Washington, D.C – In South Carolina, there are only two Planned Parenthood offices, but each year they see hundreds of low-income people who need birth control, cancer screenings, and pregnancy tests.
The group has been at the heart of the abortion debate for a long time, but its clinics all over the U.S. offer many other services as well. Medicaid patients in South Carolina often go to Planned Parenthood because it’s hard for them to find a doctor who takes their government-funded insurance.
That choice could be thrown out by a case from South Carolina that comes before the Supreme Court on Wednesday. That’s because Henry McMaster, the Republican governor of the state, wants to stop any public health care money from going to Planned Parenthood.
With very few cases, federal law already says that Medicaid funds can’t be used to pay for abortions. In South Carolina, almost all abortions are now illegal around six weeks after conception.
“This case is not about having an abortion.” Kate Farris, chief medical officer at Planned Parenthood South Atlantic, said, “This case is about health care in general.”
Still, Republican leaders in states run by conservatives have long said that public health care funds shouldn’t go to groups that offer abortions. Instead, they say, states should be able to choose where to spend those funds. A few states have already stopped giving Medicaid money to Planned Parenthood, and more could do the same if South Carolina wins.
He said, “The people of this state do not want their tax money to go to that group.”
The Trump administration will be in South Carolina for the talks on Wednesday. These are happening at the same time that people who are against abortion are trying to get Planned Parenthood to stop getting government funding.
Health care supporters, on the other hand, say that the case has effects that go beyond abortion. People on Medicaid can sue over their legal right to choose their own qualified provider. This is the main legal point.
In court papers, the American Cancer Society and other public health groups say that cases are the only real way for patients to fight for their rights. If they couldn’t go to court, it would be harder for them to get care, especially in rural places.
Julian Polaris, a lawyer who often gives advice to state Medicaid programs and health care providers, said, “If no one can enforce the statute or no one is willing to enforce the statute at the federal level, then it’s just a right on paper.” He also said that if the court sides with South Carolina, other states could try to make it harder for people to get services like care that affirms their gender.
Heidi Allen, an associate professor at Columbia University, said that one in five American women of childbearing age are now on Medicaid. To meet the needs of these people, it is very important to find providers who can provide good family planning services, as this is a requirement for Medicaid.
“It worries me that states would close down a site of care for political reasons,” Allen said.
The case goes back to 2018, before the Supreme Court removed the right to abortion across the country. That’s when McMaster first tried to cut funding to Planned Parenthood to keep a campaign promise. He signed an order that took Planned Parenthood off of a list of places that offer birth control and tests for sexually transmitted diseases.
McMaster said last week, “We need more of the good groups that offer care, counseling, and advice on maternal health needs.”
His order was thrown out by the court, but since then, courts in Texas and Missouri have agreed with similar actions, according to John Bursch, an attorney for the conservative Alliance Defending Freedom.
He said, “At its core, this case is about whether states have the freedom to spend Medicaid funds in ways that help low-income women and families the most.”
He agreed that if South Carolina won, it might stop other states from suing Medicaid. But he also said that might be good for the program as a whole because it would mean less money going to legal fees. He also said that there is an official appeals process that can be used.
“No one will be unable to get to health clinics,” Busch said. People with Medicaid could go to any of the 200 other state-funded health clinics if the state is allowed to shut down Planned Parenthood, he said.
Planned Parenthood gets $90,000 a year from Medicaid in South Carolina. This is a very small amount compared to the overall amount the state spends on Medicaid.
Amalia Luxardo, CEO of the Women’s Rights and Empowerment Network in South Carolina, said that most counties in the state have already been told by the federal government that they don’t have enough basic care providers. She said that 14 counties in the state don’t have any OB-GYN doctors working and 5 counties only have one. This means that many women already have to drive farther to find the right provider.
People come from all over the state to see Planned Parenthood because they have open hours and can make appointments quickly, she said.
“We already have a health care crisis,” Luxardo said. Her group has backed Planned Parenthood in court. “And the crisis will only get worse when decisions like these hurt the people we represent.”
