Medina v. Planned Parenthood South Atlantic (formerly Kerr v. Planned Parenthood South Atlantic)
Issue: Do Medicaid enrollees have a legally enforceable right to obtain covered family planning services from their provider of choice?
Background: In a 6:3 decision, the U.S. Supreme Court found that Medicaid enrollees cannot file federal lawsuits to enforce Medicaid’s “free-choice of provider” provision. The majority concluded that this provision lacks clear and unambiguous rights-creating language to put states on notice that accepting federal funds could subject them to lawsuits by third parties. Instead, the "typical remedy" in these cases is for the federal government to withhold funds from the state. This case arose after South Carolina terminated Planned Parenthood as a family planning services provider in its Medicaid program, not due to concerns about service quality, but because Planned Parenthood offers abortion care where it is legal, though generally not covered by Medicaid. While the decision does not directly address other Medicaid Act provisions, the majority makes clear that the test for establishing an enforceable legal right is a "demanding bar" and "significant hurdle," limited to "atypical cases." The majority observed that "[t]hough it is rare enough for any statute to confer an enforceable right, spending-power statutes like Medicaid are especially unlikely to do so." This decision opens the door for other states to exclude providers from their Medicaid programs for reasons unrelated to care quality and restrict Medicaid enrollees’ access to critical healthcare services.
Current Status: Final decision issued
U.S. Supreme Court Amicus Brief, March 12, 2025
Amici: American Public Health Association, Robert Wood Johnson Foundation, Network for Public Health Law, Council of Chairs of Obstetrics and Gynecology, Jacobs Institute for Women’s Health, American Medical Women’s Association, and 490 public health deans and scholars.
Argument Summary: Congress promoted access to family planning by repeatedly including explicit free choice of family planning provider protections in the Medicaid Act. Medicaid’s free choice of provider provision protects patient autonomy, and coverage of comprehensive family planning services is a central feature of Medicaid.
High-quality family planning services are essential to maternal and child health and foundational to public health. Family planning services significantly improve maternal and child health outcomes by reducing unintended pregnancy; reduce the risk of adverse health outcomes and infant mortality that result from untreated sexually transmitted infections; help detect and prevent reproductive health conditions that cause infertility or cancer; and result in considerable health savings. Family planning services are most effective when they come from a trusted healthcare provider.
Excluding a family planning provider from Medicaid for reasons wholly unrelated to the quality of care will worse healthcare access and harm beneficiaries. Contraceptive and maternity care deserts already exists and are likely to worsen with fewer family planning providers offering services.
Outside Counsel: Foley Hoag LLP
Citations:
“A brief by a group of public health organizations and scholars focuses on the ‘considerable impact on maternal and child health’ that it says would flow from a ruling for the state. More than 50% of South Carolina’s counties ‘are medically underserved, and nearly two in five counties are classified as contraceptive deserts,’ the group writes. Even where there are other health care providers, the group continues, ‘there is no evidence that they are in a position to accept a mass influx of patients who find themselves suddenly without access to the doctors and nurses they know and rely on.’”
Howe A. Supreme Court considers South Carolina’s effort to strip Planned Parenthood of Medicaid funding. SCOTUSblog. April 1, 2025. https://www.scotusblog.com/2025/04/supreme-court-considers-south-carolinas-effort-to-strip-planned-parenthood-of-medicaid-funding/
The “American Public Health Association and other health groups told the court more than half of South Carolina’s counties don’t have enough health services to meet demand and nearly two in five are considered ‘contraceptive deserts.’”
Groppe M. Republicans want to defund Planned Parenthood. They are asking for the Supreme Court’s help. USA Today. April 1, 2025. https://www.usatoday.com/story/news/politics/2025/04/01/supreme-court-defund-planned-parenthood-south-carolina/82745215007/
Related Resources:
GW Media Relations. Supreme Court’s ruling on Planned Parenthood threatens access to health care. June 30, 2025. https://mediarelations.gwu.edu/supreme-courts-ruling-planned-parenthood-threatens-access-health-care
GW Media Relations. A public health amicus brief urgers U.S. Supreme Court to uphold Medicaid beneficiaries; ability to legally enforce their right to choose their family planning provider. March 17, 2025. https://mediarelations.gwu.edu/public-health-amicus-brief-urges-us-supreme-court-uphold-medicaid-beneficiaries-ability-legally
Rosenbaum S, Musumeci M, Barkoff A, Azimpoor K. The Supreme Court puts access to Medicaid family planning care on the line. Health Aff. Forefront. Jan. 30, 2025. https://www.healthaffairs.org/do/10.1377/forefront.20250129.985343/full/
Funding Acknowledgement:
Supported by the Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund, its directors, officers, or staff.