In Medina v. Planned Parenthood South Atlantic, No. 23-1275 (June 26, 2025), the U.S. Supreme Court cited the Restatement of the Law Third, The Foreign Relations Law of the United States, in holding that a funding condition for Medicaid known as the “any-qualified-provider provision” did not confer an individual right that was enforceable under the Civil Rights Act, 42 U.S.C. § 1983.
In that case, South Carolina announced that Planned Parenthood South Atlantic, an organization that operated two clinics that offered medical services to Medicaid and non-Medicaid patients and also performed abortions, could no longer participate in the state’s Medicaid program. In response, the organization and one of its patients sued the director of South Carolina’s Department of Health and Human Services, arguing that the state’s exclusion of the clinics from the Medicaid program violated the any-qualified-provider provision in 42 U.S.C. § 1396a(a)(23)(A), under which “any individual eligible for medical assistance . . . may obtain” it “from any [provider] qualified to perform the service . . . who undertakes to provide” it. The plaintiffs asserted that that provision was among those federal spending-power statutes that conferred individual rights enforceable under 42 U.S.C. § 1983. The U.S. District Court for the District of South Carolina granted the plaintiffs’ motion for summary judgment, agreeing with their assessment and entering a permanent injunction preventing South Carolina from excluding the clinics from its Medicaid program. The U.S. Court of Appeals for the Fourth Circuit affirmed, with a judge writing separately to express “confusion and uncertainty” about the U.S. Supreme Court’s directions addressing when spending-power legislation created enforceable rights under 42 U.S.C. § 1983.
Justice Gorsuch, delivering the majority opinion of the Court, reversed and remanded, holding that 42 U.S.C. § 1396a(a)(23)(A) did not clearly and unambiguously confer an individual right such that the plaintiffs could sue state actors for a violation under 42 U.S.C. § 1983. The Court reasoned that Medicaid, like other federal grants originating from Congress’s spending power, was not a direct order to the governments of the states but rather a treaty between sovereigns. Such agreements were not the same as contracts “between individuals,” because, under Restatement of the Law Third, The Foreign Relations Law of the United States § 907, the background presumption for treaties was that they did not create private rights or provide for a private cause of action. Thus, concluded the Court, when a state violated a condition for a federal grant, “the typical remedy” was not a private enforcement suit, “but rather, action by the federal government,” in this case by the Secretary of Health and Human Services, “‘to terminate funds to the [s]tate.’” Otherwise, 42 U.S.C. § 1396a(a)(23)(A) did not use clear and unambiguous rights-creating language to support a private suit under 42 U.S.C. § 1983.
Read the full opinion here.