Reproductive Rights Crackdown: Planned Parenthood CEO on Supreme Court Case, Title X & More

AMY GOODMAN: The Supreme Court heard oral arguments Wednesday in a case brought by South Carolina to expel Planned Parenthood clinics from its state Medicaid program, even though states are largely already prohibited from using Medicaid to fund abortions. Planned Parenthood says the move violates the Medicaid Act’s “free choice of provider” provision. Under the Medicaid law, patients are entitled to choose their own doctors.

In South Carolina, that includes Planned Parenthood South Atlantic, which provides low-income patients with a range of services, including cancer screenings and full physical exams. This is Planned Parenthood South Atlantic’s lawyer Nicole Saharsky during Wednesday’s Supreme Court oral arguments.

NICOLE SAHARSKY: It says that there’s — any individual may obtain care from their — from any qualified and willing provider. So, it’s the combination of any individual may obtain care from any qualified and willing provider. It disables the state from doing something the state might otherwise want to do, like, you know, “We want to take this provider out of Medicaid for a reason that’s unrelated to medical qualifications,” which is what the state is doing here.

AMY GOODMAN: South Carolina, which is being represented by the Christian legal group Alliance Defending Freedom, argued that the Medicaid statute does not mention the word “right,” or its functional equivalent, and therefore individuals have no right to sue to enforce the choice-of-doctor provision. This is Justice Elena Kagan questioning lawyer John Bursch, representing South Carolina, during Wednesday’s oral arguments.

JUSTICE ELENA KAGAN: You agree that the state has an obligation here. Is that correct?

JOHN BURSCH: To provide benefits on the plan, but, significantly, it’s —

JUSTICE ELENA KAGAN: And the state has an obligation to provide this particular thing, right? Which is, the state has an obligation to ensure that a person — I don’t even know how to say this without saying “right” — has a right to choose their doctor. That’s what this provision is. It’s impossible to even say the thing without using the word “right.” Has a “benefit” to choose their doctor? The state has to ensure that individuals have a benefit to choose their doctor? The state has to ensure that individuals have a right to choose their doctor. That’s what this provision is.

JOHN BURSCH: Well, that language that you’re focused on, “may obtain,” is not clear rights-creating language for four reasons.

JUSTICE ELENA KAGAN: I don’t want four reasons. I want you to answer my question. The obligation is to ensure that individuals can choose their doctor.

AMY GOODMAN: Outside the Supreme Court Wednesday, both pro- and anti-abortion protesters held rallies as the justices inside considered South Carolina’s bid to remove Planned Parenthood clinics from state Medicaid programs.

For more, we’re joined by Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America and the Planned Parenthood Action Fund.

Alexis, welcome back to Democracy Now! Can you talk about what struck you most about Wednesday’s oral arguments, and what they indicate, the direction the justices were going?

ALEXIS McGILL JOHNSON: Well, good morning, Amy. It’s wonderful to be here.

You know, look, I think that inside the court, you know, the clip that you showed of Justice Kagan, I think, laid bare how valuable it is, once again, to have these critically thoughtful female liberal justices asking the plain questions around what is a state’s obligation to ensure nondiscrimination and the provision of dignity for every patient around a federal program, a federal insurance program like Medicaid. You know, I cannot read the tea leaves of the court, but I can tell you that I do believe that South Carolina had a hard time trying to prove that it had a right to take away the dignity of patients who choose to go to Planned Parenthood.

And that’s ultimately what this case is about. It is about whether or not Governor McMaster and his political agenda to try to take Planned Parenthood down in South Carolina really was in violation of what Congress intended when they set forth the Medicaid program and allowed patients to be able to have a free choice of their provider. Right? And let’s also think about why Congress did that: because states had been denying patients the right to do that. So, I thought it was a very compelling conversation inside of the court, and I think it was made more so by the fine arguing of Nicole Saharsky, but also from those justices who really, really made it clear that the right to choose your own provider is just a matter of dignity.

AMY GOODMAN: And let’s talk about even the state of reproductive care in South Carolina already. Almost 40% of South Carolina counties are believed to be contraceptive deserts. Can you talk about what kind of access, especially, but not limited to, low-income people who need that care?

ALEXIS McGILL JOHNSON: Look, this is a story that we see all throughout the South right now, when so many of these states that have enacted these egregious abortion bans already had maternal care deserts. They had deserts where very few counties even have practicing OB-GYNs. And the result of that is that you end up with contraceptive deserts, you end up with maternal care deserts, you end up with labor and delivery wards closing, precisely because many providers do not want to stay in a state where they may be criminalized or fined for providing the care to the best of their ability to their patients.

You know, Planned Parenthood is a health system that literally sits in the middle of the public health system and tries to strengthen it. Many patients that come to Planned Parenthood, we are the first point of entry into the healthcare system broadly. And the fact that Governor McMaster would want to deny patients access to care, when, you know, many times we are the only safety net — the safety net of the safety net — there providing care, just seems completely bonkers to us, as well.

AMY GOODMAN: And talk about what that care is. It goes way beyond abortion.

ALEXIS McGILL JOHNSON: Oh, of course it goes way beyond abortion. It is STI testing. It is access to contraception, wellness exams, breast cancer screenings, gender-affirming care — everything that someone would need to live a full and free, sexually healthy life. And I think that, you know, again, in many cases, it is — there’s primary care being provided in Planned Parenthood health centers. It is just basic healthcare. And to have a state try to deny that is what this case is about, using levers like Medicaid.

AMY GOODMAN: Already South Carolina bans abortions after six weeks of pregnancy?

ALEXIS McGILL JOHNSON: Correct.

AMY GOODMAN: Can you talk about Texas? In 2021, Texas terminated Planned Parenthood from its state Medicaid program. Talk about this precedent and also what it means if the conservative-majority Supreme Court rules in favor of South Carolina.

ALEXIS McGILL JOHNSON: Yes, so, you know, look, we have states that have taken various measures to attack Planned Parenthood and remove us from their state Medicaid system. And the impact of that, again, is on the patients, right? This isn’t about Planned Parenthood. This is about whether or not the patients have the right to use their health insurance in order to get access to the care of their choice, of their choosing, from their provider.

You know, what will happen if the Supreme Court decides to rule in favor of South Carolina is that more states will act like South Carolina and Texas. Many of those states that have enacted the most restrictive abortion bans will very likely try to remove Planned Parenthood from its ability to — or, patients’ ability to use Medicaid to go to Planned Parenthood. So it could have very devastating consequence on the patients throughout those states and their ability to get high-quality care that we believe they deserve.

AMY GOODMAN: And can you explain what the powerhouse Christian legal group Alliance Defending Freedom is? This is the group that brought the case against Planned Parenthood in South Carolina.

ALEXIS McGILL JOHNSON: Yes. So, this is, you know, a group that — should be no surprise — was incorporated in Amarillo, Texas, so that anytime they can bring a lawsuit, they can go directly to Judge Kacsmaryk, who is the only federal judge in the Northern District of Texas, a very friendly anti-abortion judge that, you know, has clearly opened his court to these kinds of cases and supporting them. We are before that court right now on a false claims case, a meritless case where not only has Texas kicked Planned Parenthood affiliates out of the Medicaid program there, they are also suing to recoup resources back to the state for all of the other services that have been provided, in a bogus lawsuit that is intended to try to bankrupt Planned Parenthood. And I think that, you know, we are watching just a patchwork of very Christian nationalist and anti-abortion organizations work with this, you know, new structural advantage that they have, both with the administration as it currently stands, the Supreme Court, and the kind of patchwork of a judicial system that has been coopted by right-wing judges.

AMY GOODMAN: The Trump administration is withholding tens of millions of dollars from nine Planned Parenthood state affiliates that provide contraceptives and other vital reproductive care, predominantly to low-income and people of color. The providers received notices this week stating their Title X funding was being temporarily retained due to “possible violations,” they said, of Trump’s policies against DEI — diversity, equity and inclusion. Health and Human Services has given the providers, which operate dozens of clinics nationwide, including in Indiana and Kentucky, 10 days to comply with Trump’s demands to eliminate DEI initiatives. In a letter, HHS pointed to mission statements and other public documents that highlight the clinics’ commitment to Black communities as supposed evidence of their noncompliance. Alexis McGill Johnson, you’re the CEO of Planned Parenthood. Your response?

ALEXIS McGILL JOHNSON: I’m a CEO of Planned Parenthood. I am a Black woman. I am, you know, someone who cares deeply about reducing disparities in healthcare in communities, as we all should. I can’t think of any American who would believe that the color of your skin should dictate what kind of care you get. And that is what Planned Parenthood stands for. No matter who you are, no matter where you live, no matter what your ZIP code is, no matter how you identify, no matter your documentation status, we are there to serve you and ensure that you get high-quality, time-sensitive care.

And so, I think about the work that Planned Parenthood providers do every day, the way they have been able to leverage a critically important, long-standing program like Title X to fund access to contraception and support communities. And the idea that the Trump administration would take those resources away, to suspend those resources because Planned Parenthood is committed to improving health outcomes in community, that is essentially what they are saying. What they are not saying is that this is, you know, just another one of the dozens of attacks that Planned Parenthood is facing, as people who want to use any means that they have to deny access and resources to Planned Parenthood because they are trying to advance their anti-abortion agenda.

AMY GOODMAN: So, are you sticking with DEI at these clinics, or the clinics?

ALEXIS McGILL JOHNSON: You know, each affiliate is going to make their decisions about how they enact improvements to health outcomes. But at our core — right? — at our core, reducing disparities, health disparities, in community is what we do. And I think that’s really important for us to move away from, you know, just these trigger words like ”DEI” and actually talk about what those words mean and what they mean in practice for community — right? — ensuring we have representation of everyone, so that we have people who speak the same languages as our patients, so that we can give them the best care, that we have an ability to improve outcomes and ensure that people are getting the right resources to do so, and that, you know, everyone is actually seen — not just seen by a doctor, but literally seen for who they are and what they want. That is what I have in my healthcare system I go to. I know when I walk into my provider, they know who I am. They are able to see me and understand my particular needs. And I think everyone in America deserves that. And I can’t imagine that this administration would be very popular in trying to deny other Americans that same right.

AMY GOODMAN: And finally, we just have a minute, but with Planned Parenthood under assault, you have also had a lot of victories. Among them, in Wisconsin, Judge Susan Crawford, who once represented Planned Parenthood as an attorney, trounced Brad Schimel, the judge who was funded by, among others, the richest man in the world, Elon Musk. The significance of this, and other victories that you consider so important at this very fraught time?

ALEXIS McGILL JOHNSON: Oh, Wisconsin was such a shot in the arm, I think, for this movement, for so many movements, because I think what it shows is that the good people of Wisconsin, the good people of America do not want to be bought. They want to do what is right. They want the ability to make decisions, to continue to vote for freedom and to ensure that their representation reflects that in their state. And I think, you know, all of us looking to Wisconsin have a lot of hope about what is possible right now as we fight back with this administration. You know, I also think — I mean, and the practical implications of that, right? We have a state that has voted in support of reproductive freedom, and to have a state Supreme Court to affirm that is going to be really important. It’s also going to be really important as we approach, you know, in five years, the year 2030 and we hit a redistricting year, and so that we’re able to kind of start to fight back structurally in the space that we are in.

I’d also point you to Missouri, Amy. The people of Missouri voted to enshrine — to actually flip a ban, abortion ban, in November. And it’s only been within the last month that the Missouri clinics have been able to provide access to abortion, because even when you win, you still have to defend it with the state AG and the statehouse, that may not be favorable. So, that is the work that we have to be reminded of, that even when we win, we have to defend those wins fiercely and remind — remind these electeds what we want and who we are and how powerful we will be to ensure that we get to maintain our freedoms.

AMY GOODMAN: Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America and the Planned Parenthood Action Fund.

When we come back, we go to Washington state, where ICE agents pulled over the car of a beloved immigrant farmworker organizer, “Lelo,” Alfredo Juarez, smashed his car window when he asked for a warrant, and hauled him away. We’ll speak to one of his closest friends. Stay with us.

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AMY GOODMAN: “New River Blues” by the legendary folk singer Michael Hurley, who died this week at the age of 83. Go to democracynow.org to see more of his performance, to see him singing his songs, and our interview when he stopped by our studio in 2020.