Medina v. Planned Parenthood South Atlantic, 606 U.S. ___, 2025 WL 1758505 (June 26, 2025, No. 23-1275)
Based on state law prohibiting public funds for abortion, South Carolina barred Planned Parenthood from participating in the state’s Medicaid program. Planned Parenthood and a patient sued the director of the state’s Department of Health and Human Services, bringing a putative class action under § 1983 to “vindicate rights secured by federal Medicaid statutes.” They claimed the exclusion violated Medicaid’s any-qualified-provider provision (42 U.S.C. § 1396a(a)(23)(A)), which conditions federal Medicaid funding on the states’ agreement that beneficiaries may obtain care from “any qualified provider.” The patient alleged she needed Medicaid coverage and preferred Planned Parenthood provide her gynecological care. The district court granted summary judgment for plaintiffs and enjoined the exclusion, and the Fourth Circuit affirmed. The Supreme Court vacated and remanded in light of Health and Hospital Corporation of Marion County v. Talevski, 599 U.S. 166 (2023), which addressed whether a spending-power statute created enforceable rights under § 1983. The Fourth Circuit reaffirmed.
The Supreme Court again granted certiorari, reversed, and remanded. The 6-justice majority explained that spending-power statutes, like Medicaid, rarely confer enforceable rights because Congress’s spending power, attributable to Article I, section eight, clause one of the U.S. Constitution, does not expressly give Congress the power to regulate conduct. For that reason, the Court has long distinguished between mere benefits and rights that are enforceable under § 1983. Moreover, the federal government’s conditional grants to states are akin to treaties between sovereigns. It follows that Congress alone has the power to enforce grant conditions unless it “clearly and unambiguously” alerted the States in advance that responding to private lawsuits was a condition of the offer. As explained in Talevski, statutes creating enforceable individual rights must do so in “clear and unambiguous terms” using “rights creating terms” and displaying an “unmistakable focus” on individuals. The majority held that Medicaid’s “any qualified provider” provision failed to meet this stringent standard and therefore created no individually enforceable right under § 1983. While undoubtedly seeking to benefit both providers and patients, the statute contains no clear and unambiguous rights-creating language; instead, it focuses on what states must do to participate in Medicaid and explains that failure to meet certain standards may result in a loss of federal funding.
