Planned Parenthood South Atlantic v. Robert Kerr
27 F.4th 945
| 4th Cir. | 2022Background
- The Medicaid Act (§1396a(a)(23)) requires state plans to let Medicaid-eligible individuals obtain services from any "qualified" provider who will undertake to provide them (the free-choice-of-provider provision).
- Planned Parenthood South Atlantic (PPSA) provided non-abortive reproductive and family-planning services to Julie Edwards, a Medicaid beneficiary in South Carolina; SC terminated PPSA’s Medicaid provider agreement by executive order because PPSA also provides abortions.
- Edwards and PPSA sued under 42 U.S.C. § 1983, seeking injunctive relief; the district court granted a preliminary injunction and later entered summary judgment and a permanent injunction preventing SC from excluding PPSA for offering abortion services.
- On interlocutory appeal the Fourth Circuit (Baker) affirmed the preliminary injunction, holding the free-choice provision confers an individual right enforceable under § 1983 and that PPSA was qualified; SC sought further review and raised mootness and other challenges on appeal.
- The Fourth Circuit (this opinion) affirmed the permanent injunction: it held the case is not moot (Edwards has imminent risk of future injury) and reaffirmed that §1396a(a)(23) unambiguously creates a private right enforceable under §1983; the court refused to overrule its prior panel decision.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Article III standing / mootness | Edwards has concrete plans and appointments with PPSA; future injury is imminent/substantial risk | Edwards has not used PPSA since filing; no concrete or imminent injury → case moot | Not moot; Edwards’ declaration and prior use show substantial risk of future harm and concrete plans; Article III satisfied |
| §1983 cause of action for §1396a(a)(23) | The statute uses rights-creating language ("any individual") and meets Blessing factors — it unambiguously creates an individual right enforceable under §1983 | Gonzaga and related precedent limit implied §1983 claims; no private right should be inferred here | §1396a(a)(23) unambiguously confers an individual right and is enforceable under §1983; Blessing factors satisfied |
| Whether Medicaid Act’s remedial scheme forecloses §1983 relief | Available remedies (HHS enforcement, state admin processes) do not furnish individual review of provider disqualification; §1983 not foreclosed | Statutory/admin remedies and enforcement by Secretary preclude private §1983 suits | No clear congressional intent to foreclose §1983; Wilder supports availability of §1983 remedies; §1983 remains available |
| Precedent / reconsideration of prior panel decision | Prior published Fourth Circuit decision (Baker) controls this appeal | State urges court to revisit/reverse Baker citing other circuits (e.g., 5th Cir.) | Prior panel decision binds; court reaffirms Baker and declines to overturn under stare decisis |
Key Cases Cited
- Blessing v. Firestone, 520 U.S. 329 (1997) (articulates three-factor test for whether a statute creates a private right enforceable under §1983)
- Gonzaga Univ. v. Doe, 536 U.S. 273 (2002) (requires an "unambiguously conferred" statutory right to support §1983 claims)
- Wilder v. Virginia Hosp. Ass'n, 496 U.S. 498 (1990) (held that the Medicaid Act’s remedial scheme does not automatically preclude §1983 enforcement)
- Maine v. Thiboutot, 448 U.S. 1 (1980) (§1983 provides cause of action for deprivation of federal statutory rights)
- Pennhurst State Sch. & Hosp. v. Halderman, 451 U.S. 1 (1981) (spending-clause conditions and state notice/contractual nature of federal-state Medicaid bargains)
- O'Bannon v. Town Court Nursing Ctr., 447 U.S. 773 (1980) (distinguished; recognizes free-choice provision protects choice among qualified providers)
- Armstrong v. Exceptional Child Ctr., Inc., 575 U.S. 320 (2015) (discusses Medicaid as Spending Clause legislation and limits on remedies)
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (1992) (requirements for establishing imminent future injury for standing)
- Dep't of Commerce v. New York, 139 S. Ct. 2551 (2019) (clarifies "substantial risk"/imminence standard for prospective injury)
- Susan B. Anthony List v. Driehaus, 573 U.S. 149 (2014) (standing principles for prospective claims)
- Planned Parenthood S. Atl. v. Baker, 941 F.3d 687 (4th Cir. 2019) (Fourth Circuit's prior published holding that §1396a(a)(23) is enforceable under §1983; controlling here)
- Planned Parenthood of Greater Tex. v. Kauffman, 981 F.3d 347 (5th Cir. 2020) (en banc) (contrary en banc circuit decision finding no §1983 right; cited as part of circuit split)