In another loss for American women from the Supreme Court’s 2022 decision to turn their reproductive health care rights over to state control, the Supreme Court on Thursday ruled that they have no right under federal law to choose their own doctor.

By a now-familiar 6-to-3 vote in major cases, the Court ruled that federal Medicaid law, which pays for health care for the poor and the disabled, does not give women a legal right to pick their care provider and confers no right to sue when that choice is taken away.

That ruling was issued as the Court continued moving toward finishing its current term, with five more cases still to be decided.

Thursday’s ruling, supported by the Court’s six-Justice conservative majority, left in place the state of South Carolina’s decision five years ago to exclude the Planned Parenthood organization from providing any medical services under the state’s Medicaid plan.

Planned Parenthood has two clinics in the state, providing a variety of women’s treatment services, including abortions.

In another facet of the new decision, the Court narrowed even further its view of when an 1871 civil rights law (so-called “Section 1983”) gives people a right to sue state governments for violating their rights.  That trend has been developing steadily over the past quarter-century.

The trend has involved interpretations of the meaning of federal laws, enacted under Congress’s power to control spending, that provide federally-funded benefits (as Medicaid has done since 1965) for individuals.

Increasingly, the Court has ruled that such laws only create individual rights when the measures use clear and specific language to create a right; access to benefits is not enough to create an enforceable right.

One of the six Justices in the majority, Clarence Thomas, argued in a separate opinion for himself that the Court should consider going even further to reduce the scope of when that old law protects civil rights.  He argued that the “original meaning” of that law was expanded too far in more recent decisions.

The new ruling (Medina v. Planned Parenthood South Atlantic came two days after the third anniversary of the Court’s ruling in Dobbs v. Jackson Women’s Health Organization, overturning the abortion rights ruling in Roe v. Wade (1973) and handing regulation of that healthcare field to the states.

One of the nation’s most prominent anti-abortion groups, Priests for Life, praised the decision, calling it “one of the unfolding victories of the 2022 Dobbs decision.”  The statement added that the ruling “rightly shows deference to the states.”

The Court’s three progressive Justices strongly condemned the decision.  In a 22-page dissenting opinion written by Justice Ketanji Brown Jackson, those three said that the result “will strip Medicaid recipients in South Carolina – and countless other Medicaid recipients around the country – of a deeply personal freedom: the ability to decide who treats us at our most vulnerable.”

Joining in that dissent were Justices Elena Kagan and Sonia Sotomayor.

The majority’s 24-page opinion was written by Justice Neil M. Gorsuch.  Justice Thomas joined it, but also wrote his own opinion. Also supporting the Gorsuch opinion were Chief Justice John G. Roberts, Jr., and Justices Samuel A. Alito, Jr., Amy Coney Barrett and Brett M. Kavanaugh.

One of the disputes between the majority and the dissenters was the meaning of a phrase in Medicaid law which allows those receiving care to obtain it “from any provider qualified to perform the service.”  The majority ruled that the clause “does not clearly and unambiguously confer individual rights enforceable” under the 1871 civil rights law.  The dissenters said “the natural and obvious” way to read the clause was to confer a right to participate and a right to sue to enforce that choice.

South Carolina shut Planned Parenthood out of the Medicaid program in July 2018 under a state law that bars public funding of abortion.

The Biden Administration had taken the position that women seeking reproductive care as a Medicaid benefit did have a right to choose their care provider and a right to enforce that choice.  In February this year, after the Trump Administration took office, it changed position and supported South Carolina’s cutoff of Planned Parenthood.

While the case before the Court involved only South Carolina, the majority’s interpretation will permit other states to do as that state did, if they wish.