Planned Parenthood S. Atl. v. Kerr
| Decision Date | 08 March 2022 |
| Docket Number | 21-1043 |
| Parties | PLANNED PARENTHOOD SOUTH ATLANTIC; JULIE EDWARDS, on her behalf and on behalf of all others similarly situated, Plaintiffs - Appellees, v. ROBERT M. KERR, in his official capacity as Director, South Carolina Department of Health and Human Services, Defendant-Appellant. REPRODUCTIVE RIGHTS AND JUSTICE ORGANIZATIONS AND ALLIED ORGANIZATIONS; NATIONAL HEALTH LAW PROGRAM; SOUTH CAROLINA APPLESEED LEGAL JUSTICE CENTER; VIRGINIA POVERTY LAW CENTER; NORTH CAROLINA JUSTICE CENTER; CHARLOTTE CENTER FOR LEGAL ADVOCACY; IPAS; SEXUALITY INFORMATION AND EDUCATION COUNCIL OF THE UNITED STATES; AMERICAN ACADEMY OF FAMILY PHYSICIANS; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN COLLEGE OF NURSE-MIDWIVES; AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS; AMERICAN COLLEGE OF PHYSICIANS; AMERICAN MEDICAL ASSOCIATION; AMERICAN PSYCHIATRIC ASSOCIATION; NURSE PRACTITIONERS IN WOMENS HEALTH; SOCIETY FOR MATERNAL-FETAL MEDICINE; SOCIETY OF GYNECOLOGIC ONCOLOGY; SOCIETY OF OB/GYN HOSPITALISTS, Amici Supporting Appellee. |
| Court | U.S. Court of Appeals — Fourth Circuit |
John J. Bursch, ALLIANCE DEFENDING FREEDOM, Washington, D.C., for Appellant.
Nicole A. Saharsky, MAYER BROWN, LLP, Washington, D.C., for Appellees.
ON BRIEF:
Kelly M. Jolley, Ariail B. Kirk, JOLLEY LAW GROUP, LLC, Columbia South Carolina, for Appellant.
Avi M Kupfer, MAYER BROWN LLP, Chicago, Illinois; Alice Clapman, PLANNED PARENTHOOD FEDERATION OF AMERICA, Washington, D.C.; M. Malissa Burnette, Kathleen McDaniel, BURNETTE, SHUTT & MCDANIEL, PA, Columbia, South Carolina, for Appellees.
Julie Rikelman, Pilar Herrero, Joel Dodge, CENTER FOR REPRODUCTIVE RIGHTS, New York, New York; Da Hae Kim, NATIONAL ASIAN PACIFIC AMERICAN WOMEN'S FORUM, Washington, D.C., for Amici Reproductive Rights and Justice Organizations and Allied Organizations.
Martha Jane Perkins, Catherine McKee, Sarah Jane Somers, Sarah Grusin, NATIONAL HEALTH LAW PROGRAM, Chapel Hill, North Carolina, for Amici The National Health Law Program, South Carolina Appleseed Legal Justice Center, Virginia Poverty Law Center, North Carolina Justice Center, Charlotte Center for Legal Advocacy, IPAS, and Sexuality Information and Education Council of the United States.
Janice M. Mac Avoy, Alexis R. Casamassima, Danielle M. Stefanucci, FRIED, FRANK, HARRIS, SHRIVER & JACOBSON LLP, New York, New York, for Amici American Academy of Family Physicians, American Academy of Pediatrics, American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, American College of Physicians, American Medical Association, American Psychiatric Association, Nurse Practitioners in Women's Health, Society for Maternal-Fetal Medicine, Society of Gynecologic Oncology, and Society of OB/GYN Hospitalists.
Before WILKINSON, WYNN, and RICHARDSON, Circuit Judges.
This case arises out of South Carolina's termination of Planned Parenthood South Atlantic's Medicaid provider agreement, an action that South Carolina took because Planned Parenthood offers abortion services. But this case is not about abortion. It is about Congress's desire that Medicaid recipients have their choice of qualified Medicaid providers. Here South Carolina terminated Planned Parenthood's agreement notwithstanding the fact that all parties agree that Planned Parenthood is perfectly competent to provide the non-abortive healthcare the individual plaintiff sought and requested. To allow the State to disqualify Planned Parenthood would nullify Congress's manifest intent to provide our less fortunate citizens the opportunity to select a medical provider of their choice, an opportunity that the most fortunate routinely enjoy.
At the outset of this litigation, the district court issued a preliminary injunction preventing South Carolina from terminating Planned Parenthood's provider agreement. We affirmed its decision then. South Carolina now returns to our court to appeal the district court's subsequent permanent injunction. For the following reasons, we again affirm the district court's judgment.
Congress created Medicaid in 1965 to provide "federal financial assistance to States that choose to reimburse certain costs of medical treatment for needy persons." Harris v. McRae, 448 U.S. 297, 301 (1980). The program furnishes "medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services." 42 U.S.C. § 1396-1. In this way, Medicaid effectively serves as a nationwide system of public health insurance for those who cannot afford medical care on their own.
Although it is federal in scope, Medicaid is administered by the states and, "[l]ike other Spending Clause legislation, Medicaid offers the States a bargain: Congress provides federal funds in exchange for the States' agreement to spend them in accordance with congressionally imposed conditions." Armstrong v. Exceptional Child Ctr., Inc., 575 U.S. 320, 323 (2015). The scheme of the Medicaid program reflects the cooperative nature of this enterprise. Under the Medicaid Act, the federal government is tasked with crafting general eligibility requirements and standards. See 42 U.S.C. § 1396 et seq. States then submit Medicaid plans for approval by the Secretary of Health and Human Services, who reviews these plans to ensure that they comply with the statutory and regulatory requirements governing Medicaid. See Douglas v. Indep. Living Ctr. of S. Cal., Inc., 565 U.S. 606, 610 (2012). Upon approval, states receive federal matching funds that they may use to reimburse providers. See id. at 611. On the other hand, the Secretary may withhold funds if he finds "that in the administration of the plan there is a failure to comply substantially" with the requirements of the Medicaid Act. 42 U.S.C. § 1396c.
Over the first two years of the Medicaid program, Congress grew concerned that states might deny recipients the opportunity to choose the provider of their choice. In Puerto Rico, for instance, indigent patients could receive medical services "only in Commonwealth facilities." President's Proposals for Revision in the Social Security System: Hearing on H.R. 5710 before the H. Comm. on Ways & Means, Part 4, 90th Cong. 2273 (1967). And in Massachusetts, private physicians at teaching hospitals were not reimbursed under Medicaid. Id. at 2301.
Accordingly, Congress amended the Medicaid Act to include the free-choice-of-provider provision, which is at issue here. That provision states:
A State plan for medical assistance must . . . provide that . . . any individual eligible for medical assistance . . . may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required . . . who undertakes to provide him such services. . . .
42 U.S.C. § 1396a(a)(23).
Planned Parenthood South Atlantic offers patients a number of family planning and reproductive health services at two South Carolina health centers in Charleston and Columbia. These services include, for instance, contraception and contraceptive counseling, cancer screenings, screenings and treatment for sexually transmitted infections, pregnancy testing, and physical exams. Planned Parenthood also performs abortions, although South Carolina Medicaid only covers abortions in certain rare circumstances required by federal law, such as rape, incest, or the need to protect the mother's life. See Consolidated Appropriations Act, 2021, Pub. L. No. 116-260, div. H, tit. V, §§ 506-07, 134 Stat. 1182, 1622 (Hyde Amendment).
Julie Edwards, the individual plaintiff in this case, is insured through Medicaid and suffers from Type 1 diabetes, for which she has obtained frequent medical attention. She has been advised by doctors that, due to high blood pressure and high blood sugar, it would be dangerous for her to try to carry a pregnancy to term. After finding that local Medicaid providers were unable or unwilling to provide her with the contraceptive care that she sought, Edwards made an appointment at Planned Parenthood's office in Columbia. Doctors there inserted an intrauterine device to prevent pregnancy and told her that her blood pressure was very high, for which she sought follow-up care. Edwards was impressed with her visit and planned to shift "all [her] gynecological and reproductive health care there," including her "annual well woman exam." J.A. 61. However, she stated that she "[would] not be able to continue going there if the services are not covered" by Medicaid and she is required "to pay out of pocket." J.A. 61.
In July 2018, the Governor of South Carolina issued an executive order directing South Carolina's Department of Health and Human Services (DHHS) "to deem abortion clinics . . . that are enrolled in the Medicaid program as unqualified to provide family planning services and, therefore, to immediately terminate them upon due notice and deny any future such provider enrollment applications for the same." J.A. 54. The Governor stated that the purpose of this decision was to prevent South Carolina from indirectly subsidizing the practice of abortion. On that same day, DHHS sent Planned Parenthood a letter stating that it was "no longer . . . qualified to provide services to Medicaid beneficiaries" and that its "enrollment agreements with the South Carolina Medicaid programs [were] terminated" effective immediately. J.A. 56.
Two weeks later, Planned Parenthood and Edwards filed suit under 42 U.S.C. § 1983...
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