Access Denied: North Carolina Congressional Bill Bars Medicaid Use at Planned Parenthood Clinics

Rebbeca Todd Peters, an Elon University professor, speaks at a Raleigh Planned Parenthood rally in 2024. Source: WUNC.

On Monday, September 22nd, the N.C. The Senate passed House Bill 192, which would prevent the DHHS (Department of Health and Human Services) from allowing patients to use Medicaid at Planned Parenthood clinics in North Carolina. The bill was first introduced in February of this year.

The general public and politicians alike have been drastically split on this issue. The passage of this bill has come after consistent pressure from conservatives in the state. For decades, Republican legislators  have made claims that Planned Parenthood is not a credible avenue for healthcare. N.C. Senator Amy Galey, in particular, has spoken out and alleged that Planned Parenthood seeks to indoctrinate its patients.

“Planned Parenthood is not a good faith provider of health care services to women,” she said at a recent Senate Appropriations Committee meeting.

Conversely, opponents of the bill have argued that the choice does not factor in the serious negative consequences for middle and working-class patients. The legislation would strictly bar access to services that include, but are not limited to, cervical cancer screenings, STI tests, and birth control prescriptions. 

This is detrimental to individuals who need quick access to these procedures to detect conditions before they worsen. Overall, many patients from underserved areas could be in grave danger due to further limits on available reproductive treatment.

A 2024 study from the nonprofit March of Dimes found that 20% of N.C.’s counties are “maternity care deserts” where no clinics are offering these services, and 17% of all N.C. counties have low or moderate access to reproductive care. Access to these services through Planned Parenthood is crucial for many individuals who cannot travel to or live far away from the clinics that do provide this care.

In particular, President Paige Johnson of Planned Parenthood South Atlantic has expressed concern that this bill has strictly partisan motivations and does not take into account the general welfare of individuals who rely solely on Medicaid. 

This is because individuals who are not able to access STI tests or cancer screenings promptly could be in grave danger. According to the CDC, as of 2025, there are approximately 13,000 new cases of cervical cancer annually, and 4,000 deaths resulting from that cancer. These figures highlight how the lack of accessibility around non-abortion services can become matters of life and death. 

Questions around reduced Planned Parenthood accessibility also could be harmful  for LGBTQ+ individuals, as many rely on the organization for gender-affirming care. This care is often not offered at other clinics that provide reproductive services, especially in the midst of recent state abortion bans. The Center for American Progress, in a study done this year, found that 11% of LGBTQ+ people were forced to change medical providers or struggled to find new ones following the bans.  

For N.C. House Bill 192 to officially become law, the House must approve of the Senate’s revisions to the bill. Additionally, Governor Josh Stein will have the option to sign off on the bill, but has not yet made any public comment regarding the matter. If it is officially enacted, Medicaid users in rural and underserved areas will need to find other ways to access these services within North Carolina's state lines. 

As of now, there are a few alternatives in place for patients who previously relied on Medicaid at Planned Parenthood. One is visiting Federally Qualified Health Centers, which can often be found in medically underserved cities and areas. The services can vary by location, but many FQHCs can provide pap smears, contraception, and more. To locate FQHCs nearby, individuals can use the find-a-health-center search tool on the Health Resources and Services Administration (HRSA) website. However, it is also important to consider that these clinics are sometimes overwhelmed with the administrative burdens keeping them afloat. According to data from Health View X, FQHCs spend around 25-30% of clinical staff time on administrative tasks.

A different solution for patients is a family planning Medicaid program called “Be Smart”, which is run by the North Carolina DHHS. “Be Smart” is designed to expand access to reproductive health. Individuals of all reproductive ages whose income is at or below 195% of the federal poverty level qualify for this program.

While harder to come by and sometimes under-resourced, there are also charitable clinics that exist in low-income areas. These will sometimes provide healthcare and family-planning services for free, depending on the staff and funding that they are equipped with. Individuals can often turn to local non-profits and community centers to locate these clinics near them, and the DHHS Office of Population Affairs also has a search tool where individuals can find family-planning clinics backed by federal Title X funding. 

Overall, the push to defund Planned Parenthood has been going on for decades and has been a significant point of contention between pro-life and pro-choice political leaders. However, only recently was there a court ruling that gave individual states the leeway to cut off funding for non-abortion medical services.

In the case of Medina v. Planned Parenthood, the Supreme Court ruled that Medicaid users can no longer go to federal court to enforce Medicaid’s “free choice of provider” provision. This provision previously made it so that individuals could seek care from any medical provider willing to accept Medicaid. Now, providers like Planned Parenthood are barred from accepting Medicaid as a form of insurance, and individuals do not have the right to bring a lawsuit  challenging that. 

This ruling, although  it took place in South Carolina, is potentially threatening because of what it could mean in other states. States such as North Carolina have already followed suit, adopting laws that largely restrict access to Planned Parenthood for many populations. These legislative provisions limit Planned Parenthood’s ability to provide a vast majority of its procedures and resources. 

This is a developing issue, and the widespread impact of the bill depends on how the state will handle the loss of services previously covered by Planned Parenthood. The question remains of whether and how these services will be reallocated.