“Confirmed Judges, Confirmed Fears” is a blog series documenting the harmful impact of President Trump’s judges on Americans’ rights and liberties. It includes judges nominated in both his first and second terms.
Trump Justice Neil Gorsuch wrote a 6-3 Supreme Court opinion, joined by Trump justices Brett Kavanaugh and Amy Coney Barrett plus Chief Justice Roberts and Justices Samuel Alito and Clarence Thomas, which effectively held that South Carolina could prohibit any Medicaid funding from going to Planned Parenthood. The majority ruled specifically that patients could not sue to vindicate their right to choose a provider under Medicaid. Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson strongly dissented in the June 2025 ruling in Medina v Planned Parenthood.
What happened in this case?
Even before the Supreme Court overturned Roe v Wade, a number of conservative states took action to defund groups like Planned Parenthood (PP) that provide abortion care, among their other work. In 2018, South Carolina’s governor announced that no PP clinic in the state could receive any Medicaid funding, even for non-abortion health care. PP sued, as did Julie Edwards, a patient who was very satisfied with the non-abortion-related medical care she was receiving from a PP clinic. She sued under the general federal civil rights statute, 42 USC 1983, contending that the state was violating her right under the Medicaid law to choose her own health care provider.
A district court ruled in Edwards’ favor on summary judgment, and the Fourth Circuit affirmed, in an opinion by conservative Judge J Harvie Wilkinson. The Supreme Court directed that the case be reconsidered in light of a recent decision, and Judge Wilkinson again ruled in favor of Edwards, enjoining the state from terminating PP from the Medicaid program. The Court determined to review the case on the merits.
What did Gorsuch and the rest of the Court do and why is it harmful?
Justice Gorsuch wrote a 6-3 decision, joined by the other Trump justices as well as Roberts, Thomas, and Alito, which reversed the Fourth Circuit. Gorsuch ruled that an individual like Edwards cannot sue under 42 USC 1983 to enforce her right to choose a health care provider under the Medicaid law. He noted that laws enacted under Congress’ spending power, like Medicaid, are “especially unlikely” to confer such enforceable rights. As a result, South Carolina’s decision to expel PP from Medicaid in the state can’t be challenged in court by the people who are harmed, even if the state’s action violates the federal Medicaid statute.
Justice Jackson wrote a strong dissent, joined by Justice Sotomayor and Kagan. She carefully reviewed the history and past precedent concerning 42 USC 1983 and whether federal laws like Medicaid create an enforceable right to sue under that civil rights law. Precedent makes clear, she explained, that the test is whether the statute “unambiguously confer[s] federal rights,” and that under that test, the Medicaid law’s choice-of-provider provision “readily creates an enforceable right.” She specifically noted that in a prior case, the Court had squarely rejected” the argument that it now appeared to embrace that there was an “implicit carveout” for laws like Medicaid enacted by Congress under its spending power. She showed how the majority’s holding “undermimes” 1983’s “core function”, “warps” past precedent, and “thwarts Congress’ will” in enacting the Medicaid law.
The result, the dissent concluded, is that the majority decision “will strip” South Carolina and “countless other Medicaid recipients around the country” of the “deeply personal freedom” to “decide who treats us at our most vulnerable,” and will further weaken “one of the country’s great civil right laws.” In addition, the case illustrates the importance of our federal courts to health, welfare and justice and the significance of having fair-minded judges on the federal bench.