Supreme Court To Hear Another Abortion Case So That's Probably Bad!
Should your state be allowed to tell you what doctors you are allowed to go to? South Carolina says YES.
In case you were feeling a little too jazzed about the election results in Wisconsin, I’m here to give you another thing to feel anxious about. Sorry!
Today, the Supreme Court will hear arguments in Medina v. Planned Parenthood South Atlantic, a case that could have enormous repercussions to healthcare throughout the United States. At issue is South Carolina’s law barring clinics that provide abortions from accepting Medicaid. Specifically, it will determine whether or not beneficiaries have the right to sue the state if they are not allowed to see their chosen provider, so long as that provider is “willing and qualified” to see them and not completely incompetent.
What do you think? Should Medicaid recipients have the right to choose their own doctors just like people who have private insurance do, or should the government make that choice for them instead? It’s a hard one!
This all started in 2018, when South Carolina Governor Henry McMaster signed an executive order barring abortion providers from receiving Medicaid reimbursements for non-abortion services — which he ridiculously claimed “results in the subsidy of abortion.” In response, PPSAT and Medicaid patient Julie Edwards filed a lawsuit arguing for her right to choose her own medical provider. The Medicaid Act’s Free Choice of Provider provision states that “a beneficiary enrolled in a primary care case management system or Medicaid managed care organization (MCO) may not be denied freedom of choice of qualified providers of family planning services.”
The only reason a state can bar a provider from accepting Medicare funds is if they’ve been found to be deficient in some way, but South Carolina has been clear that its issue is not that they are incompetent providers, but that they provide abortions.
Five federal courts have held that patients and providers do have a right to sue a state for violating that provision, while two have held that only the federal government can do anything about it. This federal government sure wouldn’t do anything about it, and even if they did, the thing they can do is withhold the state’s federal Medicaid funding — which picks up about 70 percent of South Carolina’s Medicaid tab, with the state covering the rest — and what kind of not-a-complete-monster person wants that?
The Supreme Court’s job is to resolve this split and decide which federal courts were right. Given the current Court’s track record on abortion rights, it’s not looking great. However, there is some hope, given the Court’s ruling in 2023’s Health and Hospital Corporation v. Talevski, in which they found that Medicaid beneficiaries have a right to sue Medicaid providers for violating their rights under federal law — with only Thomas and Alito dissenting.
South Carolina is being represented both by lawyers from the right-wing Alliance Defending Freedom and lawyers from the Trump administration — which pretty clearly suggests that this is something they’re looking at doing on a national scale.
The problem here is not that it hurts Planned Parenthood, but that it hurts Medicaid patients. It deprives them of the right to see the healthcare provider of their choosing, and in many cases it could deprive them of the ability to see a provider at all.
You see, we have a very, very, deeply stupid healthcare system in this country, and one of the things that is especially stupid about it is that healthcare providers can just choose to not take Medicaid — and many do, because Medicaid doesn’t pay them anywhere near as much as private insurers do. (One wonders if it has ever occurred to the people crying about their “hard-earned tax dollars” going to abortion that the private insurers they also pay into actually pay Planned Parenthood more for reproductive healthcare services. I think we can assume it has not.)
“We provide a service, and then Medicaid reimburses us for providing that service,” Dr. Katherine Farris, Planned Parenthood South Atlantic's chief medical officer, explained in a statement. “And Medicaid, as a general rule, reimburses far less than other insurance providers. Which means that often the money we get back for the service we have provided doesn't even cover that service. There is no way that it is then going on to support other services, like abortion.”
In many areas, rural areas in particular, Planned Parenthood is often one of the few providers (if not the only) that takes Medicaid for reproductive and gynecological health care. If I were queen, we’d have a free-at-the-point-of-service single payer system for everyone, which would mean that healthcare providers would have to take it, but sadly I am not.
McMasters told reporters this week that there are other options for women in South Carolina, though he seemed to largely be referring to “crisis pregnancy centers” and not, like, places where one can get a damned pap smear or a breast cancer screening or any other actual medical care.
“There are plenty of good organizations that provide maternal health, advice, counseling, care, and we need more of those. We need those kind of counselors,” he said. “But I'm confident ... that the people of this state do not want their tax money going for abortions.”
Farris, however, explained that while there are other providers doing good work, it often takes a lot longer to get an appointment with them than with Planned Parenthood.
“I regularly hear from patients that they want to get an IUD (long-lasting birth control device), and if they call the health department, the next IUD appointment is three months from now. And if they want to come into my clinic, they can get that IUD placed the same day,” Farris said. “And that is a massive difference. Delaying access to effective birth control by three months, as you can imagine, has massive impacts on patients' wellbeing.”
Gee, you think?
“Defunding” Planned Parenthood has long been a major priority for Republicans, so should the Court find in favor of South Carolina, it’s highly likely that all other red states will quickly follow suit — and that, as previously mentioned, it could even be implemented on a national basis (and probably will be).
PREVIOUSLY ON WONKETTE!
How do you tell what the right side of a SCOTUS ruling is? Thomas and Alito dissenting.
#Winning
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