(WASHINGTON) — The battle over taxpayer funding for Planned Parenthood takes center stage at the U.S. Supreme Court on Wednesday in a dispute over South Carolina’s exclusion of the group from the state Medicaid program because it provides abortions.
On the line is the ability of Medicaid beneficiaries to freely choose a healthcare provider, including physicians at Planned Parenthood who provide services other than abortion, like contraception treatments and cancer screenings.
South Carolina’s two Planned Parenthood clinics have served mostly low-income, minority women for more than 40 years. Hundreds of their patients are Medicaid recipients.
The case also implicates the millions of federal dollars Planned Parenthood receives in the form of reimbursements for treating Medicaid patients each year.
According to Planned Parenthood, 34% of its overall revenue, or $699 million, comes from government grants, contracts, and Medicaid funds.
In 2018, South Carolina’s Republican governor Henry McMaster issued executive orders disqualifying Planned Parenthood from receiving Medicaid reimbursements for non-abortion services.
Julie Edwards, a Medicaid beneficiary and type-1 diabetic who sought medical care at a Planned Parenthood clinic in Columbia, SC, sued the state alleging a violation of the Medicaid Act, which guarantees a “free choice of provider” that is willing and qualified.
“Medicaid beneficiaries often face significant barriers to obtaining care, particularly in South Carolina. Twenty-five percent of state residents live in medically underserved areas,” the plaintiffs wrote in their brief to the high court.
“[Congress] enacted the free-choice-of-provider provision to ensure that Medicaid patients, like everyone else, can choose their own doctor,” they wrote. “Congress specifically enacted this provision in response to some States’ efforts to restrict Medicaid patients’ choice of provider.”
The state argues that Congress never intended to give individuals the right to sue over access to a particular provider and that there are plenty of other clinics available to serve Medicaid recipients.
“Congress wanted states to have substantial discretion to innovate with their Medicaid programs,” the state wrote in its brief to the high court. Allowing individuals to sue over access to specific providers would “subject the state to unanticipated (and expensive) lawsuits.”
While federal law already prohibits any government funding of abortions, South Carolina contends it has the right to target non-abortion funding to abortion providers. “Because money is fungible, giving Medicaid dollars to abortion facilities frees up their other funds to provide more abortions,” the state told the court.
“[Planned Parenthood] can restore Medicaid funding if it stops performing abortions— but it has chosen not to do so,” South Carolina wrote.
If the justices allow the suit to go forward, Edwards and Planned Parenthood can continue to challenge the clinics’ exclusion from the state’s Medicaid program in a lower court.
If the justices side with the state, they would bolster efforts to cut off Planned Parenthood from sources of government funding and effectively limit the number of providers available to Medicaid recipients.
A decision in the case is expected by the end of the Court’s term in June.
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