A major Supreme Court case and sweeping budget cuts are threatening the future of Medicaid, the program that provides health care for over 72 million low-income Americans.
On Wednesday, the U.S. Supreme Court will hear a case from South Carolina that could give states more power to deny Medicaid funding to providers like Planned Parenthood. At the same time, Republican lawmakers are pushing for $880 billion in federal Medicaid cuts over the next decade. These two developments could reshape access to care across the country.
Court Case Could Strip Patient Choice in Medicaid
In South Carolina, Medicaid patients often turn to Planned Parenthood for cancer screenings, pregnancy testing, and contraception. But Governor Henry McMaster wants to end Medicaid funding to the provider entirely. He argues that state funds should not support any organization affiliated with abortion services.
Federal law already bars Medicaid from covering abortion, except in rare cases. Still, the governor’s executive order to remove Planned Parenthood from the Medicaid provider list could severely limit access to general care. Fourteen counties in South Carolina have no OB-GYNs, and five more have only one.
“This case is not about abortion. This case is about general health care,” said Dr. Katherine Farris, chief medical officer at Planned Parenthood South Atlantic.
Health advocates say the case could set a dangerous precedent. If the Court rules in favor of South Carolina, states could cut off other providers and patients may lose their legal right to choose where they get care.
“This isn’t just about Planned Parenthood,” said Julian Polaris, a Medicaid policy expert. “It could affect access to gender-affirming care, birth control, and more.”
Budget Cuts Would Hit Hospitals and Patients Hard
Beyond the courtroom, Medicaid is facing a financial crisis. A budget plan passed by the U.S. House of Representatives proposes deep federal cuts. Analysts warn that these reductions could push millions off the program and force hospitals to scale back services—or close entirely.
Rural hospitals are especially vulnerable. In Washington state, Valley Medical Center laid off 101 employees in March after federal Medicaid reimbursements ended. The loss of $80 to $100 million annually created what the hospital called “rapid and unsustainable” financial strain.
In Pennsylvania, Fulton County Medical Center CEO Mike Makosky said Medicaid makes up 25% of the hospital’s revenue. If funding drops, the hospital may cut services or shut down its long-term care nursing home.
“We already lose money on every Medicaid patient,” Makosky said. “If cuts happen, it’ll be even worse. That could be the difference between saving a life or not.”
Deep Cuts Could Impact Millions
Medicaid covers 40% of U.S. children and 60% of nursing home residents. It also supports millions of disabled adults and working-class families. The proposed $880 billion cut would reduce coverage, eliminate jobs in the health sector, and close hundreds of hospitals by 2030.
The Kaiser Family Foundation estimates that new work requirements alone would end coverage for 4.6 million people. That includes single parents, students, and caregivers. Critics argue that these changes would not reduce fraud or waste—but would instead punish vulnerable groups.
Even conservative voices are pushing back. Former Trump strategist Steve Bannon warned that Medicaid cuts could backfire politically. Many in the Republican base rely on the program, he said, and slashing it could alienate key voters.
A recent KFF poll found only 17% of Americans support cutting Medicaid. Nearly half said they want funding increased.
Medicaid’s Future in the Balance
Whether the Supreme Court rules against Planned Parenthood or lawmakers push through major cuts, the result could be the same: fewer providers, longer travel times, and reduced access to care.
“We’re already in a health care crisis,” said Amalia Luxardo of the Women’s Rights and Empowerment Network. “Decisions like these will only make it worse.”
Medicaid was designed to ensure that low-income Americans could access health services. What happens next—whether in court or in Congress—could determine whether that promise still holds true.
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