The recent Supreme Court ruling on Medicaid enforcement will have far-reaching effects across the healthcare landscape. Caroline Farrell, counsel at Foley Hoag LLP and former HHS attorney, weighs in: “States might try to exclude providers from Medicaid as a means of restricting access to other politically disfavored care.” With the Court barring individual lawsuits to enforce the right to choose a Medicaid provider, Farrell warns this could embolden states to target not just abortion providers, but also those offering gender-affirming care and other essential services.
 
Farrell highlights the real-world impact: “The ruling — certainly in South Carolina — is going to create reproductive care deserts, and if other states follow suit, you will see more of the same deserts in other states.” She also notes that enforcement now depends on federal priorities and resources, making it harder for patients and providers to protect their rights.
 
This decision could reshape access to care for millions, with ripple effects far beyond South Carolina. As Farrell puts it, “States might be a little more brazen in doing things like what they’ve done to defund Planned Parenthood.” Given the reality that, as a result of the decision, most Medicaid requirements are now not privately enforceable by Medicaid beneficiaries and providers, states may feel emboldened to take aggressive positions that could jeopardize care for those who rely on Medicaid. The stakes for Medicaid beneficiaries and providers have never been higher. Read our recent client alert on this ruling to learn more.

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