South Carolina Wants to End Medicaid for Planned Parenthood
The latest effort by conservative politicians to attack Planned Parenthood has the potential to strip the group of its ability to provide health care for the poorest Americans. On April 2, the U.S. Supreme Court will hear arguments over whether South Carolina can prohibit Medicaid funding for any health care services provided by Planned Parenthood.
The case, Medina v. Planned Parenthood South Atlantic, stems from a 2018 order by South Carolina Republican Gov. Henry McMaster, declaring that any clinic offering abortion services would be barred from the state’s Medicaid program. Medicaid is a state-federal program that provides health insurance coverage for people who are low income, and in the majority of states—including South Carolina—it doesn’t provide coverage for abortions, with very limited exceptions. In South Carolina, abortion is banned after about six weeks of pregnancy.
[time-brightcove not-tgx=”true”]After McMaster issued the order, Planned Parenthood and one of its patients filed a lawsuit, arguing that the order violates a provision of the Medicaid Act that allows recipients to choose any qualified health care provider. Lower courts blocked the governor’s order, and the U.S. Supreme Court agreed in December to hear the case.
Planned Parenthood South Atlantic (PPSAT)—which serves South Carolina, as well as North Carolina, Virginia, and West Virginia—has two clinics in South Carolina: one in Columbia and the other in Charleston. Planned Parenthood clinics in the state provide abortion services before week six of pregnancy, in accordance with state law, but they also offer many other health care services including birth control, STI testing and treatment, and cancer screenings.
“It’s completely clear that the case is motivated by the anti-abortion views of the South Carolina government,” says Dr. Katherine Farris, chief medical officer of PPSAT. “But the problem is what the case is actually about is not abortion—what it’s about is people being able to access preventative health care.”
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Alliance Defending Freedom (ADF), a conservative Christian and anti-abortion legal advocacy group, is representing South Carolina in the case. John Bursch, vice president of appellate advocacy for ADF and lead counsel for South Carolina on the case, says the state does “not want to use its tax dollars to prop up the abortion industry.” He adds that there are “many other publicly funded health care clinics in South Carolina [that] provide more comprehensive and real health care” that receive Medicaid funding, and claims that South Carolina is “not denying choice to anybody” to choose their medical provider.
More than a million people in South Carolina were enrolled in Medicaid as of June 2024, according to KFF. Many Medicaid recipients are people of color—in South Carolina, nearly three in five people enrolled in Medicaid identify as non-white, according to the Guttmacher Institute. Many of the patients who visit Planned Parenthood clinics are Medicaid recipients.
Farris says that if the state bars Medicaid coverage of Planned Parenthood services, that could lead to many patients not receiving care or their care being delayed. That could have “major health ramifications,” Farris says, such as unintended pregnancies or worsening health outcomes—for instance, if screenings and treatment for STIs or cancer are put off.
“The vast majority of health care providers either decline to accept Medicaid patients or severely restrict the number of new Medicaid patients that they will accept,” Farris says. “So functionally, those patients can’t get in and don’t have a provider. And at Planned Parenthood South Atlantic, we do not limit the number of Medicaid patients that we will see, which is fairly rare in the medical world.”
The U.S. Supreme Court will hear the case at a time when three other states—Texas, Arkansas, and Missouri—have already removed Planned Parenthood from their Medicaid programs.
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Many reproductive rights organizations—including the Center for Reproductive Rights, which filed an amicus brief for the case—have urged the court to side with PPSAT.
“We all know what a personal decision it is to decide what doctor to see and what doctor to visit, and you want somebody that you feel comfortable with, and that is even more important and essential when you are seeking sexual and reproductive health care,” says Autumn Katz, interim director of U.S. litigation for the Center for Reproductive Rights.
Bursch says that the Medicaid Act dictates that a state can disqualify a provider if it doesn’t provide services in compliance with state law. He says that PPSAT still provides abortion services before six weeks of pregnancy (which is legal in South Carolina) and that the group advocates against South Carolina’s abortion restrictions. When asked about Bursch’s comments in a press briefing, Catherine Peyton Humphreville, senior staff attorney for Planned Parenthood Federation of America who is representing PPSAT in this case, said that the organization “complies with all South Carolina laws—this includes South Carolina’s very draconian abortion ban.”
“PPSAT does provide the very limited number of abortions it’s able to provide under the state’s abortion ban,” Humphreville says. “The idea that [South Carolina] can punish PPSAT for advocating—simply advocating for abortion, not just providing abortion, but advocating for abortion—has serious First Amendment issues.”
On March 31, Planned Parenthood said that nine of its affiliates received notice from the Trump Administration that starting April 1, the government would freeze funding under a federal program known as Title X, which makes millions of dollars available to clinics that provide family planning services for people who are low income. Planned Parenthood receives more Title X funding than any other provider.
Reproductive rights advocates say that the impact of Medina v. Planned Parenthood South Atlantic could be far-reaching. Katz says that if the U.S. Supreme Court was to side with South Carolina, other states that have implemented abortion restrictions or bans could follow suit, and that it could even open the door to states disqualifying other providers from the Medicaid program for arbitrary reasons. “They could try to exclude providers who provide other forms of health care that a state politician disagrees with or finds offensive,” Katz says. “I think that that is really what’s at stake.”
“This is not the first time that a state has tried to exclude Planned Parenthood from participating in the Medicaid program,” she says, “but other states will certainly try to do the same.”