Supreme Court reframes Medicaid patients' rights
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The Supreme Court on Thursday curtailed low-income patients' rights to chose their health providers while giving conservative-led states a bigger opening to exclude Planned Parenthood affiliates from their Medicaid programs.
The big picture: The 6-3 decision by the court's conservative majority potentially adds more obstacles to care, on top of financial barriers or poor health, and comes as Congress debates major changes to Medicaid that could cause millions of people to lose health coverage.
- While the arguments before justices were narrow in scope, the ruling has huge ramifications for women trying to access reproductive care. Medicaid covers 1 in 5 women of child-bearing age and is the biggest source of coverage for women with low incomes, covering more than 4 in 10, per KFF.
The latest: Justices ruled Medicaid patients in South Carolina couldn't sue under a civil rights law to choose their provider after the governor excluded Planned Parenthood from its Medicaid program in 2018 because it provided abortion care.
- Shutting the organization out of Medicaid has been a longtime priority of conservative politicians — and is one of the policy changes in the Republican budget bill now before Congress.
- Such moves not only curtail abortion access but place restrictions on other care the clinics provide, including for sexually transmitted infections and cancer screening, birth control and mental health services.
- Patient choices already are limited because, as KFF notes, many states require Medicaid beneficiaries to enroll in managed care plans with defined network of providers. Federal law states they can go out of network for family planning. But Thursday's ruling effectively cuts them off from enforcing their right to choose a provider.
What they're saying: "This case fits within a pattern of anti-abortion lawmakers and governors seeking to weaponize their authority and overreach into constitutionally and federally protected spaces to deny not only abortion rights, but any other type of reproductive health care that they themselves personally disagree with," said Michele Bratcher Goodwin, co-faculty director at Georgetown's O'Neill Institute for National and Global Health Law.
- Planned Parenthood said more than 1 million South Carolinians receive health care services through the Medicaid program, and approximately 5% of those recipients sought sexual and reproductive health care services.
- "Today's decision is a grave injustice that strikes at the very bedrock of American freedom and promises to send South Carolina deeper into a health care crisis," Paige Johnson, president and CEO of Planned Parenthood South Atlantic, said in a statement.
The other side: "By rejecting Planned Parenthood's lawfare, the Court not only saves countless unborn babies from a violent death and their mothers from dangerously shoddy 'care,' it also protects Medicaid from exposure to thousands of lawsuits from unqualified providers that would jeopardize the entire program," Katie Daniel, director of legal affairs and policy counsel for Susan B. Anthony Pro-Life America, said in a statement.
What we're watching: More red states are expected to follow South Carolina's lead, with 18 states weighing in on the case, the Associated Press reported.
- Legal experts say states may have more latitude to exclude providers on political grounds now that Medicaid recipients can't legally press their right to chose a provider.
- Planned Parenthood South Atlantic said it intends to continue to operate and offer care in South Carolina, including to Medicaid recipients.
