WASHINGTON – The U.S. Supreme Court cleared the way on Thursday for South Carolina to strip Planned Parenthood of funding under the Medicaid health insurance program in a ruling that bolsters efforts by Republican-led states to deprive the reproductive healthcare and abortion provider of public money.

The 6-3 ruling overturned a lower court’s decision barring Republican-governed South Carolina from terminating regional affiliate Planned Parenthood South Atlantic’s participation in the state’s Medicaid program because the organization provides abortions.

The court’s three liberal justices dissented from the decision.

The case centered on whether recipients of Medicaid, a joint federal and state health insurance program for low-income people, may sue to enforce a requirement under U.S. law that they may obtain medical assistance from any qualified and willing provider.

Since the Supreme Court in 2022 overturned its landmark Roe v. Wade ruling that had legalized abortion nationwide, a number of Republican-led states have implemented near-total bans or, like South Carolina, prohibitions after six weeks of pregnancy.

Planned Parenthood South Atlantic operates clinics in the South Carolina cities of Charleston and Columbia, where it serves hundreds of Medicaid patients each year, providing physical examinations, screenings for cancer and diabetes, pregnancy testing, contraception and other services.

The Planned Parenthood affiliate and Medicaid patient Julie Edwards sued in 2018 after Republican Governor Henry McMaster ordered South Carolina officials to end the organization’s participation in the state Medicaid program by deeming any abortion provider unqualified to provide family planning services.

The plaintiffs sued South Carolina under an 1871 U.S. law that helps people challenge illegal acts by state officials. They said the Medicaid law protects what they called a “deeply personal right” to choose one’s doctor.

The South Carolina Department of Health and Human Services, represented by the Alliance Defending Freedom conservative legal group and backed by President Donald Trump’s administration, said the disputed Medicaid provision in this case does not meet the “high bar for recognizing private rights.”

A federal judge ruled in Planned Parenthood’s favor, finding that Medicaid recipients may sue under the 1871 law and that the state’s move to defund the organization violated the right of Edwards to freely choose a qualified medical provider.

In 2024, the Richmond, Virginia-based 4th U.S. Circuit Court of Appeals also sided with the plaintiffs.

The Supreme Court heard arguments in the case on April 2.

The dispute has reached the Supreme Court three times. The court in 2020 rejected South Carolina’s appeal at an earlier stage of the case. In 2023, it ordered a lower court to reconsider South Carolina’s arguments in light of a ruling the justices had issued involving the rights of nursing home residents that explained that laws like Medicaid must unambiguously give individuals the right to sue.

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(Reporting by Andrew Chung; Editing by Will Dunham)