In another decision along ideological lines that strikes another blow to women's health and choice over their own healthcare, the Supreme Court has ruled in favor of South Carolina's crusade to disqualify Planned Parenthood from receiving Medicaid funds.

We once again have a decision by the Supreme Court's six-person conservative majority that is clearly aimed at abortion rights and the accessibility of healthcare for women. But, in the majority opinion written by Justice Neil Gorsuch, you'd think that this was a highly technical, legally wonky decision that deals only with the wording of statutes and what statutes are "rights-granting."

That is how things often go with these decisions that have broad-ranging political implications, and which clearly have the support of justices who, themselves, lean politically to the right — and don't like abortion as a rule.

As the New York Times explains, the 6-3 decision in Medina v. Planned Parenthood South Atlantic comes down to the wording of the federal law that created Medicaid, which says that individuals needing medical services "may obtain such assistance from any institution” that is “qualified to perform the service or services required.”

The main plaintiff in the case, a South Carolina woman named Julie Edwards, said that she preferred to use a Planned Parenthood office near her for gynecological care, and she was suing because of a 2018 order from the state's Republican Governor Henry McMaster that ordered state legislators to withhold all Medicaid funds from clinics that provide abortions.

In his opinion, Gorsuch points to the word "qualified" in the federal statute, and suggests that states can make their own determinations if an institution is "qualified" at their discretion. And he argues that the statute does not grant a right to Edwards to choose her medical provider against the state's guidelines.

Governor McMaster, who remains in office, put out a celebratory statement Thursday saying, "Seven years ago, we took a stand to protect the sanctity of life and defend South Carolina's authority and values – and today, we are finally victorious. The legality of my executive order prohibiting taxpayer dollars from being used to fund abortion providers like Planned Parenthood has been affirmed by the highest court in the land."

In her dissent, Justice Ketanji Brown Jackson writes in a more straightforward manner, and says, "The majority’s effort to resist the natural and obvious rights-creating reading of the Medicaid Act’s free-choice-of-provider provision is, ultimately, unpersuasive."

And, Justice Jackson argues, the majority "conspicuously" avoids using the same reasoning it used to decide another similar case in 2023, Health and Hospital Corporation of Marion County v. Talevski, concerning Medicaid funding for nursing homes. In that case, Jackson wrote the court's majority opinion, which was was joined by six other justices, with only Alito and Thomas dissenting, and concluded that the Civil Rights Act of 1871 assured citizens' ability to challenge state laws that violated their federal civil rights.

"The Court’s decision today is not the first to so weaken the landmark civil rights protections that Congress enacted during the Reconstruction Era," Justice Jackson writes. "That means we do have a sense of what comes next: as with those past rulings, today’s decision is likely to result in tangible harm to real people. At a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them."

Photo by Adam Michael Szuscik