The U.S. Supreme Court will hear a high-stakes case this week that could affect how some low-income women in South Carolina have access and autonomy over their health care as Medicaid recipients.
The Medicaid Act gives its recipients the choice to "obtain services from any qualified Medicaid provider that undertakes to provide the services to them."
South Carolina is challenging that provision in Medina v. Planned Parenthood South Atlantic, for which SCOTUS will hear arguments on Wednesday. The state wants to block clinics like Planned Parenthood from being considered a "qualified Medicaid provider" because they also provide abortion services.
Medicaid consists of federal and state funds that help low-income people help cover medical costs. Under federal law, in a provision known as the Hyde Amendment, Medicaid funds can cover abortion only in cases of rape, incest or to preserve the life of the pregnant person. At the state level, South Carolina does not allow for Medicaid funds to cover abortions, whereas some states like New York and California do.
South Carolina has a strict abortion law in place, banning the procedure at six weeks and later. Planned Parenthood has two clinics in South Carolina, both of which are in compliance with this state law. The locations also provide reproductive services like prenatal and postpartum exams, STI testing and treatment, and provide birth control and emergency contraception. But if Planned Parenthood is cut from the Medicaid program in South Carolina, these non-abortion-related services also won’t be covered for recipients in the state.
"Medicaid is a significant source of health coverage for women who have higher rates of abortion in the U.S. including women with low incomes, and women of color," according to the Kaiser Family Foundation.
The high-profile case comes before the high court as Congress weighs a budget plan that could cause sweeping cuts to Medicaid funds that provide coverage to 72 million low-income and disabled people.
Here’s what to know about the case.
[ Explain it to me in two sentences ]
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Explain it to me in two sentences
In Medina v. Planned Parenthood South Atlantic, the Supreme Court will weigh whether states can remove providers like Planned Parenthood from its Medicaid program because they offer abortion services, regardless of the fact that they also provide non-abortion-related services like gynecological and obstetrical care and cancer screenings. If the high court rules in favor of South Carolina, health care options will be jeopardized for Medicaid patients in the state — and could embolden other states to remove Planned Parenthood from the program, effectively defunding it.
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The Medina v. Planned Parenthood South Atlantic case stems from a 2018 order by Republican South Carolina Gov. Henry McMaster, who declared that any health clinic in the state that also offers abortion services be cut from the Medicaid program. Medicaid consists of federal and state funds that help low-income people help cover medical costs. McMaster's reason for the order was because the "payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life."
A South Carolina Medicaid recipient and a patient at Planned Parenthood argued that McMaster’s order violates a provision of the Medicaid Act that allows any Medicaid-eligible person to receive health care from any “qualified” provider.
Now, the justices will decide in the coming months if any Medicaid recipient has the right to sue to enforce the Medicaid Act’s provision that enforces their right to choose their health care provider under the program.
Take me through a deep dive
Medicaid helps cover medical costs for qualified people who have limited income and resources. It's a joint federal and state program. Under a federal law, known as the Hyde Amendment, Medicaid funds can cover abortion only in cases of rape, incest or to preserve the life of the pregnant person.
At the state funding level, most states, like South Carolina, limit Medicaid coverage for abortions to those federal law exceptions. But some states, like California and New York, do use specific state funds to cover abortions for Medicaid enrollees.
In South Carolina, abortion is currently banned at six weeks and later. The state currently has three clinics that also provide abortion services, two of which are Planned Parenthood locations that also provide gynecological and obstetrical care, STI testing and cancer screenings.
Back in 2018, Republican South Carolina Gov. Henry McMaster issued an executive order for the state’s Department of Health and Human Services to ban clinics that also provide abortions from participating in the Medicaid program. McMaster argued that the “payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life.”
Women make up 63% of Medicaid recipients in South Carolina — and of all the women in South Carolina who are of reproductive age, 20% of them are enrolled in Medicaid, according to the Guttmacher Institute, a research organization that supports abortion rights.
One of those Medicaid recipients in South Carolina is Julie Edwards, who suffers from diabetes. She went to a Planned Parenthood clinic for birth control and wanted to return to that location to continue receiving care. Because of McMaster’s order, she couldn’t.
Edwards, along with Planned Parenthood, took their case to federal court in South Carolina to argue that the governor’s order violated the Medicaid Act’s provision that recipients should have the freedom to get health care from any “qualified provider.”
At stake are the rights of Medicaid recipients to choose their health care provider under the program.
Republican-led states like Arkansas, Missouri and Texas have already terminated the eligibility of some health clinics, like Planned Parenthood, to be Medicaid providers because they have provided abortions.
If SCOTUS rules in favor of South Carolina, other red states could be emboldened by the decision and also aim to restrict from the Medicaid program any health clinics that currently or have provided abortions in the past.