Conservative U.S. Supreme Court justices appeared sympathetic on Wednesday to South Carolina's bid to strip Planned Parenthood of funding under the Medicaid program in a case that could bolster efforts by Republican-led states to deprive the reproductive healthcare and abortion provider of public money.
The justices heard arguments in South Carolina's appeal of a lower court's decision barring the Republican-governed state from terminating Medicaid funding to Planned Parenthood South Atlantic, the organization's regional affiliate, because the organization provides abortions.
The Supreme Court has a 6-3 conservative majority.
The justices focused on whether the language of the law governing Medicaid, a joint federal and state health insurance program for low-income people, allows recipients to sue to enforce a requirement that they may obtain medical assistance from any qualified and willing provider.
In a 2023 ruling involving the rights of nursing home residents, the Supreme Court explained that laws like Medicaid must unambiguously give individuals the right to sue.
John Bursch, a lawyer with the Alliance Defending Freedom conservative legal group representing South Carolina, told the justices that the statute should include explicit "rights-creating language" but does not use the word "right," or similar words, such as "entitlement" or "privilege."
"I'm not allergic to magic words, because magic words — if they represent the principle — will provide the clarity that will avoid the litigation that is a huge waste of resources for states, courts, providers, beneficiaries," conservative Justice Brett Kavanaugh told Bursch.
Liberal justices pushed back on the need for explicit words, since the state's obligations under the law are clear.
"The state has an obligation to ensure that a person ... has a right to choose their doctor," liberal Justice Elena Kagan said.
"It's impossible to even say the thing without using the word 'right,'" Kagan added.
South Carolina is backed by President Donald Trump's administration in the case.
Since the Supreme Court in 2022 overturned its landmark Roe v. Wade ruling that had legalized abortion nationwide, 12 states have implemented near-total bans while four states, including South Carolina, outlaw abortion after six weeks of pregnancy.
Planned Parenthood South Atlantic operates clinics in the South Carolina cities of Charleston and Columbia, where it serves hundreds of Medicaid patients each year, providing physical examinations, screenings for cancer and diabetes, pregnancy testing, contraception and other services.
The Planned Parenthood affiliate and Medicaid patient Julie Edwards sued in 2018 after Republican Governor Henry McMaster ordered state officials to end the organization's participation in the state Medicaid program by deeming any abortion provider unqualified to provide family planning services.
The suit was brought under an 1871 U.S. law that helps people challenge illegal acts by state officials.
It is the third time that the South Carolina Planned Parenthood defunding dispute has reached the Supreme Court, which in 2020 rejected the state's appeal at an earlier stage of the case. In 2023, the justices ordered a lower court to reconsider the state's arguments in light of its nursing home-related ruling.
Planned Parenthood said on Monday that the Trump administration is withholding federal family planning funding to the organization under a program known as Title X, affecting birth control, cancer screenings and other services for low-income people.
In the South Carolina case, a federal judge ruled in Planned Parenthood's favor, finding that Medicaid recipients may sue under the 1871 law and that the state's move to defund the organization violated the right of Edwards to freely choose a qualified medical provider.
In 2024, the Richmond, Virginia-based 4th U.S. Circuit Court of Appeals sided with the plaintiffs.
"Preserving access to Planned Parenthood and other providers means preserving an affordable choice and quality care for an untold number of mothers and infants in South Carolina," the 4th Circuit said in its ruling.
A Supreme Court ruling is expected by the end of June.
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