The US Supreme Court held on Thursday that states are permitted to prevent Medicaid funding from going to Planned Parenthood.

The case involved two Planned Parenthood clinics in South Carolina that served both Medicaid and non-Medicaid patients. In 2018, South Carolina Governor Henry McMaster issued an executive order banning public money for abortions, excluding Planned Parenthood from its Medicaid program. The state claimed other healthcare providers would still be available for patients.

Planned Parenthood and a patient named Julie Edwards sued, saying the state’s action violated Section 1396a(a)(23)(A). Edwards said she preferred getting her care from Planned Parenthood but relied on Medicaid to pay for it. They filed a class action suit under Section 1983, which allows individuals to file civil lawsuits when their rights, protected by the Constitution or federal laws, are violated by a government actor.

The court wrestled with the question of whether denying patients the ability to use Medicaid to pay their chosen healthcare provider allowed them to bring a Section 1983 suit against the state. Justice Neil Gorsuch framed the question as “whether individual Medicaid beneficiaries may sue state officials under 42 U.S.C. § 1983 for failing to comply with the any-qualified-provider provision.”

Plaintiffs argued that by cutting off funding for Planned Parenthood, the state opened itself up to a Section 1983 action because another federal rule—Section 1396a(a)(23)(A)—allows Medicaid patients to choose any qualified provider. The provision states that:

[A]ny individual eligible for medical assistance (including drugs) may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required (including an organization which provides such services, or arranges for their availability, on a prepayment basis), who undertakes to provide him such services.

However, the court held that Section 1396a(a)(23)(A) “lacks the required clear rights-creating language” to confer protection under Section 1983. It pointed to the Federal Nursing Home Reform Act (FNHRA), indicating that Congress, in those provisions, creates a clear “right to choose a personal attending physician,” which was not the case in the contested section.

The opinion explained that while Section 1983 lawsuits can protect individual rights and promote state accountability, they do not always serve the public good, as litigating may divert state resources from social services. It emphasized that the decision to allow private enforcement lies with Congress, not the courts.

Deferring to congressional intent is a long-standing judicial principle, especially when interpreting unclear laws. Allowing courts to provide remedies where Congress has already spoken, the Court held, risks undermining the separation of powers.