Supreme Court Upholds South Carolina Executive Order Barring Medicaid from Planned Parenthood
A Protestor in a straw sun hat holds up a sign that reads “Keep Our Right To Choose” in Red Ink on a white Background. The message has a heart beside it.
On Thursday, June 26th, 2025, the Supreme Court ruled that states can cut off Medicaid funding to Planned Parenthood, thus upholding a 2018 executive order by Gov. Henry McMaster directing the South Carolina Department of Health and Human Services to remove Planned Parenthood from the SC Medicaid Provider list.
Giving a statement, which is posted on his website, the Governor said: “Seven years ago, we took a stand to protect the sanctity of life and defend South Carolina's authority and values – and today, we are finally victorious. The legality of my executive order prohibiting taxpayer dollars from being used to fund abortion providers like Planned Parenthood has been affirmed by the highest court in the land.”
While Planned Parenthood provides abortion care (Something that is stated in plain language on the governor’s website), Planned Parenthood also covers sexual, reproductive, and gender-affirming care and information. So while the ruling backs McMaster’s — And the Republican Party in general’s — movement to ban abortion nationwide, it has a broad reach of people it could affect, including the Disabled community.
People who rely on Planned Parenthood for disability-related concerns, such as those with Endometriosis, or even people with disabilities who cannot carry a fetus to term, will find themselves at risk given the ruling. This seems to be the opinion of Justice Ketanji Brown Jackson, who dissented in a 6-3 vote along party lines, saying that the ruling "is likely to result in tangible harm to real people. At a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them." A great example of this was the case that enjoined McMaster’s 2018 executive order when the state of South Carolina was sued by a woman who wanted to continue going to Planned Parenthood for Birth Control pills, given that her Diabetes made a potential pregnancy dangerous. Medicaid funding for Planned Parenthood amounts to about $90,000, and abortion is banned at six months.
Endometriosis is a chronic, systemic inflammatory condition that can affect the reproductive, gastrointestinal, urological, and neurological systems. It’s ranked among the 20 most painful conditions by the NHS and is now associated with increased risk of premature mortality, multiple comorbidities, and even higher cancer risk in some cases. Yet, federal research funding lags behind other chronic diseases by hundreds of millions annually. For those navigating poverty, limited provider networks, or chronic dismissal from the healthcare system, Medicaid and safety-net clinics are often the only way to access diagnosis and symptom relief.
Planned Parenthood reports that nearly 41% of its patients rely on Medicaid, and in many rural and underserved communities, it’s the only reproductive health provider accepting Medicaid at all. Stripping funding means these patients lose access to:
Hormonal medications used to manage pain and suppress portions of disease activity, like oral contraceptives, progestins, and GnRH analogs. While these don't treat endometriosis at its root, they remain frontline therapies for managing symptoms and improving daily function
Ultrasound imaging, essential for tracking ovarian cysts, endometriomas, and uterine abnormalities - often the first diagnostic step before a surgical referral.
Specialist referrals, especially critical in rural areas where OB-GYNs trained in complex disease are scarce.
Over 20 million women in the U.S. receive health coverage through Medicaid, and chronic gynecologic conditions are among the top reasons for reproductive-age women to seek care. This population includes not just cisgender women, but also trans men, nonbinary individuals, adolescents, and postmenopausal patients - many of whom face additional layers of dismissal, misdiagnosis, and economic hardship When the Supreme Court simultaneously upheld the state’s defunding effort and blocked the right of patients to challenge it in court, they left endometriosis patients voiceless and increasingly vulnerable.
Yet, despite its widespread impact, endometriosis remains severely underfunded by the NIH, receiving just a fraction of the research dollars allocated to conditions like diabetes or heart disease. Meanwhile, the cost of care is staggering, with Medicaid patients incurring high rates of ER visits, surgeries, and pharmaceutical expenses. The disease also leads to reduced earnings, job loss, and increased reliance on disability benefits over time.
This ruling adds another barrier and silences patients further. By not only upholding South Carolina’s Medicaid defunding effort, but also blocking patients’ rights to challenge it in federal court, the Court has rendered many of us voiceless.
“This isn’t about abortion. This is about losing the last thread of medical care that many have left. As someone living with endometriosis, I know firsthand how dangerous it is when access to reproductive and chronic disease care is politicized or taken away. I almost lost my life to endometriosis. For millions of us, clinics like Planned Parenthood are not about strictly abortion access. They are often the only place where we can access affordable pain management, pelvic imaging, or even a provider who takes our symptoms seriously. When access is denied early, especially for adolescents and young adults, whose symptoms are often dismissed as “normal period pain”, we are left with worsening disease progression, years-long diagnostic delays, and preventable loss of fertility, income, trust in the medical system, and simply being alive. ACOG itself recommends early evaluation and treatment in teens, yet state policies are making that impossible."
-Chelsea Hardesty - Invisible Voice Columnist, Founder and President of Getting the Better of Endometriosis, Research Assistant and Ohio State Rep for Worldwide EndoMarch, USA, CEO of SATIREV, Volunteer with American End of Endo Project and The Autoimmune Alliance
When access is cut off under the guise of political posturing, chronically ill patients are left behind, not because our condition changed, but because someone decided our medical needs no longer mattered.
Planned Parenthood has said that the decision will hinder approximately one million Medicaid recipients, with the Chief Medical Officer of Planned Parenthood South Atlantic, Katherine Farris, stating that the ruling makes citizens “Fundamentally less free” if they fall on hard times. Medicaid recipients reportedly make up 3.5% of people who go to Planned Parenthood for services unrelated to abortion or gender affirming care, and given that an estimated number of over 936,000 residents are on the government-funded insurance program, that makes up roughly 94,000 people. Combine that with the people who do use those services, and you open up a potential black hole that many fear will ruin their lives as a result.
The ruling means that patients cannot sue for coverage under Medicaid, which is, of course, mostly an accountability tool when, unfortunately, patients fall through the cracks of the insurance system, and it is nearly impossible to monitor every case of every patient in America. One could argue that even though the law allows for citizens to choose where they get their care, allowing the state to dictate their choice to go to Planned Parenthood violates one of the country’s most fundamental laws and constitutes what many call a “backdoor abortion ban.”
While McMaster has long been a proponent of a nationwide abortion ban, the Governor has come under heavy criticism for his role, or lack thereof, in the success of the state’s public education. South Carolina ranks 32nd in overall public education (Up from 43rd in 2022), but 49th in school safety as of 2024, according to the World Population Review. The state has had record-low test scores for generations, and while McMaster has gone on something of a personal crusade to get us to where we are now, the children in the state, of which I am a citizen, have continued to suffer from an appalling lack of educational standards and assistance to thrive in their daily life, which is an issue that is only exacerbated when you are a child with a disability, which often leads to even more barriers later in life.
It could be construed as hypocritical, therefore, that McMaster calls his victory about “protecting the sanctity of life” when South Carolina citizens are not afforded that same respect once they are born. The ruling raises more questions than answers about how best to raise a family and live life as a disabled person in America in an already dark political climate.
Chelsea Hardesty, Invisible Voice Columnist, Founder and President of Getting the Better of Endometriosis, Research Assistant and Ohio State Rep for Worldwide EndoMarch, USA, CEO of SATIREV, and Volunteer with American End of Endo Project and The Autoimmune Alliance, was a contributor to this article. Her knowledge of and lived experience with Endometriosis was invaluable towards its publishing
