A victory for life and law

In a win for life and the rule of law, the United States Supreme Court allowed states to direct limited healthcare dollars to healthcare facilities that provide comprehensive care for women–not primarily abortion and high-risk gender transition drugs. With its holding that a particular provision of the Medicaid Act does not confer a private right of action, the Court not only delivered a setback to the abortion lobby—it also sent a clear message: the rule of law matters and it is up to Congress not federal courts to create new ways to get into federal court.

This case originated when South Carolina deemed abortion facilities unqualified to receive Medicaid funding. This change redirects Medicaid funds from abortion facilities to health clinics that provide a wider range of medical services for low-income women. It also implemented the view of South Carolinians expressed through their elected representatives that taxpayer funds should not be used to pay for abortions. And since money is fungible, funneling taxpayer funds to abortion facilities for any purpose indirectly subsidizes abortions.

Planned Parenthood sued in federal court. Alliance Defending Freedom (where I work) defended South Carolina, arguing that Congress did not authorize private lawsuits in federal court and that the American people should not be forced to fund activist organizations like Planned Parenthood that perform abortions and distribute dangerous gender-transition drugs to minors.

Let’s be clear: This case was never about access to healthcare. There are roughly 200 publicly funded healthcare clinics in South Carolina that provide a broad range of high-quality healthcare services, including family-planning services. Planned Parenthood’s two South Carolina locations, on the other hand, offer limited services—mostly abortion, contraception, and high-risk gender-transition drugs.

Yet Planned Parenthood tried to twist the Medicaid Act into something Congress never meant it to be—a vehicle for private lawsuits aimed at forcing states to keep the abortion industry flush with taxpayer dollars. In fact, between 2018 and 2023, Planned Parenthood received $3.2 billion in direct public funding. It has amassed over $2.5 billion in net assets. Yet according to the New York Times, Planned Parenthood spends most of its funds on pro-abortion politicking and legal support. Preventative services and cancer screenings have decreased dramatically and Planned Parenthood “leaders say they have repeatedly prioritized the fight for abortion rights over clinics.”

A 6-3 majority of the Supreme Court rightly recognized that Congress did not give individuals a private right to sue states over provider exclusions under the Medicaid Act. Medicaid is what’s known as a Spending Clause statute. That means that instead of identifying an enumerated power, Congress persuaded the states to participate in the program by offering them funds. The typical remedy for a spending clause violation is that the state doesn’t get the federal funds. The question here was whether Congress had provided an additional remedy. The Supreme Court has long held that the legitimacy of Congress’s exercise of its spending power depends on a state’s voluntary and knowing acceptance of terms–including whether accepting federal funds would subject the state to private lawsuits. As a result, Congress must use “clear, rights-creating language” in a Spending Clause statute like Medicaid in order to create a private right of action. The Court held that Congress used no such language in the relevant provision, rejecting the creative but dangerous theory that federal spending laws can be enforced by anyone with a grievance and a lawyer.

Make no mistake: Medina is a blow to the abortion-industrial complex. It pulls the plug on a favorite tactic—filing lawsuits against states that say “no” to Planned Parenthood. And it paves the way for state legislatures to make life-affirming decisions. In fact, ten states have done something to disqualify Planned Parenthood and redirect funds to real women’s healthcare. The Supreme Court’s decision in this case allows them to do just that.

This ruling is not just a win for the unborn—it’s a win for every American who believes the rule of law should mean something. And it’s a big win for the people of South Carolina, who don’t want their tax dollars supporting abortion.