Overview

• The court’s 6–3 majority held that Medicaid’s free-choice provision does not create a private right to sue under Section 1983, reversing lower-court rulings.
• Justice Neil Gorsuch wrote that spending-power statutes like Medicaid rarely confer enforceable individual rights, a view sharply contested in dissent by Justice Ketanji Brown Jackson.
• The dispute originated with South Carolina’s 2018 executive order by Gov. Henry McMaster to exclude Planned Parenthood South Atlantic from Medicaid, challenged by patient Julie Edwards.
• Planned Parenthood warns that losing about $90,000 in annual Medicaid reimbursements could force the closure of its two South Carolina clinics and threaten roughly 200 centers nationwide.
• Reproductive health advocates caution the ruling will deepen care gaps for low-income and rural Medicaid enrollees who depend on Planned Parenthood for contraception, cancer screenings and other essential services.