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THE SUPREME COURT HAS DEALT ANOTHER DEVASTATING BLOW TO WOMEN  
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Elie Mystal
June 26, 2025
The Nation
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_ The court’s ruling in Medina v. Planned Parenthood twists logic,
common sense, and the law to further the right-wing assault on bodily
autonomy. _

A pro-choice demonstrator holds a sign in front of the US Supreme
Court Building as the Medina v. Planned Parenthood South Atlantic case
is heard on Wednesday, April 2, 2025., Tom Williams / CQ-Roll Call,
Inc via Getty Images

 

The Supreme Court dealt a devastating blow to women, their ability to
choose their own doctor, and the entire structure of civil rights
protections today. By a vote of 6–3 (which broke down along the
usual partisan lines), the court ruled that women on Medicaid cannot
choose their own doctor, or sue the state to defend their civil
rights, unless Republican state legislators in South Carolina approve.

This case, _Medina v. Planned Parenthood_
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is _not_ about abortion—at least not as a legal matter. Since the
passage of the Hyde Amendment back in 1976, federal funds, including
Medicaid funds, cannot be used for abortion services. The Hyde
Amendment is one of the worst laws we’ve ever passed
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and a consistent excuse
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treating women’s health care as a political chit, but this case did
not challenge it. Nor did it seek to overturn the Republican court’s
neolithic stance on abortion rights.

But this case is _all about_ abortion as a political matter.
That’s because, in 2018, South Carolina passed a law saying that
Medicaid funds could not be used with any provider that _also
provides_ abortion services, even if the patient isn’t seeking an
abortion.

Planned Parenthood provides a lot of medical services to people that
have nothing to do with abortion. It is a critical health care
provider to poor women, who are much more likely to be on Medicaid.
South Carolina’s law was a direct attack on Planned Parenthood for
its abortion services, but also an attack on poor women who need
healthcare whose only crime is being poor.

The plaintiff in this case, Julie Edwards, went to Planned Parenthood
for general gynecological services. Edwards is a diabetic and has
increased risks for pregnancy. She claimed that Planned Parenthood not
only provided the care she needed, but did so in a “judgment-free”
environment… which I imagine can be pretty hard to find in South
Carolina. She sued the state over its anti–Planned Parenthood law,
accusing South Carolina of violating her civil rights under Section
1983 of the 1871 Civil Rights Act.

In truth, Edwards didn’t even need to give a reason for why she
preferred Planned Parenthood doctors, because the 1965 Medicaid Act
includes a freedom-of-choice provision right in its text. If states
accept Medicaid funds, they must also “provide that…any individual
eligible for medical assistance (including drugs) may obtain such
assistance from any institution, agency, community pharmacy, or
person, qualified to perform the service or services required.”

Read that language closely. It doesn’t say “any institution,
except for Planned Parenthood” or “only institutions that Jesus
agrees with.” It’s a blanket rule that ensures freedom of choice
to Medicaid recipients.

At least it did until the Supreme Court took it away today. Justice
Neil Gorsuch, writing for the 6–3 Republican supermajority, ruled
that the statute I just quoted was not “clear” or
“unambiguous” enough to support a private right to sue when
freedom of choice is violated. He wrote that the language in the
Medicaid statute guaranteeing freedom of choice doesn’t actually
create an “enforceable right” to a freedom of choice. He said that
if Congress wanted to create a right to choose your own doctor, it
could have, but somehow it didn’t, even though Congress literally
says that people can get medical care from “_any_” institution
qualified to perform the services.

When people accuse the Republicans on the Supreme Court of making
things up as they go along to justify their own personal policy
preferences, this is what they mean. There is no commonsense read of
the Medicaid statute that doesn’t include freedom of choice. There
is no legal analysis of the statute that doesn’t include freedom of
choice. There is no history of precedent interpreting the Medicaid
statute that doesn’t include freedom of choice. There is just no way
to explain what the conservatives are doing here other than servicing
their own political agenda in a way that is detached from any logical
or reasonable reading of the law and text of the statute.

That political agenda is, again, _not_ just about abortion,
and _not_ just about the Republicans’ ongoing war against
women’s health. The agenda also involves the continued evisceration
of the Civil Rights Act of 1871, and the denuding of the
Reconstruction Amendments in this court’s quest to reset this
country to antebellum times.

The 1871 version of the Civil Rights Act still serves a critical
function in modern law because it includes the private right to sue.
Section 1983 of the law is _the thing_ that lets people sue over
discrimination. Without it, there’s no ability for individual
citizens to hold the government accountable for violations of civil
rights.

Predictably, the Republicans on the court are hell-bent on getting rid
of Section 1983, or whittling it down until it protects nothing.
In _Medina_, Gorsuch takes a giant step toward doing just that. The
legal upshot of his ruling is that Congress cannot create a right to
sue under Section 1983 unless it uses “clear” and
“unambiguous” language. And even if it does, as it did in the
Medicaid Act, Gorsuch can just deny the obvious clarity of that
language and ban it anyway. The result is that only Neil Gorsuch (and
his Republican friends) can tell what’s “clear” and what’s
not, and Gorsuch here proves that he’s able to insert faux-ambiguity
into any statute he doesn’t like.

This repudiation of civil rights is what Justice Kentanji Brown
Jackson zeroed in on in her dissent. She wrote: “he project of
stymying one of the country’s great civil rights laws continues.…
South Carolina asks us to hollow out [Section 1983] so that the State
can evade liability for violating the rights of its Medicaid
recipients to choose their own doctors. The Court abides South
Carolina’s request. I would not.”

It’s been three years since the court overturned _Roe v.
Wade_ in _Dobbs v. Jackson Women’s Health_ _Organization_, but
the conservatives are still using abortion as the Trojan Horse to
smuggle in all of their worst ideas about reshaping the country in
their white male image. Here, in a case that isn’t even about
abortion, the Republican justices have managed to take away freedom of
medical choice for poor women, limit the effectiveness of Medicaid,
and eviscerate the private right to sue over issues of discrimination
and civil rights. They’ve done it all because South Carolina passed
a law targeted at Planned Parenthood, a law that should have been
ruled facially unconstitutional in the pre-_Dobbs_ environment when
it was passed. And, almost as an externality to their dread aims,
they’ve managed to dissuade any medical institution, hospital, or
clinic, from providing abortion services, lest they too be kicked off
of Medicaid.

This case is a terrible and perfect example of why taking back control
of the Supreme Court must be the first priority for Democrats should
they ever be allowed to wield power again. Civil rights in this
country cannot survive the loss of the Civil Rights Act. Women’s
rights in this country cannot survive Neil Gorsuch’s magic abilities
to insert ambiguity into any statute that doesn’t involve Native
Americans. And abortion rights, “restored” or otherwise…
straight up cannot survive any Republican power on the Supreme Court.

If you’re a straight white man, congratulations. If you’re anybody
else, this Supreme Court has it in for you.

_ELIE MYSTAL is The Nation’s justice correspondent and a columnist.
He is also an Alfred Knobler Fellow at the Type Media Center. He is
the author of two books: the New York Times bestseller Allow Me to
Retort: A Black Guy’s Guide to the Constitution
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Popular Laws That Are Ruining America, both published by The New
Press. You can subscribe to his Nation newsletter “Elie v.
U.S.” here [[link removed]]._

_Copyright c 2024 THE NATION. Reprinted with permission. May not be
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* Supreme Court
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* Women
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* Civil Rights
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* abortion
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* Planned Parenthood
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* South Carolina
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* Civil Rights Act
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