Supreme Court hears oral arguments on states’ right to refuse Medicaid funds to abortion providers

The US Supreme Court on Wednesday heard oral arguments in a case that could decide whether states may stop funding Planned Parenthood through the federal Medicaid program.

In Medina v. Planned Parenthood South Atlantic, the state of South Carolina is defending its right to exclude abortion vendors from receiving Medicaid taxpayer dollars.

At a press briefing following the oral arguments, Alliance Defending Freedom (ADF) Senior Counsel John Bursch, who argued before the High Court on behalf of the South Carolina Department of Health and Human Services, described the case as one “that will decide whether South Carolina is free to direct taxpayer Medicaid dollars in a way that it believes will most benefit low income women and families.” 

Bursch said Planned Parenthood was engaged in “performing abortions and providing dangerous gender transition drugs – not comprehensive health care,” citing financial details from Planned Parenthood’s own annual reports as evidence.

“According to its own reporting, Planned Parenthood performs between one-third and two-thirds of all abortions in the United States annually, while its provision of other medical services declined,” he said. “Between 2022 and 2023, preventative care visits fell 31% and the number of patients seen annually has fallen by 60% since the 1990s. Meanwhile, cancer screening and prevention services have dropped by 71% since 2010.” 

Busch then referred to a February New York Times exposé that described a Planned Parenthood organization “in crisis” and delivering “botched care.”

According to the bombshell story, he asserted, “over the last five years, the national office has distributed more than $899 million to affiliates to help them deliver care, but none of it went directly to medical services.”

“Much of it went instead to pro-abortion politicking and legal support,” Busch observed. “Planned Parenthood’s own leaders say they have repeatedly prioritized the political fight for abortion over supporting their affiliates that are supposed to be providing care for women. In sum, Planned Parenthood’s leadership has openly prioritized abortion activism over maintaining its facilities and offering essential health care for low-income patients.” 

In addition to serving as the nation’s largest provider of abortions, Planned Parenthood has also become America’s “second largest provider of dangerous gender transition drugs,” Bursch continued. “They even admit to giving them to minors across the country. These drugs cause irreversible harm and create lifelong medical dependencies.”

“Taxpayers should not be compelled to fund an organization that profits from abortion and pushes experimental treatments on vulnerable children, and low-income women are entitled to better treatment than Planned Parenthood provides,” Busch said, explaining that South Carolina already offers about 200 publicly-funded health care clinics that provide numerous high quality health care services, including family planning.

“We are hopeful that the Court will affirm that Congress never intended for Medicaid recipients to be able to drag states to federal court to defend individual provider disqualification decisions, or for courts to override states’ reasonable decisions about who is qualified to provide health care,” Busch said.

In a press statement released following oral arguments, Rep. Chris Smith, R-NJ, co-chair of the House Pro-Life Caucus, said that “South Carolina rightly decided to make its Medicaid dollars available for real health care options.” 

“The multibillion-dollar abortion industry cleverly markets the sophistry of choice while going to extraordinary lengths to ignore, trivialize and cover-up the battered baby-victim,” Smith added. “However, the truth is that the child decapitation, dismemberment and starvation that occur at Planned Parenthood is not health care.”

Smith’s office observed that “Medicaid reimbursements are by far Planned Parenthood’s largest federal funding source, providing $1.5 billion in reimbursements nationwide over three years.” 

Planned Parenthood’s access to Medicaid funding “remains uncertain,” reported the Washington Examiner following what it described as “an intense oral argument session” before the Court, during which “abortion was only briefly mentioned.”

“Much of the courtroom debate centered not on abortion, but on whether patients have any legal standing to challenge the state’s decision,” the Examiner noted.

Bursch reportedly told the media outlet that his team felt confident about its case.

“The Justices seemed to get the point that we were making, which is that Congress creates rights enforceable in federal court only when it uses clear, explicit language in the statute, and that provision that we’re talking about today simply doesn’t have that,” he said, adding that four of the justices – Brett Kavanaugh, Neil Gorsuch, John Roberts, and Amy Coney Barrett – appeared open to South Carolina’s view.

Kavanaugh, in particular, the report noted, asserted that “this court has failed to give guidance” on the central issue in the case, adding, “One of my goals coming out of this will be to provide that clarity.”

In 2018, South Carolina, a pro-life state, determined via an executive order of Republican Gov. Henry McMaster’s that Planned Parenthood – whose main service is abortion – is not a qualified recipient of taxpayer funds under the Medicaid program. But a lawsuit on behalf of a Medicaid user led to a federal district court forcing the state to permanently restore Planned Parenthood’s funding.

ADF attorneys appealed to the US Court of Appeals for the 4th Circuit, which ruled against South Carolina. After several years of litigation, the Supreme Court granted review in December.