Federal law says that “any individual eligible for medical assistance” from a state Medicaid program may obtain that care “from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.” In other words, all Medicaid patients have a right to choose their doctor, as long as they choose a health provider competent enough to provide the care they seek.

On Thursday, however, the Republican justices ruled, in Medina v. Planned Parenthood, that Medicaid patients may not choose their health provider. And then they went much further. Thursday’s decision radically reorders all of federal Medicaid law, rendering much of it unenforceable. Medina could prove to be one of the most consequential health care decisions of the last several years, and one of the deadliest, as it raises a cloud of doubt over countless laws requiring that certain people receive health coverage, as well as laws ensuring that they will receive a certain quality of care.

All three of the Court’s Democrats dissented.

Justice Neil Gorsuch’s opinion in Medina is a trainwreck of legal reasoning. It’s hard to think of a principled reason why, two years after the Court took a much more expansive approach to Medicaid law in Health and Hospital Corporation v. Talevski (2023), the Republican justices abruptly decided to reverse course. It is easy, however, to see a political reason for the Medina decision.

The plaintiff in Medina, after all, is Planned Parenthood, an abortion provider Republicans love to hate. Medina involved South Carolina’s attempt to forbid Medicaid patients from choosing Planned Parenthood as their health provider, a policy that violates federal law.

In an apparent attempt to spite Planned Parenthood, the Republican justices have now effectively repealed that law. This is not aberrant behavior from this Court’s Republican majority.

Four years ago, before the Court overruled Roe v. Wade and eliminated the constitutional right........

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