The U.S. Supreme Court ruled Thursday that states can bar Medicaid payments to Planned Parenthood, the nation’s largest abortion provider.
The federal government and many states already block using Medicaid funds to cover abortion. But the state-federal health insurance program for lower-income people does pay for other services from Planned Parenthood, including birth control, cancer screenings and testing and treatment for sexually transmitted infections.
The ruling comes at a moment when Congress is considering blocking Planned Parenthood from receiving any federal Medicaid funding, a move that the group says would force hundreds of clinic closings — most of them in states where abortion remains legal.
Here are things to know about the situation:
Abortion opponents see it as a victory on principle
This legal dispute goes back to a 2018 executive order from South Carolina Gov. Henry McMaster that barred abortion providers from receiving Medicaid money in the state, even for services unrelated to abortion.
In its 6-3 ruling, the Supreme Court overruled lower courts and said that patients don’t necessarily have the right to sue for Medicaid to cover their health care from specific providers.
Abortion opponents hail it as a victory on principle.
“No one should be forced to subsidize abortion,” CatholicVote President Kelsey Reinhardt said in a statement.
Abortion rights advocates say it will hurt health care access
Supporters of Planned Parenthood see the ruling as an obstacle to health care aside from abortion.
Planned Parenthood “provides services for highly disadvantaged populations and this will mean not only that many women in the state will lose their right to choose providers, but it will also mean that many women will lose services altogether,” said Lawrence Gostin, who specializes in public health law at Georgetown Law.
For many people with Medicaid, Gostin said, Planned Parenthood is a trusted service provider, and it’s often the closest one.
Others emphasize that the people who could be most impacted are women who already face the greatest obstacles to getting health care.
“People enrolled in Medicaid, including young people and people of color, already face too many barriers to getting health care,” Kimberly Inez McGuire, the executive director of Unite for Reproductive & Gender Equality, said in a statement. “This decision makes a difficult situation worse.”
The implications may be narrow in South Carolina, but broader elsewhere
Planned Parenthood has two clinics in South Carolina, one in Charleston and one in Columbia.
Combined, they’ve been receiving about $90,000 a year from Medicaid out of nearly $9 billion a year the program spends in the state.
South Carolina has banned most abortions after six weeks gestational age, before many women realize they’re pregnant. It’s one of four states to bar abortion at that point. Another 12 are enforcing bans at all stages of pregnancy. The bans were implemented after the Supreme Court overturned Roe v. Wade in 2022.
The most recent high court ruling isn’t a guarantee that other states will follow South Carolina’s lead, but Republican attorneys general of 18 other states filed court papers supporting the state’s position in the case.
“We can imagine that there’s anti-abortion legislators in states who are looking to this case and may try to replicate what South Carolina has done,” said Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, a research organization that supports abortion rights.
The federal government is also targeting Planned Parenthood
The U.S. House last month passed a budget measure that would bar all federal payments for 10 years to nonprofit groups that provide abortion and received more than $1 million in federal funding in 2024.
A Senate vote on the measure, which President Donald Trump supports, could happen in coming days.
Planned Parenthood says that if the measure becomes law, it would force its affiliates to close up to 200 of their 600 facilities across the U.S. The hardest-hit places would be the states where abortion is legal.
If the federal effort is successful, Friedrich-Karnik said states that support abortion rights could use their own tax revenue to keep clinics open.
On a call with reporters this week, SBA Pro-Life America President Marjorie Dannenfelser said it’s a priority for her group to hobble Planned Parenthood.
She said starving Planned Parenthood of Medicaid reimbursements would not have a major impact on patients, because other clinics offer similar services without providing abortion.
“Medicaid money is attached to the person, so she’ll retain the same amount of money,” Dannenfelser said. “She’ll just take it to a different place.”
Abortion funding is already battered
The 2022 Supreme Court ruling that ended the nationwide right to abortion jolted the abortion system across the U.S. and left clinics struggling.
Women in states with bans in place now use abortion pills or travel to states where it’s legal.
Surveys have found that the number of monthly abortions nationally has risen since the court ruling.
But over the same time period, some clinics have closed and funds that help people obtain abortion have said it’s hard to stretch their money to cover the added cost of travel.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
