for federalism.

It also has national significance because of the parties involved. Planned Parenthood has long used the courts as a tool to keep its taxpayer funding flowing, even when states determined it was unqualified to receive it. States now have the green light to end those contracts and reinvest in providers who put women’s health over abortion politics.

And they should. More evidence is mounting that Planned Parenthood is a political machine wrapped in a health-care logo. The organization has made clear that its priority isn’t women’s health—it’s abortion advocacy.

In the last five years, Planned Parenthood’s national office distributed more than $899 million to its affiliates to “help them deliver care,” but much of that went to abortion rights campaigns and litigation rather than medical services. The human cost of this politicization is tragic.

One former Planned Parenthood employee described facilities as “a conveyor belt” where women were rushed through appointments like boxes on an assembly line. She saw mistakes happen—ranging from women being taken to the wrong rooms or prepped for wrong procedures to botched blood draws and women being given wrong medications.

That’s not appropriate care. And yet taxpayers have been forced to fund it. That needs to end.

The good news is that the American people agree.

According to multiple polls, a strong majority of Americans oppose using taxpayer dollars to fund abortions. And yet Planned Parenthood continues to receive more than half a billion dollars a year from taxpayers in the form of health services reimbursements and grants—adding up to $3.2 billion between 2018 and 2023.

Planned Parenthood rakes in hundreds of millions of dollars from private donors. It has a massive media presence and a powerful political lobbying arm. If it wants to pursue an ideological agenda, it can do that on its own dime.

We need to invest in providers that meet real needs. That means community health centers, rural clinics, and family health providers that offer everything from cancer screenings to prenatal care to menopause management. These are the clinics that walk with women through every stage of life.

Medina v. Planned Parenthood South Atlantic was a pivotal case that clarified whether states can be required to keep funding abortion businesses. The Supreme Court rightly said no. And that ruling sets a nationwide precedent, empowering every state to take back control of its health-care priorities.

Other states should follow South Carolina’s lead and end Medicaid contracts with Planned Parenthood. And Congress should go further—ending all federal funding to Planned Parenthood once and for all.

The case is Medina v. Planned Parenthood S. Atl., U.S., No. 23-1275, decided 6/26/25.

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.

This article does not necessarily reflect the opinion of Bloomberg Industry Group, Inc., the publisher of Bloomberg Law, Bloomberg Tax, and Bloomberg Government, or its owners.

Author Information

John Bursch is senior counsel and vice president of appellate advocacy with Alliance Defending Freedom and counsel of record for South Carolina officials in Medina v. Planned Parenthood South Atlantic.

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