States have more leeway to defund Planned Parenthood, the nation’s largest abortion provider, after a major decision from the Supreme Court on June 26.
The case, known as Medina v. Planned Parenthood, focused on South Carolina’s attempt to prevent Medicaid dollars from flowing to the organization.
Planned Parenthood and one of its patients sued, alleging that the state’s decision violated the federal law establishing Medicaid, which allows recipients to choose their providers.
The Supreme Court’s ruling, however, said that patients didn’t have a clear right to sue over that provision of the Medicaid Act.
The justices discussed a variety of issues, including a separate law known as Section 1983 that allows Americans to sue the government over alleged violations of their rights.
This, in turn, sparked discussion about the history of that law and the civil rights movement within the United States.
Here are some key takeaways from the court’s new opinion, as well as insights on how this could impact state efforts to defund Planned Parenthood.
No Right to Sue Over Medicaid Providers
States receive Medicaid funding after submitting a plan to the federal Health and Human Services Department, which can revoke states’ funding based on whether they comply with various conditions.
One of those falls under the “any-qualified-provider provision” of the Medicaid Act, which allows Medicaid recipients to obtain medical assistance from the qualified provider they choose.
It’s unclear what exactly “qualified” means in the law, but Justice Neil Gorsuch’s majority opinion indicated that whether a provider is designated qualified or unqualified should be left to the states.
However, the Health and Human Services secretary may still withhold a state’s Medicaid funding if that official deems the state out of compliance with conditions outlined in federal law.
As Gorsuch noted, this case didn’t prevent the secretary from doing that.
Instead, the state questioned whether recipients could attempt to enforce the Medicaid Act through Section 1983, which allows lawsuits over violations of rights.
The problem in this case, the majority said, was that even though the Medicaid Act allowed recipients to choose their providers, it didn’t clearly establish the kind of right that would allow a lawsuit under Section 1983.
Part of the majority’s reasoning was that the Medicaid Act was better viewed as a form of spending that provided benefits, rather than “rights.”
It also said that for Congress to establish some kind of enforceable right in a federal law, it had to do so in a clear or unambiguous way.
That didn’t happen with the provider provision, according to the majority.
Easier to Defund Planned Parenthood
The court’s decision represented a narrow win for the pro-life movement, which has been struggling for years to defund Planned Parenthood at both the state and federal levels.
Missouri, Arkansas, Mississippi, and Texas previously removed Planned Parenthood from their Medicaid networks, according to the group.
Although the case didn’t settle whether states could deem Planned Parenthood an unqualified provider, it did remove a legal path groups can use to challenge a state’s decision on the qualification issue.
The court’s decision opened the door for other states to remove the abortion provider’s Medicaid funding.
Alliance Defending Freedom attorney Erik Baptist, whose organization represented South Carolina at the Supreme Court, said on June 26 that the decision “liberates” other states that faced court orders blocking their Planned Parenthood defunding attempts.
Justice Ketanji Brown Jackson’s dissent similarly indicated the decision could have big consequences.
“It will strip those South Carolinians—and countless other Medicaid recipients around the country—of a deeply personal freedom,” she said.
Congress Needs to Explicitly Grant Right to Sue
Justice Neil Gorsuch said that Section 1983 only allows private plaintiffs to sue under federal spending-power statutes such as the Medicaid Act in unusual situations where the law “clearly and unambiguously confers an individual right.”
The problem is the Medicaid Act isn’t one of those statutes, he said.
Creating new rights for some means creating new duties for others, as well as forcing governments to spend money litigating instead of providing public services, and courts shouldn’t be deciding such an important issue, he said.
“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,” Gorsuch said.
Thomas and Jackson Diverge on Civil Rights
Justice Clarence Thomas said Section 1983, which came out of the Civil Rights Act of 1871, is being used today in ways that were not originally intended.
Over the years, it has expanded to cover state actions barely connected to civil rights, he said.
Thomas said the court should revisit its past decisions to reassess the “bounds” of Section 1983 and the “rights” enforceable under it.
Jackson said that in this case, South Carolina asked the court to allow it to “evade liability” for violating Medicaid patients’ rights.
The court’s decision will probably cause “tangible harm to real people” who want to enforce a right to redress that Congress explicitly gave them, she said.
This article by Sam Dorman and Matthew Vadum appeared June 26, 2025, in The Epoch Times.