() The Supreme Court will hear oral arguments Wednesday on whether a South Carolina woman can bring a lawsuit challenging that state’s decision to ban Planned Parenthood from its Medicaid program for nonabortion health care services. 

The issue landed in the nation’s court after a 2018 executive order by South Carolina Gov. Henry McMaster directed the state’s Department of Health and Human Services to prevent clinics that provide abortions from participating in the government health insurance program even if they provide other medical care.

His order stated that the “payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life.” 

South Carolina currently has a six-week abortion ban. 

Medicaid provides health insurance to low-income individuals, so the case could significantly change access for the thousands utilizing the program in South Carolina. 

A federal appeals court ruled against the state three times, which has led the case to the nation’s highest court under Medina v. Planned Parenthood South Atlantic.

What is the case about? 

Medicaid patient Julie Edwards, along with Planned Parenthood, sued the state, saying they have illegally blocked her right to visit the clinic for nonabortion health care. 

Edwards, a diabetes patient, claimed that she went to Planned Parenthood for birth control but wanted to return to the clinic to receive other care in the future, including blood pressure screenings, according to the appeals court ruling. 

Planned Parenthood offers several health services, including contraception, cancer and blood pressure screenings, pregnancy testing and physical exams. Clinics in Charleston and Columbia also offer same-day appointments and extended clinic hours to help low-income patients come in more easily, the ruling noted. 

But under McMaster’s order, Edwards was “not able to continue going there if the services [were] not covered” by Medicaid because she could not afford “to pay out of pocket,” the ruling stated. 

She and the clinic brought suit, saying that McMaster’s order violated federal law that allows any patient who is eligible for Medicaid to seek health care from any “qualified” provider.

The Medicaid Act states that “any individual eligible for medical assistance” may obtain that care “from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.”

Medicaid offers federal funding to states that agree to comply with certain conditions, including the “free-choice-of-provider” provision added in 1967, which ensures Medicaid beneficiaries can obtain medical assistance from any “qualified” provider.

The U.S. Court of Appeals for the Fourth Circuit sided with Edwards, saying that people who use Medicaid as their insurance have the right to visit any qualified family planning provider that accepts Medicaid, including those that provide abortion, like Planned Parenthood.

What is Planned Parenthood arguing? 

Edwards and the health center say the state violated federal law under the Medicare and Medicaid Act by limiting which provider a Medicaid patient can see and by disqualifying Planned Parenthood as a Medicaid-eligible provider. 

What is South Carolina’s argument? 

Conservative group Alliance Defending Freedom is defending the state and argues that not allowing state officials to decide how to spend infringes upon its rights.

They say the state has the ability to determine a health provider unqualified to receive payment from Medicaid for any reason, including providing abortions. They also say federal law was never intended to restrict the state’s ability to make its own determinations.

“Taxpayer dollars should never be used to fund facilities that make a profit off abortion,” said ADF Senior Counsel John Bursch in a statement. “State officials should be free to determine that Planned Parenthood and other entities that peddle abortion are not qualified to receive taxpayer funding through Medicaid. Congress did not create a right for Medicaid recipients to drag states into federal court to challenge those decisions.”

What’s at stake? 

A majority of the more than one million people on Medicaid in South Carolina are women, so the outcome of the case could significantly affect their access to medical care.

Sixty-three percent of Medicaid recipients in South Carolina are women, and 20% of all women of reproductive age in South Carolina are enrolled in Medicaid, according to KFF. 

Advocates say that access to basic health care is already challenging for Medicaid recipients, and added restrictions may make things even more difficult. 

“If the Supreme Court decides that Medicaid recipients cannot fight back in court when the South Carolina Department of Health and Human Services prevents them from freely choosing their health care provider, the effects could ripple far beyond South Carolina. Other states could follow suit, especially those that have tried to defund Planned Parenthood or otherwise cut it out of public programs,” the Guttmacher Institute, a research organization that supports abortion rights, said on the case.