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Alliance Defending Freedom presented oral arguments before the U.S. Supreme Court on April 2, 2025, challenging Planned Parenthood's access to Medicaid funding in South Carolina. The case, Medina v. Planned Parenthood South Atlantic, addresses whether states can direct taxpayer funds away from abortion providers.

South Carolina's Effort to Redirect Medicaid Funds

The legal challenge originated when South Carolina Governor Henry McMaster ordered the state's Department of Health and Human Services to classify abortion facilities, including Planned Parenthood, as unqualified to receive Medicaid funding if they continue performing abortions. This policy aligns with a South Carolina statute prohibiting taxpayer funds from being used for abortions.

After Planned Parenthood and an individual plaintiff sued to have the funding reinstated, lower federal courts ruled against South Carolina. Alliance Defending Freedomthen appealed the case to the Supreme Court on behalf of South Carolina's DHHS Director, arguing that states should have discretion over Medicaid provider qualifications when it comes to abortion facilities.

The legal advocacy organization's position centers on the argument that money provided to Planned Parenthood is fungible—meaning that government funding for non-abortion services can indirectly support abortion operations within the same organization.

Questions About Resource Allocation at Planned Parenthood

Recent reporting from The New York Timeshas highlighted concerns about Planned Parenthood's operational priorities. According to their 2022-2023 Annual Report, Planned Parenthood performed 392,715 abortions between October 2021 and September 2022, representing a 70 percent increase from two decades ago.

During this same period, the organization has reduced contraceptive services and cancer screenings. Analysis from the Charlotte Lozier Institute found that abortions constituted 97.1% of Planned Parenthood's pregnancy resolution services, compared to prenatal services (1.6%), miscarriage care (0.9%), and adoption referrals (0.4%).

The Times investigation noted that despite raising $498 million in donations in 2022, many Planned Parenthood state affiliates reported financial difficulties maintaining facilities and services. According to the Times, "the majority of the money is spent on the legal and political fight to maintain abortion rights" rather than direct patient care.

Several Planned Parenthood facilities have closed due to budget issues, including four locations in New York. Planned Parenthood of Northern California discontinued a prenatal program serving 200-250 low-income women monthly, citing financial constraints despite the organization's substantial fundraising success.

Alliance Defending Freedom's Legal Strategy

Alliance Defending Freedom has positioned this case as a significant test of states' rights regarding healthcare funding decisions. The nonprofit legal organizationargues that South Carolina should be permitted to prioritize comprehensive women's healthcare providers over organizations primarily focused on abortion services.

"Americans have repeatedly rejected taxpayer funding of abortion, and they should not be forced to fund political organizations like Planned Parenthood," Alliance Defending Freedom statedin materials about the case. The organization maintains that states should be able to "direct taxpayer Medicaid funds to medical providers offering real healthcare services instead of abortion facilities."

Alliance Defending Freedom has been involved in multiple high-profile cases involving abortion funding and religious liberty issues. The Medina case represents one of the organization's most significant Supreme Court appearances to date on the specific question of state discretion over Medicaid provider qualifications.

Alliance Defending Freedom continues to advance legal argumentssupporting South Carolina's position that the state can make funding determinations based on its policy priorities regarding abortion services, particularly when evidence suggests that organizations like Planned Parenthood concentrate resources on abortion provision rather than comprehensive women's healthcare.