In a pair of high-profile legal battles, reproductive health care providers in South Carolina and Maine are fighting to preserve their access to Medicaid funding after a series of court decisions and legislative moves that threaten to upend care for thousands of low-income patients. The disputes—one centered on Planned Parenthood South Atlantic in South Carolina, the other on Maine Family Planning—highlight the growing national divide over funding for clinics that offer abortion services, even when the vast majority of their work involves unrelated care like cancer screenings and birth control.
On August 21, 2025, Planned Parenthood South Atlantic (PPSAT) filed an updated legal challenge in South Carolina, seeking to halt Governor Henry McMaster’s executive order that blocks Medicaid funds from clinics providing abortions. As reported by The Hill, the complaint asks a federal judge to allow PPSAT to remain a Medicaid provider while the case proceeds. The organization operates two clinics in the Palmetto State, where it provides a range of non-abortion services, including annual physicals, contraception, and testing and treatment for sexually transmitted infections.
“What started as a crusade against abortion has devolved into an even greater assault on essential, preventive care,” declared Paige Johnson, president and CEO of Planned Parenthood South Atlantic, in a statement quoted by The Hill. “Planned Parenthood South Atlantic provides high-quality, comprehensive health care, and any attempt to remove our health centers as a care option for patients with Medicaid is not only blatantly political but unconstitutional.”
The state, however, remains firm in its resolve. Brandon Charochak, a spokesman for Governor McMaster, told The Hill that the Supreme Court “has made clear that South Carolina has the right to exclude abortion providers from our Medicaid program. Planned Parenthood’s latest filing is nothing more than a desperate, last-gasp attempt to relitigate an issue that has already been decided.”
At the heart of the dispute is a recent U.S. Supreme Court decision that allowed South Carolina to restrict federal funding, opening the door for the state to block Planned Parenthood from Medicaid reimbursement. The ruling, handed down in June 2025, determined that individual Medicaid patients cannot sue to enforce their right to choose a provider, effectively giving states greater leeway to exclude organizations like Planned Parenthood from their Medicaid programs. Medicaid, for its part, is already prohibited from paying for almost all abortions, and Planned Parenthood receives no state or federal reimbursement for the abortions it does provide. In South Carolina, abortion is legal only in the first six weeks of pregnancy, in certain medical emergencies, and in cases of rape or incest.
The new complaint from PPSAT also challenges budget riders passed by the South Carolina General Assembly that seek to prevent federal funds from going to the organization. As the complaint itself states, “This case is not about the legality or constitutionality of abortion. Rather, this case is about Planned Parenthood’s provision of essential health care services, other than abortion, to its patients in South Carolina.” The organization warns that terminating its Medicaid participation “will have a devastating impact on its ability to provide a wide range of non-abortion health care,” potentially forcing clinics to turn away patients who might have no alternative provider or who may forgo care altogether.
South Carolina is not alone in this approach. Texas, Arkansas, and Missouri already bar Planned Parenthood from seeing Medicaid patients, and, according to The Hill, the organization expects many other Republican-led states to follow suit in the wake of the Supreme Court’s decision. Meanwhile, the national Planned Parenthood organization is fighting a provision in the new federal tax and spending law that would ban all of its clinics from Medicaid. A federal judge has temporarily blocked that provision from taking effect.
While South Carolina’s fight plays out, a similar drama is unfolding in Maine, where Maine Family Planning—an independent network operating 18 clinics—remains without Medicaid funding as it challenges Trump administration restrictions on abortion providers. On August 25, 2025, U.S. District Judge Lance Walker ruled that Medicaid payments will not resume while the case is ongoing, a decision first reported by Newsweek and Reuters. The cuts stem from President Donald Trump’s signature 2025 tax and spending package, known as the One Big Beautiful Bill Act, which bars Medicaid dollars from going to Planned Parenthood and other abortion providers. The law’s reach, however, goes further: it also affects smaller organizations like Maine Family Planning, which serves roughly 8,000 low-income patients statewide with reproductive health care, primary care, contraception, and cancer screenings.
George Hill, president and CEO of Maine Family Planning, told Newsweek, “This ruling is a devastating setback for Mainers who depend on us for basic primary care. The loss of Medicaid funds—which nearly half our patients rely on—threatens our ability to provide life-saving services to communities across the state. Mainers’ health should never be jeopardized by political decisions, and we will continue to fight for them.”
The group argues that the Medicaid cuts unfairly targeted it, even though Medicaid funds do not cover abortion care, which constitutes only a small fraction of its services. Supporters emphasize that the clinics deliver essential care far beyond abortion. “This ruling means that thousands of Mainers across the state may lose access to their trusted health provider for essential health care services, including cancer screenings, birth control, and primary care at Maine Family Planning,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, in a statement to Newsweek. She added, “This ruling takes a sledgehammer to an already overstretched health care network, and Mainers statewide will feel the effects of defunding Maine Family Planning, regardless of their insurance status.”
Judge Walker, a Trump appointee, acknowledged the hardship but wrote in his opinion, as reported by Reuters, that it would be an act of “judicial hubris” for him to block a law produced through the democratic process from taking effect. “The Judicial Branch, despite much generated confusion on this basic point, does not serve as an omnibus super-legislature to sit in final judgment as to which policy outcomes it prefers. That judgment rests with the people,” Walker wrote. He further noted that Congress was entitled to withhold federal subsidies to achieve a reduction in abortions and “disassociate from conduct that is not enshrined as a constitutional right.”
The stakes for Maine Family Planning are high. The organization previously warned that without Medicaid dollars, it could be forced to halt primary care services by the end of October 2025. As reported by Reuters, up to nine of its 18 clinics may be shuttered due to the loss of funding. The law specifically targets providers primarily engaged in family planning services that received more than $800,000 from Medicaid in 2023, a threshold that Maine Family Planning argues was lowered precisely to ensure the cuts extended beyond Planned Parenthood.
Both the South Carolina and Maine cases underscore a broader national trend: the move by Republican-led legislatures and the federal government to restrict public funding for organizations associated with abortion, regardless of the scope of their other health services. These efforts have drawn fierce criticism from reproductive rights advocates, who warn that the consequences will be felt most by low-income patients with few other options for care.
As these legal fights continue, the future of Medicaid funding for reproductive health providers remains uncertain. What is clear is that the fallout will reverberate far beyond the courtrooms—impacting clinics, patients, and the very fabric of health care access in some of the nation’s most vulnerable communities.
