Supreme Court to Hear Case About States’ Funding of Abortion Facilities

Pro-life states like South Carolina should be able to direct Medicaid funds away from abortion providers such as Planned Parenthood.
Alliance Defending Freedom

Written by Alliance Defending Freedom

Published November 1, 2022

Revised July 12, 2024

Supreme Court to Hear Case About States’ Funding of Abortion Facilities

Should states be able to determine which healthcare providers are entitled to receive Medicaid funds? A new Supreme Court case is showing why the answer to that question could have serious implications for pro-life states.

How the Medicaid program works

In 1965, Congress created Medicaid to help low-income families pay for medical expenses. It is a joint program between the federal government, which provides some of the funding, and the states, which are responsible for providing the rest and administering the program.

Two years later, Congress amended the Medicaid Act to add a provision requiring that plans must allow eligible individuals to obtain medical assistance from any qualified provider. At the same time, the amendment did not define who was “qualified,” and it allowed states broad authority to make that determination.

In the decades since, this amendment has created confusion in the courts over whether “Spending Clause” statutes like the Medicaid Act create a “privately enforceable right” for individuals on Medicaid. In other words, does the individual’s ability to seek medical assistance from any qualified provider mean they have a right to challenge a state’s determination that a specific medical provider is not qualified to receive Medicaid funds in federal court?

That question leads to another: whether pro-life states can direct their limited Medicaid funds—funds intended to help low-income individuals obtain necessary medical assistance—away from abortion providers like Planned Parenthood.

That question is at the heart of Alliance Defending Freedom’s case Medina v. Planned Parenthood South Atlantic.

A sign on the side of the road marks the South Carolina state line
States should be free to use taxpayer dollars to support life-affirming healthcare options.

How did this case reach the Supreme Court?

In July 2018, consistent with a state law prohibiting the use of taxpayer funds to pay for abortions, South Carolina’s governor issued an executive order directing the South Carolina Department of Health and Human Services (SCDHHS) to label abortion facilities unqualified to provide family-planning services through Medicaid. This order rendered abortion providers like Planned Parenthood unable to receive Medicaid funding in South Carolina.

In response, Planned Parenthood and one of its clients sued in federal court. An earlier version of the case, Planned Parenthood South Atlantic v. Baker, went up to the Supreme Court but was denied review. This allowed a preliminary ruling in Planned Parenthood’s favor from the U.S. Court of Appeals for the 4th Circuit to stand. While the case proceeded in the district court, that court issued a summary judgment in Planned Parenthood’s favor, followed by a permanent injunction preventing South Carolina from denying Planned Parenthood Medicaid funding based on the governor’s determination that abortion facilities are not qualified providers.

After that, South Carolina appealed again to the 4th Circuit. ADF Senior Counsel and Vice President of Appellate Advocacy John Bursch argued the case on behalf of South Carolina. Unfortunately, the 4th Circuit again ruled in favor of Planned Parenthood, so ADF appealed to the Supreme Court.

In June 2023, the Supreme Court issued its decision in Health and Hospital Corporation of Marion County v. Talevski, a different case that raised similar issues. In light of that ruling, the Supreme Court vacated the 4th Circuit’s decision in ADF’s case and remanded the case back to that court to reconsider. When that court once again ruled in favor of Planned Parenthood, ADF appealed the case back to the Supreme Court.

Planned Parenthood shouldn’t receive Medicaid funds

Planned Parenthood is already rolling in public funding. Between 2019 and 2021, the organization received over $1.5 billion in direct payments from the government—to say nothing of its private donors. What’s more, while Planned Parenthood calls itself a “healthcare provider,” a better descriptor for the organization would be “abortion peddler.”

According to its most recent annual report, Planned Parenthood performed 392,715 abortions between Oct. 1, 2021, and Sept. 30, 2022, representing a 5 percent increase from the previous year and an increase of over 70 percent in just two decades. At the same time, Planned Parenthood’s legitimate medical services have all decreased in recent years. From 2022 to 2023, preventative care visits fell by 31 percent.

By one recent count, there are 140 federally qualified women’s healthcare clinics and pregnancy centers in South Carolina. These providers offer a much broader range of care than Planned Parenthood does, with many of them capable of treating pregnancy complications. Can pro-life states like South Carolina, consistent with the will of their citizens and state law, direct taxpayer Medicaid funds to medical providers offering real healthcare services instead of abortion providers like Planned Parenthood?

The answer should be yes. States should be free to use taxpayer dollars in accordance with their own state laws and priorities. No citizen should be forced to fund facilities that perform life-ending and medically fraught procedures like abortion.

Medina v. Planned Parenthood South Atlantic

  • July 2018: The governor of South Carolina issued an executive order directing the South Carolina Department of Health and Human Services to label abortion facilities enrolled in the Medicaid program as unqualified to provide family-planning services. Two weeks later, Planned Parenthood and one of its individual clients sued. The ensuing case (Planned Parenthood South Atlantic v. Baker) was preliminarily decided in Planned Parenthood’s favor at the district court and the 4th Circuit before being denied review at the Supreme Court.
  • September 2020: Based on the 4th Circuit’s ruling, the district court issued a summary judgment in Planned Parenthood’s favor.
  • December 2020: The district court issued a permanent injunction preventing Planned Parenthood from being terminated as a qualified Medicaid provider. South Carolina appealed this decision to the 4th Circuit, where ADF Senior Counsel John Bursch argued on behalf of South Carolina.
  • March 2022: The 4th Circuit affirmed the lower court’s decision. ADF then appealed to the Supreme Court.
  • June 2023: The Supreme Court vacated the 4th Circuit’s decision and remanded the case back to that court to reconsider.
  • December 2023: ADF attorneys presented oral argument before the 4th Circuit.
  • March 2024: The 4th Circuit ruled in favor of Planned Parenthood.
  • June 2024: ADF attorneys again appealed to the Supreme Court.
  • December 2024: The Supreme Court announced it would hear the case.

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