Allowing better options for women

In early April, the Supreme Court will weigh in on South Carolina’s decision to send its taxpayer dollars to healthcare providers other than abortion giants like Planned Parenthood. Alliance Defending Freedom (where I work) is defending South Carolina and arguing that the states should be able to refuse to subsidize abortions and choose instead to fund healthcare facilities that offer women comprehensive care. The technical legal issue in the case—whether Planned Parenthood can sue directly in federal court or must go through a state administrative process—is the first step in ensuring states have that ability.

The federal government invites states to administer Medicaid plans subject to oversight by the secretary of the U.S. Department of Health and Human Services. States decide which medical providers are qualified to provide and receive payment for certain services. The South Carolina legislators enacted a statute that prohibits the use of taxpayer funds to pay for abortions. And because money is fungible, and funneling taxpayer funds to abortion facilities subsidizes abortions, South Carolina deemed abortion facilities unqualified to receive Medicaid funds.

Planned Parenthood sued in federal court. South Carolina argues that states should be free to exclude organizations like Planned Parenthood—whose primary business is abortion—from public funding. Indeed, there are roughly 200 publicly funded women’s healthcare clinics and pregnancy centers in South Carolina that provide a broad range of high-quality, life-affirming healthcare services. Meanwhile, Planned Parenthood’s two South Carolina locations offer limited services—mostly abortion and risky gender-transition drugs.

Planned Parenthood is a multi-billion-dollar political organization. Between 2018 and 2023, Planned Parenthood received $3.2 billion in public funding. Since the Dobbs decision, Planned Parenthood has enjoyed a fundraising bonanza. It raised nearly $500 million in 2022 alone. Since 2022, the organization has amassed over $2.5 billion in assets.

According to a recent New York Times exposé, Planned Parenthood spends many of these assets on political activism, not people. Its bylaws require that most of its funds go to political advocacy, not medical care. And per the New York Times, “Over the last five years, the national office has distributed more than $899 million to affiliates to help them deliver care, but none of it went directly to medical services.” It went to pro-abortion politicking and legal support—not healthcare. Even Planned Parenthood’s leaders say the organization has “repeatedly prioritized the fight for abortion rights over clinics.”

Indeed, even while its fundraising has skyrocketed, the organization has done less for women. Between 2022 and 2023, preventative-care visits fell 31 percent, and the number of patients seen annually has fallen 60 percent since the 1990s. Cancer screening and prevention services have dropped by 71% since 2010, including declines of 72% for breast exams and 74% for pap tests. When Planned Parenthood of Northern California faced a budget crunch—again despite record-breaking national fundraising—it discontinued its prenatal program for 250 to 300 low-income women, calling it “a difficult but necessary decision.”

Even among the limited care that Planned Parenthood does provide, the New York Times investigative report highlighted “scores of allegations” of malpractice and botched care. That report, based on interviews with more than 50 current and former employees, describes Planned Parenthood’s intense efforts to shorten patient interactions to boost its bottom line: “Employees said there has been constant pressure to more than double the number of patients seen from the present 2.1 million, to help bring in more revenues.” According to a previous Planned Parenthood affiliate manager, this conveyor-belt mentality left patients feeling “like they were in a factory.”

And when combined with the poor training uncovered by the New York Times, the hurry-up mentality has led to allegations of serious medical malpractice. These allegations include botched abortions, severe nerve damage from an IUD, insertion of an IUD into a woman who was already pregnant, and failure to document STD test result. One young woman who received an IUD was “told it would be rough, and just ride it out,” but because Planned Parenthood botched the procedure she “suffered months of sharp pain and bleeding,” yet could only reach “automated phone tree messages” from Planned Parenthood.

Plus, according to the New York Times, many of the clinics are in need of upgrades and repairs. At one abortion facility in Omaha, for example, sewage from a backed-up toilet seeped into an abortion recovery room for two days. Patients vomited from the stench. Despite all this, when Planned Parenthood employees complained about the safety and resource problems, the organization reminded the employees “that they were in a ‘mission moment’” that “overshadowed their concerns.”

States should be able to prioritize women’s health over that mission moment. A Supreme Court holding that Planned Parenthood and other abortion giants shouldn’t be able to skip the usual state remedy and run to federal court is a crucial step in ensuring that states have the ability to ensure that women receive real medical care.