In a landmark decision, the Supreme Court backed South Carolina’s right to restrict federal Medicaid funding, raising profound questions about legal implications and the enduring legacy of justice.
At a Glance
- The U.S. Supreme Court ruled 6-3 in favor of South Carolina, allowing the state to exclude Planned Parenthood from its Medicaid program.
- The decision holds that Medicaid recipients do not have the right under federal law to sue states in federal court over their choice of providers.
- The case stemmed from South Carolina’s 2018 move to defund Planned Parenthood because it is an abortion provider.
- The ruling is a major victory for conservative states seeking to block Medicaid funds from going to organizations that offer abortions.
The Supreme Court’s Landmark Decision
The U.S. Supreme Court delivered a major blow to abortion rights advocates on Thursday, June 26, 2025, ruling that states have the authority to exclude abortion providers like Planned Parenthood from their Medicaid programs. In a 6-3 decision split along ideological lines, the court reversed lower court rulings that had blocked South Carolina’s efforts to defund the organization.
The core of the ruling is that individual Medicaid patients do not have a right under federal law to sue states in federal court to challenge the disqualification of a medical provider. This effectively removes a key legal avenue that has been used for decades to protect patient access to care at Planned Parenthood clinics.
The South Carolina Case
The legal battle began in 2018 when South Carolina, under the leadership of Republican Governor Henry McMaster, moved to terminate Planned Parenthood’s provider contract with the state’s Medicaid program. The state argued it had the right to do so because the organization is the nation’s largest abortion provider.
This was despite the fact that federal law already prohibits the use of Medicaid funds for abortions, except in cases of rape, incest, or to save the life of the mother. The funds in question were for other health services, such as contraception, STI testing, and cancer screenings. “Taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs,” Governor McMaster said in a statement reported by National Review.
Gorsuch and the Majority’s Reasoning
Writing for the conservative majority, Justice Neil Gorsuch argued that the federal Medicaid statute does not create a right that can be enforced by individuals in court. He asserted that it is up to federal agencies, not individual patients, to ensure states are complying with the law.
“Though it is rare enough for any statute to confer an enforceable right,” Gorsuch wrote, according to The Wall Street Journal, “spending-power statutes like Medicaid are especially unlikely to do so.” The decision significantly strengthens states’ authority over how they administer their Medicaid programs.
The ruling is expected to have immediate national implications, as other conservative states that have been blocked by lower courts from defunding Planned Parenthood are now likely to move forward with similar policies.
