WASHINGTON (AP) — A divided Supreme Court allowed states to cut off Medicaid money to Planned Parenthood in a ruling handed down Thursday amid a wider Republican-backed push to defund the country’s biggest abortion provider.

The case centers on funding for other health care services Planned Parenthood provides in South Carolina, but the ruling could have broader implications for Medicaid patients.

The court split 6-3 in the opinion, with the three liberal justices dissenting.

Public health care money generally can’t be used to pay for abortions. Medicaid patients go to Planned Parenthood for things like contraception, cancer screenings and pregnancy testing, in part because it can be tough to find a doctor who takes the publicly funded insurance, the organization has said.

South Carolina’s Republican governor says no taxpayer money should go the organization. The budget bill backed by President Donald Trump in Congress would also cut Medicaid funding to Planned Parenthood. That could force the closure of about 200 centers, most of them in states where abortion is legal, the organization has said.

Gov. Henry McMaster first moved to cut off Medicaid funding to Planned Parenthood in 2018 but was blocked in court after a lawsuit from a patient named Julie Edwards. Edwards wanted to keep going there for birth control because her diabetes makes pregnancy potentially dangerous, so she sued over a provision in Medicaid law that allows patients to choose their own qualified provider.

South Carolina, though, argued that patients shouldn’t be able to file those lawsuits. The state pointed to lower courts that have been swayed by similar arguments and allowed states such as Texas to block Medicaid funding from Planned Parenthood.

Public health groups like the American Cancer Society, by contrast, said in court papers that lawsuits are the only real way that Medicaid patients have been able to enforce their right to choose their own doctor. Losing that right would reduce access to health care for people on the program, which is estimated to include one-quarter of everyone in the country. Rural areas could be especially affected, advocates said in court papers.

In South Carolina, $90,000 in Medicaid funding goes to Planned Parenthood every year, a tiny fraction of the state’s total Medicaid spending. The state banned abortion at about six weeks’ gestation after the high court overturned it as a nationwide right in 2022.

A representative from Planned Parenthood told WBRZ that "Medicaid itself is not a part of Planned Parenthood’s budget nor is it a grant or blank check to providers." 

"Today’s Supreme Court decision does not impact Louisiana patients nor our services or operations here in Louisiana; it is limited to South Carolina at this time. We really want to emphasize that patients with Medicaid in Louisiana can continue to come to Planned Parenthood Gulf Coast for high-quality, affordable sexual and reproductive health care and can continue to use their Medicaid coverage for services at PPGC’s Baton Rouge and New Orleans health centers," the representative said.

In 2015, the Associated Press reported that Louisiana cut Medicaid funds to Planned Parenthood. After a legal challenge, a federal appeals court upheld the move in 2020.