In a landmark decision, the U.S. Supreme Court ruled 6-3 that states have the authority to exclude Planned Parenthood from receiving Medicaid funding for non-abortion services. This ruling, handed down on June 26, 2025, marks a significant moment in the ongoing legal battle over Medicaid funding for clinics that provide reproductive health services, including abortion.
Background of the Case: Medina v. Planned Parenthood South Atlantic
The case, Medina v. Planned Parenthood South Atlantic, involved South Carolina’s 2018 executive order, which barred Medicaid reimbursements to any clinic affiliated with abortion providers. The dispute began when South Carolina attempted to defund Planned Parenthood’s Medicaid reimbursements for non-abortion services, citing the organization’s affiliation with abortion services. In response, Planned Parenthood filed a lawsuit arguing that the exclusion violated the Medicaid Act’s provision for patient choice, which ensures that Medicaid recipients can choose their healthcare providers.
In 2020, a district court ruled in favor of Planned Parenthood, blocking the state from implementing the defunding order. However, this decision was overturned in 2022 by the Fourth Circuit Court of Appeals, which sided with the state’s ability to disqualify Planned Parenthood from receiving Medicaid funds. After the case was appealed, the Supreme Court took up the matter and delivered a final ruling on June 26, 2025.
The Supreme Court’s Majority Opinion
Justice Neil Gorsuch, writing the opinion for the majority, emphasized that the Medicaid Act does not confer an individual right to sue over the choice of providers. He explained that while the Medicaid Act allows for federal funding to be allocated for healthcare services, it does not grant beneficiaries the right to enforce provider eligibility in court. Instead, it gives states broad discretion in choosing which entities can receive Medicaid funds.
Gorsuch also acknowledged that the decision could restrict the availability of certain healthcare services, particularly reproductive health services, in certain states. However, the majority ruled that it was within the state’s right to choose how to allocate Medicaid funds, as long as the state complied with federal minimum requirements for patient care.
Dissenting Opinion: A Call for Patient Access
In the dissenting opinion, Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson argued that the decision would have a detrimental effect on patient access to necessary healthcare services. Justice Jackson pointed out that the ruling could particularly harm low-income women of color, who disproportionately rely on Planned Parenthood for healthcare services such as cancer screenings, birth control, and general reproductive care.
Sotomayor and Kagan further criticized the decision for undermining the Medicaid Act’s intent to expand healthcare access. They warned that the ruling would allow states to politically target and defund healthcare providers based on their involvement in services such as abortion, even if those providers offer critical healthcare services unrelated to abortion.
Implications for Planned Parenthood and Medicaid Recipients
This ruling marks a significant victory for conservative state lawmakers who have long sought to defund Planned Parenthood and restrict access to abortion-related services. With this decision, it is expected that other states will follow South Carolina’s lead in excluding Planned Parenthood and similar organizations from Medicaid funding.
For Planned Parenthood, this decision presents a setback, as it has historically relied on Medicaid reimbursements to provide essential health services to millions of women. The organization has vowed to continue fighting in other states, where similar restrictions on Medicaid funding are in place or being proposed. Planned Parenthood has also announced plans to explore additional legal avenues, including challenging state-level Medicaid restrictions in lower courts and seeking new protections through legislative action at the federal level.
The decision also raises concerns about the future of healthcare access for low-income Medicaid recipients, who may face barriers in obtaining essential reproductive and healthcare services if their providers are defunded.
Looking Ahead: What This Means for State Medicaid Programs
This ruling solidifies the broader trend of allowing states to exercise greater control over Medicaid funding decisions. While states have long had the authority to design their own Medicaid programs within the framework of federal guidelines, this decision could open the door for more states to disqualify providers based on political or ideological factors.
Legal experts warn that the ruling could set a precedent for challenges to Medicaid funding for other healthcare providers that perform services considered controversial by certain political groups. The ruling could also prompt federal lawmakers to introduce new legislation to better protect patients’ rights under Medicaid and ensure that political considerations do not restrict access to essential healthcare services.
