The U.S. Supreme Court may have turned the page on its previous role in ruling on national abortion policy, but it appears that the justices will still have a prominent part to play in the next chapter.
On April 2, the court will hear a case that does not directly affect abortion law but could have significant implications for the nation’s largest abortion provider.
At the heart of the case is the question of whether federal law unambiguously bestows Medicaid patients with the right to choose a specific provider. Planned Parenthood and the Fourth Circuit Court of Appeals say it does.
But the state of South Carolina, which bars taxpayer funding of abortion, says the law empowers states to decide which providers are qualified for Medicaid funding. South Carolina has asked the Supreme Court to step in.
The Case
The case was prompted by South Carolina Gov. Henry McMaster’s 2018 directive ordering the state’s health department to terminate all abortion providers from the Medicaid program. The order deemed all abortion clinics to be “unqualified” to provide family planning services.Planned Parenthood South Atlantic and one of the affiliate’s Medicaid patients swiftly filed a federal lawsuit challenging the order.
At issue is a provision of the Social Security Amendments of 1965, also called the Medicare and Medicaid Act. The statute requires state Medicaid plans to “provide that any individual eligible for medical assistance ... may obtain such assistance from any [provider] qualified to perform the service or services required ... who undertakes to provide him such services.”
Planned Parenthood holds that verbiage grants Medicaid beneficiaries the right to receive care from the qualified and willing provider of their choice.
The district and appeals courts both agreed, finding that the law “unambiguously [creates] a right privately enforceable” under a civil rights statute.
But John Bursch, Alliance Defending Freedom senior counsel, who represents South Carolina in the case, told The Epoch Times that the law does not define what constitutes a qualified provider, leaving that determination to the states. He said that fact alone contradicts the claim that patients have a right to choose any provider they wish.
“If you think about our free speech rights in the First Amendment, that would be like the First Amendment then giving Congress the ability to say what speech is. We don’t create rights that way,” he said.
Bursch also argued that Planned Parenthood did not follow the appropriate legal process for appealing its Medicaid disenrollment.
He noted that the South Carolina Department of Health and Human Services has an administrative appeal process for Medicaid determinations that providers agree to when they enroll in the program.
“[Planned Parenthood] could have filed an administrative appeal, and if that wasn’t successful, appealed to the state court system; and if that wasn’t successful, appealed to the U.S. Supreme Court. But instead, they recruited a client and had her bring a federal lawsuit with Planned Parenthood as co-plaintiff,” Bursch said.
One case that Planned Parenthood is likely to cite during the Supreme Court hearing is Health and Hospital Corporation of Marion County v. Talevski, a case that the court decided in 2023.
“There, they had a statute that basically included a nursing home residents’ bill of rights in which the word ‘right’ appears like two dozen times,” he said.
Bursch also noted that the law in question also contained a choice of doctor provision that used the phrase “resident’s right to choose a doctor.”
“This is the exact converse of that,” he said, holding that the Medicaid Act “doesn’t have any rights-creating language.”
“All it does is require that a state have this ‘any qualified provider’ provision in its plan,” Bursch said.
The Numbers
South Carolina law expressly prohibits the use of taxpayer dollars to fund abortion, a procedure that the state has restricted to within the first six weeks of pregnancy, with limited exceptions.While the Hyde Amendment prohibits federal funding of abortion, Planned Parenthood still receives billions of taxpayer dollars every year to provide patients with other services, including contraception, testing for pregnancy and sexually transmitted diseases, and screenings for cancer and other health conditions.
Planned Parenthood’s most recent annual report reveals that it received nearly $700 million, or 34 percent of its total revenue, from taxpayers in 2023. The organization also reports that more than three-quarters (76 percent) of its clinics are in rural or low-income communities, and nearly half (49 percent) of all its patient visits are covered by Medicaid or the Title X family planning program.
“Every person should be able to access quality, affordable health care from a provider they trust, no matter their income or insurance status,” Jenny Black, then-Planned Parenthood South Atlantic President and CEO, said after the Supreme Court accepted the case in December 2024.
“This case is politics at its worst: anti-abortion politicians using their power to target Planned Parenthood and block people who use Medicaid as their primary form of insurance from getting essential health care like cancer screenings and birth control.”
McMaster, on the other hand, argued that even funds directed toward those services ultimately subsidize abortion by offsetting Planned Parenthood’s other expenses.
“South Carolina has made it clear that we value the right to life. Therefore, taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs,” the governor said in a Feb. 10 statement.
“Just as I was in 2018, I am confident in our authority to terminate funding for Planned Parenthood, and I trust that the U.S. Supreme Court will agree.”
The Stakes
For Planned Parenthood, such a ruling could prove fatal given the organization’s heavy reliance on government funding.While it wouldn’t mark the first time that a state has successfully defunded Planned Parenthood—Arkansas, Mississippi, and Texas have already done so—the decision would likely embolden additional states to take the same path.
The ramifications could also go beyond limiting funding for the major abortion provider, according to Stacey Lee, a Johns Hopkins University professor of law and ethics.
“This case extends far beyond abortion,” Lee told The Epoch Times. “It questions whether a low-income woman can continue seeing her established doctor for annual exams, cancer screenings, or contraception—simply because that provider also performs legal abortions with separate, non-Medicaid funds. If the court sides with South Carolina, the resulting patchwork of care would disproportionately harm vulnerable populations with limited health care options.”
She also contended that the case could encourage states to strip other health care providers of government funding for political reasons “rather than quality of care or professional qualifications.”
On the contrary, Bursch argued that a ruling in favor of Planned Parenthood could have negative repercussions for women and children.
“To the extent that you’re getting any services at all in a Planned Parenthood clinic, [those services are] not very good,” he said, citing recent reports of the deteriorating facilities and care at various Planned Parenthood clinics.
“And then on top of all that, you now have them bragging that they are the second-biggest provider of those dangerous and experimental gender transition drugs—drugs that the worldwide medical community have condemned for children and which Planned Parenthood not only gives to minors but does so without their parents’ consent.”
Bursch said he hoped that federal lawmakers would consider those factors when deciding whether to defund Planned Parenthood at the national level.
A push to strip the organization of all federal funding has been revived in recent months. A favorable ruling from the nation’s high court could add to that momentum.
However, the opposite ruling could be a blow for the pro-life movement. Other states’ decisions on the matter would likely be walked back, and the political shift could deter some lawmakers from voting to change the status quo nationwide.
At the Alliance Defending Freedom, a pro-life organization, Bursch said he and his colleagues relish any opportunity to “promote the value of protecting unborn life.”
“[But this case] isn’t just about protecting babies,” he said. “It’s also about protecting women.”
