Charleston, S.C. (CN) — A federal appeals court wrestled Friday with whether a South Carolina woman could sue the state for removing Planned Parenthood from its Medicaid network.
Julie Edwards, a Medicaid patient of Planned Parenthood South Atlantic, claims the governor violated her civil rights when he disqualified the organization as a Medicaid-eligible provider. The state maintains Edwards has no right to sue under the Medicare and Medicaid Act.
Edwards won a federal court battle over the issue in 2020, but the case was granted new life in June after the U.S. Supreme Court’s decision in Health and Hospital Corporation of Marion County v. Talevski.
The ruling in Talevski raised questions about the role of individual citizens to hold government officials accountable through civil rights lawsuits. The justices determined that while citizens can sue the government for such violations, the rights must be “unambiguously” conferred by statute.
The Supreme Court vacated Edwards’ judgment and remanded the case for new arguments after Talevski.
On Friday, a three-judge panel from the 4th Circuit Court of Appeals weighed whether a key provision of the Medicaid Act was sufficiently unambiguous.
States receive Medicaid funding to subsidize the costs of health care services provided to low-income families and individuals. In exchange, states agree to follow certain rules established by Congress.
At the heart of the Planned Parenthood case is the “free-choice-of-provider” provision, which requires that states permit Medicaid recipients to obtain health services from a qualified provider of their choosing.
South Carolina Governor Henry McMaster issued an executive order in 2018 banning Planned Parenthood South Atlantic and other abortion providers from receiving Medicaid payments. McMaster said at the time he wanted to avoid indirectly subsidizing abortions in the state.
Planned Parenthood South Atlantic and its patient, Edwards, quickly filed suit in South Carolina federal court, claiming Edwards’ right to choose her provider was violated. The court granted a preliminary injunction and the Fourth Circuit Court of Appeals affirmed it. In 2020, the lower court granted plaintiffs’ motion for summary judgment, but similar cases had split the circuits.
Texas removed Planned Parenthood from its list of qualified Medicaid providers in 2016. After four years of litigation, the 5th Circuit Court of Appeals ruled the healthcare provider’s clients were not entitled to bring a civil rights claim challenging the decision.
South Carolina petitioned the U.S. Supreme Court to review its case. The high court ordered the Fourth Circuit to give the case further consideration in light of Talevski.
Attorney John Bursch, of Caledonia, Michigan, represented South Carolina at Friday’s hearing. He argued that the decision in Talevski made it clear Medicaid recipients were not entitled to sue states for their decision to disqualify medical providers.
The Supreme Court wrote in Talevski that federal statutes can create enforceable civil rights, but the statute must “unambiguously confer those rights.”
Bursch told the judges the “free-choice-of-provider” provision contained in the Medicaid Act is too vaguely written to construe an enforceable right for individual patients.
The Department of Health and Human Services could terminate Medicaid funding for South Carolina if it believed the state violated federal law, Bursch said, but he believed the state was substantially compliant.
Attorney Avi Kupfer of Mayer Brown in Chicago represented Planned Parenthood and Edwards.
He argued the provision was written to create a right for individual patients — not the government. The Talevski decision should be interpreted as one of several recent opinions meant to help guide the lower courts as they grapple with civil rights litigation, Kupfer said, but the Fourth Circuit reached the right decision when it affirmed the earlier injunction.
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