Medina v Planned Parenthood Case Reinterprets Any Willing Provider Provision: Jennifer Evans, JD

Jennifer Evans, JD, health care shareholder at Polsinelli's Denver office, spoke with The American Journal of Managed Care® about the Medina v Planned Parenthood case decided on June 26, which effectively allowed South Carolina to withhold Medicaid funding from Planned Parenthood. Evans discussed how the Supreme Court came to this decision and what the financial implications would be for Planned Parenthood clinics.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

Can you explain the Supreme Court decision in the Medina v Planned Parenthood case?

The Medina case was trying to consider whether the Social Security Act's Medicaid provision allowing beneficiaries to choose any willing provider to offer them the health care they need was essentially held to not be enforceable by an individual. It's an interesting case in that it was really styled as a question of individual rights but has a lot of language that suggests some uncertainty around what it takes to be enrolled as a Medicaid provider and the ability of states to make sort of non-clinical judgments about whether or not a provider is qualified. It was interesting; in the Medicaid bar, we always call it the "Any Willing Provider" provision, but Justice [Neil] Gorsuch called it the "Any Qualified Provider" provision, which certainly signals a change in how he intended to use the statute in the opinion.

Does this decision threaten Planned Parenthood clinics across the country, especially those that have cut funds previously?

I think the short answer is no, although I certainly am not familiar with Planned Parenthood's financials or what percent of their revenue comes from Medicaid in South Carolina or anywhere else. It is interesting in that, as you know and as your readers know, certainly Medicaid does not pay for abortions. Federal funds have not been eligible to be used to pay for abortions for decades under the Hyde Amendment. Planned Parenthood, as they argued in this case, certainly as a provider, offers a significantly more expansive range of services than just abortion, particularly around primary care and cancer screenings. What's interesting here is that the one service that Planned Parenthood might furnish, even though Medicaid wouldn't pay for it under the South Carolina framework, has eliminated its ability to furnish covered Medicaid services to Medicaid beneficiaries as well. In almost every jurisdiction where Medicaid covers beneficiaries, there's an access to care issue, particularly for primary care, and so it essentially decides it's more important to prevent a provider who offers a service that the state disfavors than it is to allow promotion of access to care by following the Any Willing Provider statute, as it was previously understood.