The U.S. Supreme Court ruled Thursday that South Carolina may exclude Planned Parenthood from its Medicaid program. The 6-3 decision, split along ideological lines, gives a green light to other conservative-led states seeking to stop taxpayer funds from reaching the nation’s largest abortion provider.
Justice Neil Gorsuch authored the majority opinion, siding with South Carolina in a case brought by Planned Parenthood South Atlantic and a patient, Julie Edwards. Edwards had argued that the state’s 2018 move to exclude Planned Parenthood from Medicaid coverage violated her right to choose her healthcare provider under federal law. The Court disagreed, upholding the state’s right to decide which providers qualify for Medicaid reimbursement.
The decision is a major win for the pro-life movement, which has long argued that taxpayer dollars should not support organizations that provide abortions—even indirectly. Although federal law, through the Hyde Amendment, already bars direct funding of abortion procedures, Planned Parenthood still receives hundreds of millions in Medicaid reimbursements for other services.
According to its most recent annual report, Planned Parenthood received $800 million in government funding, roughly $2 million per day. At the same time, the organization reported performing a record number of abortions, sparking renewed efforts from conservative lawmakers to cut off its funding altogether.
Critics of the ruling, including Planned Parenthood, warn that defunding could have serious consequences for low-income women. The organization claims that losing Medicaid reimbursement could force the closure of up to one-third of its clinics nationwide, limiting access to cancer screenings, contraceptives, and routine gynecological care for thousands of women.
However, pro-life advocates counter that Planned Parenthood is not the only option for women’s health services. According to the Charlotte Lozier Institute, a pro-life research group, there are 15 federally qualified health centers for every one Planned Parenthood clinic across the United States, many of which provide similar services without performing abortions.
The Supreme Court’s decision may set a precedent for other red states looking to follow South Carolina’s lead. Legal experts say it effectively empowers states to redefine their Medicaid provider networks without running afoul of federal patient choice provisions.
Meanwhile, the fight over federal funding for Planned Parenthood continues on Capitol Hill. Republican lawmakers have included a provision to permanently block Medicaid reimbursements to abortion providers in their sweeping budget proposal, often dubbed the “big, beautiful” budget bill. The measure is currently under review by the Senate parliamentarian, who will determine whether it can be included under special budget reconciliation rules that bypass the filibuster.
