medical care

WASHINGTON — The Supreme Court ruled Thursday that states may exclude Planned Parenthood clinics from providing medical screenings and other healthcare for women on Medicaid.

The court’s conservative majority reversed the longstanding rule that said Medicaid patients may obtain medical care from any qualified provider.

In a 6-3 vote, the justices ruled the Medicaid Act does not give patients an “individual right” to the provider of their choice.

The dispute has turned on abortion. Medicaid is funded by the federal government and the states. For decades, conservative states have argued their funds should not be used in Planned Parenthood clinics because some of those clinics perform abortions.

But until now, the federal government and the courts had said that Medicaid patients can go to any qualified provider for healthcare.

In dissent, Justice Ketanji Brown Jackson said the decision “will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them. And, more concretely, it will strip those South Carolinians — and countless other Medicaid recipients around the country — of a deeply personal freedom: the ability to decide who treats us at our most vulnerable.” Justices Sonia Sotomayor and Elena Kagan agreed.

Planned Parenthood clinics provide cancer screenings, birth control medical screenings, pregnancy testing, contraception and other healthcare services.

Congress pays most of the state’s costs for Medicaid, and it says “any individual eligible for medical assistance” may receive care from any provider who is “qualified to perform the service.”

Lupe Rodríguez, executive director of National Latina Institute for Reproductive Justice, called the decision “an attack on our healthcare and our freedom to make our own decisions about our bodies and lives. By allowing states to block Medicaid patients from getting care at Planned Parenthood health centers, the Court has chosen politics over people and cruelty over compassion.”

Three years ago, the Supreme Court overturned Roe vs. Wade and ruled states may prohibit nearly all abortions.

Nonetheless, South Carolina continued its legal fight to prevent Medicaid patients from receiving care at Planned Parenthood’s clinics in Charleston and Columbia.

Former Gov. Henry McMaster, who issued the ban on Planned Parenthood in 2018, said he did so to protect “his state’s sovereign interests.”

Critics of the move said the state has a severe shortage of doctors and medical personnel who treat low-income patients on Medicaid.

WASHINGTON — The Supreme Court ruled Wednesday that states may ban hormone treatments for transgender teens, rejecting the claim that such gender-based discrimination is unconstitutional.

In a 6-3 decision, the justices said states are generally free to decide on proper standards of medical care, particularly when health experts are divided.

Chief Justice John G. Roberts, writing for the court, said the state decides on medical regulations. “We leave questions regarding its policy to the people, their elected representatives, and the democratic process,” he said.

In dissent, Justice Sonia Sotomayor said the law “plainly discriminates on the basis of sex… By retreating from meaningful judicial review exactly where it matters most, the Court abandons transgender children and their families to political whims. In sadness, I dissent.” Justices Elena Kagan and Ketanji Brown Jackson agreed.

The ruling upholds laws in Tennessee and 23 other Republican-led states, all of them adopted in the past four years.

Tennessee lawmakers said the number of minors being diagnosed with gender dysphoria had “exploded” in recent years, leading to a “surge in unproven and risky medical interventions for these underage patients.”

California and other Democratic-led states do not prohibit doctors from prescribing puberty blockers or hormones for those under age 18 who are diagnosed with gender dysphoria.

While the court’s ruling in the Tennessee case should not directly affect California’s law, the Trump administration seeks to prevent the use of federal funds to pay for gender affirming care.

This could affect patients who rely on Medicaid and also restrict hospitals and other medical clinics from providing hormones and other medical treatments for minors.

Wednesday’s decision highlights the sharp turn in the past year on trans rights and “gender affirming” care.

Solicitor Gen. Elizabeth Prelogar, representing the Biden administration, had appealed to the Supreme Court in November, 2023, and urged the justices to strike down the red state laws.

She spoke of a broad consensus in favor of gender affirming care. It was unconstitutional, she argued, for states to ban “evidence-based treatments supported by the overwhelming consensus of the medical community.”

But Republican lawmakers voiced doubt about the long-term effect of these hormone treatments for adolescents.

Their skepticism was reinforced by the Cass Report from Britain, which concluded there were not long-term studies or reliable evidence in support of the treatments.

In his first day in office, President Trump issued an executive order condemning “gender ideology extremism.”

He said his administration would “recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.”

His administration later said its ban on gender affirming care for minors would extend to medical facilities receiving federal funds.