Written by Skylar Laird, SC Daily Gazette.
South Carolina’s two Planned Parenthood clinics can no longer accept Medicaid health insurance for non-abortion health care services.
A provision of Republicans’ “big, beautiful” law that barred Medicaid reimbursements to Planned Parenthood for one year took effect in South Carolina on Monday. That’s because a federal judge’s ruling that partially suspended the law elsewhere didn’t apply to the Palmetto State.
Meanwhile, it remains unclear whether the nonprofit can get reimbursed for the visits of about 1,000 Medicaid-covered patients in South Carolina due to a separate lawsuit.
Last month, a U.S. Supreme Court ruling effectively allowed the state to remove Planned Parenthood from its list of approved Medicaid providers, potentially settling a seven-year-old case. But that ruling has yet to take effect.
The nation’s highest court must still send its decision back to a lower court. A judge could decide to simply let Gov. Henry McMaster’s 2018 executive order — which has been blocked by the lawsuit ever since — take effect. Or more legal arguments could be required.
After the June 26 ruling, Planned Parenthood clinics in Columbia and Charleston continued accepting Medicaid for health care services the government insurance program normally would cover, such as cancer screenings, contraceptives, and treatment for sexually transmitted infections. But they haven’t asked the state’s Medicaid agency to get paid for those services, according to Vicki Ringer, a longtime lobbyist for Planned Parenthood in South Carolina.
Since there’s a possibility the judge will let McMaster’s order retroactively take effect with the high court’s ruling, Planned Parenthood doesn’t want to have to pay the state back.
While questions on that case continue, a different federal judge’s ruling on the massive tax-and-spending law signed July 4 by President Donald Trump immediately stopped Planned Parenthood from accepting Medicaid, said spokeswoman Molly Rivera.
That’s because the ruling allowed payments to continue only to clinics that either don’t provide abortions or are parts of regional membership organizations that received no more than $800,000 from Medicaid in 2023. South Carolina’s clinics, which continue to provide abortions as allowed under the state’s 2023 law, met neither of those exceptions.
Planned Parenthood’s attorneys will keep fighting both the federal law’s one-year ban and the state’s executive order, said Susanna Birdsong, an attorney for the nonprofit’s South Atlantic region.
While they involve lawmakers’ decisions seven years apart and separate rulings in different courts, the result is the same — at least, for now.
“They’re pulling at different levers, but the effect is, because we provide abortions, we are not allowed to bill Medicaid for other services we provide,” Birdsong said.
The state Attorney General’s Office did not respond to a request for comment.
Medicaid doesn’t pay for abortions in South Carolina except in cases of rape, incest or to save a patient’s life. However, under the 2023 state law, abortions remain legal until an ultrasound first detects cardiac activity. The state Supreme Court’s most recent ruling in May upholding that law kept the ban at six weeks of pregnancy.
Despite the imminent loss of funding, the state’s clinics aren’t in danger of closing, Ringer said.
Because South Carolina never expanded Medicaid eligibility as the 2010 federal health care law intended, the reimbursements for procedures covered under Medicaid were already relatively low. So, the clinics didn’t depend on them to keep operating, she said.
The nonprofit’s bigger concern is how Medicaid patients will get care if they can’t go to Planned Parenthood’s two clinics in South Carolina. Not all doctors accept Medicaid as insurance, and those who do often have long waits, Ringer said.
She stressed that Medicaid patients can continue visiting Planned Parenthood and using its income-based payment system to get low-cost treatments.
However, their government-provided insurance will no longer cover the visits.
Leaders for the nonprofit have vowed to continue serving patients and finding ways to challenge the governor’s decision.
The U.S. Supreme Court’s ruling last month — that patients don’t have the right to sue to see the provider of their choice — was technical. But other legal questions remain, Birdsong said.
The decision “doesn’t foreclose other possible ways to challenge the executive order,” Birdsong said.
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