The Supreme Court on Wednesday grappled with a case testing whether South Carolina was legally allowed to cut off Medicaid funding for Planned Parenthood.
South Carolina restricted Planned Parenthood from participating in Medicaid because the organization provides abortions.
However, the lawsuit was not about abortion access, but whether a Medicaid beneficiary has the “right” to pick their preferred health provider and sue if they can’t.
The state, backed by the Trump administration, argued there was no such right.
Conservative justices seemed sympathetic to concerns raised by the state about a constant flood of lawsuits if patients were allowed to sue over their provider being removed from Medicaid.
“We’re talking about 9,000 providers who have been disqualified across the country, any one of whom, if you rule in favor of Respondents, can recruit a beneficiary and go to federal court and then line their pockets with the attorneys’ fees,” argued John Bursch, a lawyer with conservative legal group Alliance Defending Freedom, who was representing South Carolina.
Liberal justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson suggested Congress clearly created a “right” for patients to choose any qualified provider they want, even if the Medicaid law doesn’t explicitly use the word.
“The state knows it has an obligation … and the state knows the content of that obligation, which is that every individual has a right to choose their doctor,” Kagan said.
The law says that “any individual” insured through Medicaid “may obtain” care from any qualified and willing provider.
The justices noted that if patients don’t have the power to sue over their preferred provider, states could act as gatekeepers and defund providers for any arbitrary reason.
“It would be people who provide abortion, people who don’t provide abortions… people who do gender transition treatment. Every state could split up the world by providers like that,” Kagan said. “That does not seem what this statute is all about.”
Justice Amy Coney Barrett wondered if patients should be able to sue if their preferred provider was removed from Medicaid for malpractice complaints.
“Does it make sense in that circumstance for Congress to have wanted plaintiffs to have a right to come in and sue?” she said.
Attorneys for Planned Parenthood South Atlantic argued Congress wanted to protect the “intensely personal right” of a patient to choose a doctor.
“There aren’t many things that are more important than being able to choose your doctor, the person that you see when you’re at your most vulnerable, facing some of the most significant challenges to your life and your health,” Nicole Sharsky argued for the organization.
The lawsuit comes as red states across the country are looking for ways to deprive Planned Parenthood of funding. Nationally, the Trump administration recently said it will withhold federal family planning grants from nine Planned Parenthood affiliates.
Medicaid is prohibited from paying for almost all abortions, but states want to cut government funding for other services it provides as well.
South Carolina said the money Planned Parenthood receives for providing other health services-— like cancer screenings, birth control, physical exams and more — “frees up their other funds to provide more abortions.”
Three other states — Texas, Arkansas and Missouri — already block Planned Parenthood from seeing Medicaid patients and the organization has said it expects many other Republican-led states to do the same if the Supreme Court sides with South Carolina.
A decision is expected later this summer.
