The Supreme Court, in a split decision, has permitted states to withdraw Medicaid funding from Planned Parenthood. This decision, announced on Thursday, aligns with a broader movement led by Republicans to stop funding the nation’s largest provider of abortion services.

The legal case primarily involves funding for various health services offered by Planned Parenthood in South Carolina. However, its effects may extend to Medicaid beneficiaries nationwide.

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

Federal healthcare funds typically cannot finance abortion procedures. Many Medicaid patients rely on Planned Parenthood for essential services such as birth control, cancer tests, and pregnancy assessments. This is partly because it can be challenging to find healthcare providers who accept the government-backed insurance, according to Planned Parenthood.

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.