In a 6-3 decision on Medina v. Planned Parenthood South Atlantic, the U.S. Supreme Court ruled Thursday that South Carolina can exclude Planned Parenthood from its Medicaid program—a technical decision with major implications for both abortion access and healthcare rights. The case focused on whether Medicaid patients can sue under Section 1983 of the Civil Rights Act when denied access to a qualified provider. Justice Neil Gorsuch, writing for the majority, stated the Medicaid Act does not unambiguously grant individuals the right to sue, and enforcement should rest with federal agencies, not the courts. “New rights for some mean new duties for others,” Gorsuch wrote, emphasizing that such public policy decisions should be made by elected lawmakers.

The ruling is a victory for South Carolina Governor Henry McMaster, who in 2018 ordered the removal of abortion providers, including Planned Parenthood South Atlantic (PPSAT), from the state’s Medicaid network. Although federal law bars Medicaid funds from covering abortions except in limited cases, McMaster argued that all funding to Planned Parenthood indirectly supports abortion access. In dissent, Justice Ketanji Brown Jackson, joined by Justices Sotomayor and Kagan, criticized the majority’s “narrow and ahistorical” interpretation, warning that it restricts patient choice. South Carolina has only two Planned Parenthood clinics, both serving hundreds of low-income patients with essential healthcare services such as contraception, STI testing, and cancer screenings. Planned Parenthood maintains the case is about healthcare access, not abortion. Lower courts had sided with PPSAT, but the Supreme Court’s decision now allows the state’s restrictions to move forward.