Supreme Court Denies Right to Challenge Medicaid’s Planned Parenthood Exclusion

On June 26th, 2025, the Supreme Court decided against Medicaid recipients’ right to challenge the exclusion of Planned Parenthood as a covered provider. Under the direction of its governor, Henry McMaster, South Carolina began excluding Planned Parenthood from its Medicaid program in 2018. The exclusion came because of the organization’s offering of abortion services, which the governor argued would be “effectively subsidized”, should it continue being funded by the program. Medicaid, while made possible through the states’ partnership, is federally funded, which generally bars use of the funds on abortion services.

This exclusion is what led Julie Edwards to bring suit, arguing that the exclusion violated the “any qualified provider” provision of the Medicaid Act. The provision provides that any recipient under the Medicaid program may seek care from any qualified provider, which Edwards sought to do. She had been previously treated by Planned Parenthood and was seeking to transfer all gynecological and reproductive care to the organization.

The majority based their denial of the right to challenge on a 2023 decision of the court, which upheld participants right to sue under the Federal Nursing Home Reform Act. Justice Gorsuch stating that the earlier decision allowed for suit due to the laws explicit language – “a right to choose a personal attending physician”, rather than “any qualified provider”. The court here found the Medicaid Act language too broad to meet the bar previously set. Gorsuch also shuts down room for interpretation of the rights existence, saying Congress knows how to write clear and unambiguous language to provide for those rights, and chose not to do so for the Medicaid Act.

The majority emphasized that for laws like the Medicaid Act, private lawsuits are not typical. Instead, most violations of laws providing funding with conditions from Congress, such as the Medicaid Act, result in the termination of federal funds. To have standing, Gorsuch states plaintiffs would have to prove the entity receiving the federal funds was put on notice to potential private lawsuits, through Congress’ clear and unambiguous “intent to confer individual rights”.

Dissenting Justices pointed to the “stymying” of civil rights and the majority’s “simple” interpretation of the Act. Focusing on the language of the “any qualified provider” provision and its title, Jackson felt the burden of the unambiguous conferring of individual rights was met in this case. And yet, without Planned Parenthood’s challenge of its exclusion through administrative processes or state courts, the exclusion will remain in place for South Carolina Medicaid recipients.

For more information about your rights under the Medicaid program, contact the qualified attorneys at Rock Fusco & Connelly, LLC.