Attorney General Bonta Urges U.S. Supreme Court to Defend Medicaid Recipients’ Freedom to Choose Qualified Healthcare Providers

Coalition argues that Medicaid Act’s free-choice-of-provider provision ensures Medicaid recipients access to a wide variety of qualified providers by conferring an individual right to patient choice

OAKLAND — California Attorney General Rob Bonta, as part of a coalition of 17 attorneys general, today filed an amicus brief with the U.S. Supreme Court in support of Medicaid recipients' individual right to receive care from the qualified providers of their choice, including Planned Parenthood. In Planned Parenthood South Atlantic v. Medina, the state of South Carolina unlawfully terminated Planned Parenthood South Atlantic’s (Planned Parenthood) participation in Medicaid only because the organization performed abortions outside of the Medicaid program. As a result of the termination, Planned Parenthood immediately had to begin turning away Medicaid patients. At issue is whether Medicaid beneficiaries have a private right of action to obtain assistance from any institution that is “qualified to perform the service or services required” under the Medicaid Act’s free-choice-of-provider provision. There is no genuine dispute that Planned Parenthood is a “qualified” provider of health services, and Medicaid does not pay for abortion except in the very limited circumstances required by federal law (pregnancies due to rape, incest, or when the pregnancy person’s life is at risk).

“Politicians should not be dictating whether Medicaid beneficiaries in their state can or cannot see undisputedly qualified providers. That is precisely why Congress passed the free-choice-of-provider provision at issue in this case,” said Attorney General Bonta. “In South Carolina and across the nation, many low-income residents who are enrolled in Medicaid turn to Planned Parenthood for critical services, including physical exams, pregnancy testing and counseling, and screening for conditions such as diabetes, depression, and high blood pressure. My fellow attorneys general are proud to stand with Planned Parenthood and to support the ability of Medicaid recipients to access critical reproductive health services.”  

Created in 1965 and jointly funded by state and federal expenditures, Medicaid ensures that our country’s most vulnerable populations have access to safe, affordable, quality healthcare. Planned Parenthood South Atlantic and its predecessors have provided healthcare to low-income residents of South Carolina for four decades. Planned Parenthood operates two health centers in medically underserved communities in the state, one in Charleston and one in Columbia. Those centers provide essential medical care to hundreds of Medicaid patients each year. Congress enacted the free-choice-of-provider provision to address a specific problem: during the first two years of Medicaid’s existence, some states “forc[ed] recipients to choose from a very narrow list of public providers.”

In 2018, South Carolina Governor Henry McMaster issued an executive order directing the South Carolina Department of Health and Human Services to remove any organization that provides abortion services, including Planned Parenthood, from the state’s Medicaid provider list. A South Carolina Medicaid recipient challenged the state’s decision, and a federal district court ruled that the state’s exclusion of Planned Parenthood was unlawful. In March 2024, the U.S. Court of Appeals for the Fourth Circuit affirmed the trial court’s decision, holding that the Medicaid Act gives patients a private right of action to ensure the freedom to choose their own qualified healthcare providers, notwithstanding the Governor’s action. South Carolina sought review in the U.S. Supreme Court, which will hear the case on Wednesday, April 2.  

In the amicus brief, Attorney General Bonta and his fellow attorneys general argue that:

• Access to a variety of qualified providers is a key component of Medicaid’s success. Medicaid recipients have the same range of health concerns as patients on private insurance, and so they require access to the same range of qualified providers and specialists as patients on private insurance.
• The free-choice-of-provider provision ensures that patients have access to a range of qualified health providers and services. The provision is a limited exception to states’ otherwise substantial discretion over their Medicaid offerings. Enacted to counter state policies that restricted Medicaid recipients to a narrow subset of state-sanctioned healthcare providers, the statute safeguards patients’ medical decisions from government micro­management.  
• South Carolina’s efforts to stymie patient choice show why Congress thought it necessary to confer an individual right. South Carolina is attempting to substitute its own judgments — unrelated to provider qualifications — for those of its Medicaid recipients. The statute clearly does not permit it to do so.

Joining Attorney General Bonta in filing the amicus brief are the attorneys general of Colorado, Delaware, District of Columbia, Hawai’i, Massachusetts, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, and Washington. 

A copy of the amicus brief can be found here.