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WASHINGTON (AP) — The Supreme Court appeared divided Wednesday in a case over whether states should be able to cut off Medicaid funding to Planned Parenthood, which comes amid a wider push from abortion opponents to defund the nation’s largest abortion provider.
Low-income patients who go there for things like contraception, cancer screenings and pregnancy testing could see their care upended if the court sides with South Carolina leaders who say no public money should go the organization.
The court is considering a legal question that could have wider effects: Whether Medicaid patients can continue to sue over the right to choose their own qualified provider.
South Carolina says those lawsuits aren't allowed and barring them would save public money in legal fees. Some conservatives appeared open to that argument. Justice Brett Kavanaugh said there has been confusion over the question in lower courts. “One of my goals coming out of this will be to provide that clarity,” Kavanaugh said.
The Trump administration weighed in to argue against the right to sue, with attorney Kyle Hawkins saying the government had “re-evaluated its position” after the election and come down on South Carolina's side.
The state says people could go through an administrative appeal process if denied coverage, though justices like Amy Coney Barrett raised questions about whether that would work for low-income patients. “That’s the beneficiary taking the risk, going to the provider she wants to see, and then potentially having to pay out of pocket, right?”
Planned Parenthood argues that Congress clearly wanted people to be able to make their own “intensely personal” decisions about which doctor to visit, and lawsuits are the only real way that right has been enforced.
Justice Elena Kagan agreed that patients do have the right to choose their doctor under the law, and suggested that blocking them from suing would be a sea change. “This is kind of changing the rules midstream, isn’t it?” Kagan said.
People on both sides of the issue gathered outside the court for demonstrations that included a brass band before arguments unfolded.
The case started in 2018, before the court's decision that overturned the nationwide right to abortion. South Carolina has since banned it after around six weeks’ gestation.
South Carolina's move to cut off Medicaid funding was blocked in court following a lawsuit from Medicaid patient Julie Edwards, who wanted to keep going to Planned Parenthood for the birth control she needed because her diabetes could make it dangerous for her to carry a pregnancy to term, according to court papers. The state eventually appealed to the Supreme Court.
Federal law prohibits Medicaid money from being used for abortions, with very limited exceptions, but patients often go there for other services because it can be tough to find doctors who accept the publicly funded insurance program and can schedule appointments quickly.
Other conservative states have also moved to cut Planned Parenthood out of the Medicaid program, and more would likely follow if South Carolina prevails. Attorneys for the state say patients can visit other health centers for care.
About one-quarter of everyone in the U.S. is enrolled in the program, and the American Cancer Society has said that losing the ability to sue would hurt their access to care, especially in rural areas.
In South Carolina, $90,000 in Medicaid funding goes to Planned Parenthood every year — a tiny fraction of a percentage point of the state’s total Medicaid spending.
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