In a major decision affecting healthcare access and states' authority, the U.S. Supreme Court ruled Thursday that South Carolina can block Medicaid funds from going to Planned Parenthood clinics.

The 6-3 ruling limits the ability of Medicaid patients to challenge states' provider restrictions in federal court, further intensifying national debates over abortion access and healthcare equity for low-income communities, Fox News reported.

The case, Medina v. Planned Parenthood South Atlantic, focused on whether patients enrolled in Medicaid programs have the right to sue under federal civil rights law when states prevent them from choosing certain medical providers. At issue was a key provision in the Medicaid Act allowing patients the freedom to pick among qualified healthcare providers.

State Order Sparked Legal Clash

The dispute began with a 2018 executive order from South Carolina Gov. Henry McMaster. The order directed the state’s Department of Health and Human Services to exclude abortion providers—including Planned Parenthood South Atlantic—from the list of approved Medicaid healthcare providers.

Planned Parenthood challenged the directive, asserting it violated federal rules that guarantee Medicaid recipients the freedom to choose their healthcare provider. The organization, which operates clinics in Columbia and Charleston, said the move would reduce access to contraception, cancer screenings, and STI testing for hundreds of low-income patients.

Lower federal courts initially sided with Planned Parenthood. The Fourth Circuit Court of Appeals allowed patients to challenge the South Carolina directive, ruling that the Medicaid Act gave them enforceable rights under Section 1983 of the Civil Rights Act of 1871.

Supreme Court Reverses Patients' Legal Path

On June 26, the Supreme Court reversed that decision. Writing for the majority, Justice Neil Gorsuch said that the Medicaid law’s provider-choice clause did not give patients an individual right to sue under Section 1983.

Gorsuch stated that private litigation under Section 1983 is only allowed when a statute unmistakably creates a personal right. “New rights for some mean new duties for others,” he wrote, noting that letting individuals sue could financially burden state governments.

He also emphasized that decisions about balancing benefits and costs should be left to elected lawmakers and not the judiciary. According to the majority opinion, the responsibility for resolving such policy issues lies with the Secretary of Health and Human Services.

Dissent Warns Against Eroding Patient Protections

Justice Ketanji Brown Jackson authored the dissent, joined by Justices Sonia Sotomayor and Elena Kagan. Jackson argued that the ruling severely weakens longstanding protections under Section 1983, which historically allowed individuals to seek remedies in federal court for violations of federal law.

“That venerable provision,” she wrote, “permits any citizen to obtain redress in federal court for the deprivation of any rights … secured by the Constitution and laws.” She accused South Carolina of attempting to circumvent federal requirements by restricting Medicaid participants' access to trusted providers.

Planned Parenthood maintained that the case was not about abortion services, which are already restricted from federal Medicaid funding except in limited cases. Instead, the organization emphasized it was about ensuring continued access to basic healthcare services for vulnerable patients.

National Implications and Public Response

Protesters gathered outside the Supreme Court during oral arguments in April, demonstrating the emotion and attention surrounding the case. Opponents of state restrictions underscored the potential for reduced healthcare options, especially in underserved areas.

South Carolina, represented by the conservative legal group Alliance Defending Freedom, argued that hundreds of other publicly funded clinics remained available across the state. They said this ensured Medicaid patients could still access care without government funds going to organizations associated with abortion services.

Currently, South Carolina bans most abortions after about six weeks, with few exceptions. This decision adds another policy dimension to the state's stance on reproductive care and could influence similar efforts in other states seeking to withhold funds from certain providers.

Healthcare and Rights in Question

By barring lawsuits based on the free-choice-of-provider provision, the ruling narrows how Medicaid recipients challenge state-level healthcare decisions. For opponents, this sets a precedent that may allow more states to enact similar exclusions without legal consequences from patients.

The ruling could reverberate beyond South Carolina. As states assert greater control over Medicaid programs, federal courts may offer fewer opportunities for patient-led challenges involving access and provider selection.

This case not only underscores deep divides over abortion-related funding but also raises enduring questions about who can hold state governments accountable for federal healthcare policy compliance.