NOTICE: This opinion is subject to
formal revision before publication in the United States Reports.
Readers are requested to notify the Reporter of Decisions, Supreme
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SUPREME COURT OF THE UNITED STATES
_________________
No. 23–1275
_________________
EUNICE MEDINA, DIRECTOR, SOUTH CAROLINA
DEPARTMENT OF HEALTH AND HUMAN SERVICES, PETITIONER
v.
PLANNED PARENTHOOD SOUTH ATLANTIC, et al.
on writ of certiorari to the united states
court of appeals for the fourth circuit
[June 26, 2025]
Justice Gorsuch delivered the opinion of the
Court.
Medicaid offers States “a bargain.”
Armstrong v.
Exceptional Child Center, Inc.,
575 U.S.
320, 323 (2015). In return for federal funds, States agree “to
spend them in accordance with congressionally imposed conditions.”
Ibid. Should a State fail to comply substantially with those
conditions, the Secretary of Health and Human Services can withhold
some or all of its federal Medicaid funding. This case poses the
question whether, in addition to that remedy, individual Medicaid
beneficiaries may sue state officials for failing to comply with
one funding condition spelled out in 42 U. S. C.
§1396a(a)(23)(A).
I
Congress created Medicaid in 1965 to subsidize
state efforts to provide healthcare to families and individuals
“ ‘whose income and resources are insufficient to meet the
costs of necessary medical services.’ ”
Armstrong, 575
U. S., at 323 (quoting §1396–1). Today, all 50 States
participate in Medicaid. Congressional Research Service, Medicaid:
An Overview 1 (2025) (CRS). In order to do so, a State must submit
to the Secretary a “plan for medical assistance.” §1396a(a); see
also §1396–1. To win the Secretary’s approval, that plan must
satisfy more than 80 separate conditions Congress has set out in
§1396a(a). Once the Secretary approves a plan, federal funds begin
flowing to help the State execute it. Of course, States must
contribute their own money, too. See §1396d(b). Historically, the
federal government has provided on average about 57% of the funds
required to implement Medicaid, and States have supplied the
balance. CRS 21.
This case concerns one of the conditions state
plans must meet. Located in §1396a(a)(23)(A), Medicaid’s any-
qualified-provider provision, as it is sometimes called, requires
States to ensure that “any individual eligible for medical
assistance . . . may obtain” it “from any [provider]
qualified to perform the service . . . who undertakes to
provide” it. The provision does not define the term “qualified,”
perhaps because States have traditionally exercised primary
responsibility over “matters of health and safety,” including the
regulation of the practice of medicine.
De Buono v.
NYSA–ILA Medical and Clinical Services Fund,
520 U.S.
806, 814 (1997); see also
Linder v.
United
States,
268 U.S.
5, 18 (1925); 42 CFR §431.51(c)(2) (2024). But everyone
acknowledges that, if a State fails “to comply substantially” with
this (or any) congressionally specified condition, the Secretary
may withhold some or all of the State’s federal funding until he is
“satisfied that there will no longer be any such failure to
comply.” §1396c.
The parties’ dispute concerns whether, in
addition to that remedy, the law recognizes another. The dispute
arose this way. Planned Parenthood South Atlantic operates two
clinics in South Carolina, one in each of the State’s two most
populous cities.
Planned Parenthood South Atlantic v.
Kerr, 95 F. 4th 152, 156–157 (CA4 2024). At both
locations, the group offers “a wide range” of services to Medicaid
and non-Medicaid patients.
Ibid. It also performs abortions.
Ibid. Citing a state law prohibiting the use of its own
public funds for abortion, South Carolina announced in July 2018
that Planned Parenthood could no longer participate in the State’s
Medicaid program. App. to Pet. for Cert. 157a–162a. At the same
time, the State took steps that, it said, would help ensure that a
“variety of other nongovernmental entities and governmental
agencies” would continue to provide “access to necessary medical
care and important women’s health and family planning services.”
Id., at 158a. According to the State, it has “140 [other]
federally qualified health clinics and pregnancy centers, not
counting the numerous private health providers who accept
Medicaid.” Brief for Petitioner 9.
In response to the State’s announcement, Planned
Parenthood and one of its patients, Julie Edwards, sued the
director of the State’s Department of Health and Human Services.
They argued that South Carolina’s exclusion of Planned Parenthood
from its Medicaid program violated the any-qualified-provider
provision. Specifically, Ms. Edwards alleged that, while she
regularly visits other medical care providers, she has had
especially positive experiences with Planned Parenthood and would
like “to shift all [her] gynecological and reproductive health care
there.’’ App. 32, 33. But none of that will be possible, she
continued, unless Medicaid covers those services.
Ibid.
Based on these allegations, Ms. Edwards and Planned Parenthood
brought a putative class action “pursuant to 42 U. S. C.
§1983 to vindicate rights secured by the federal Medicaid
statutes.”
Id., at 1.
First enacted as part of the Civil Rights Act of
1871, §1983 allows private parties to sue state actors who violate
their “rights” under “the Constitution and laws” of the United
States. But federal statutes do not confer “rights” enforceable
under §1983 “as a matter of course.”
Health and Hospital
Corporation of Marion Cty. v.
Talevski, 599 U.S. 166,
183 (2023). That is particularly true of statutes, like Medicaid,
enacted pursuant to Congress’s spending power. The spending power
allows Congress to offer funds to States that agree to certain
conditions. See,
e.
g.,
South Dakota v.
Dole,
483 U.S.
203, 207–208 (1987). But when a State violates those
conditions, “ ‘the typical remedy’ ” is not a private
enforcement suit “ ‘but rather action by the Federal
Government to terminate funds to the State.’ ”
Gonzaga
Univ. v.
Doe,
536 U.S.
273, 280 (2002) (quoting
Pennhurst State School and
Hospital v.
Halderman,
451 U.S.
1, 28 (1981)).
Appreciating all this, the plaintiffs argued
that their case implicated an exception to the usual rule. The
any-qualified-provider provision, they said, is among those rare
federal spending-power statutes that confer individual rights
enforceable under §1983. And, they submitted, South Carolina
violated Ms. Edwards’s rights under that provision when it denied
her the opportunity to select Planned Parenthood as her healthcare
provider. Agreeing with the plaintiffs’ assessment, the district
court granted summary judgment to them and entered a permanent
injunction preventing the State from excluding Planned Parenthood
from its Medicaid program.
Planned Parenthood South Atlantic
v.
Baker, 487 F. Supp. 3d 443, 448 (SC 2020).
On appeal, the Fourth Circuit affirmed the
district court’s decision.
Planned Parenthood South Atlantic
v.
Kerr, 27 F. 4th 945 (2022). Writing separately,
Judge Richardson expressed “confusion and uncertainty” about this
Court’s directions addressing when spending-power legislation
creates enforceable rights under §1983.
Id., at 959 (opinion
concurring in judgment). And he voiced “hop[e]” that we might
provide “clarity . . . soon.”
Ibid.
Seeking review of the Fourth Circuit’s decision,
the State filed a petition for certiorari in this Court. In light
of our intervening decision in
Talevski, 599 U.S. 166, in
which we addressed whether another spending-power statute created
§1983-enforceable rights, we granted the State’s petition, vacated
the decision of the court of appeals, and remanded the case for
further proceedings.
Kerr v.
Planned Parenthood South
Atlantic, 599 U. S. ___ (2023).
On remand, the court of appeals reaffirmed its
earlier decision. 95 F. 4th, at 153. And, once more, Judge
Richardson wrote separately. Even after
Talevski, he said,
lower courts “continue[d] to lack the guidance” they need from this
Court to determine when a federal spending-power statute creates a
right that private parties can enforce under §1983. 95 F. 4th, at
170 (opinion concurring in judgment). Other circuit judges have
expressed similar concerns. See,
e.g., Saint Anthony
Hospital v.
Whitehorn, 132 F. 4th 962, 971 (CA7
2025) (en banc);
id., at 982 (Hamilton, J., dissenting);
New York State Citizens’ Coalition for Children v.
Poole, 935 F.3d 56, 60 (CA2 2019) (Livingston, J.,
dissenting from denial of rehearing en banc).
In response to the Fourth Circuit’s latest
decision, the State filed another petition for certiorari. In it,
South Carolina noted that other lower courts have disagreed with
the Fourth Circuit regarding whether §1396a(a)(23)(A) confers an
individually enforceable right. Cf.
Planned Parenthood of
Greater Tex. Family Planning & Preventative Health Servs.,
Inc. v.
Kauffman, 981 F.3d 347, 350 (CA5 2020) (en
banc);
Does v.
Gillespie, 867 F.3d 1034, 1037 (CA8
2017). We agreed to hear the case. 604 U. S. ___ (2024).
II
To resolve the circuits’ disagreement and
address our lower court colleagues’ calls for clarification, we
begin by outlining how to determine whether a statute confers an
individually enforceable right under §1983.
A
The Constitution charges the Executive Branch
with enforcing federal law. Art. II, §3. But sometimes
Congress also allows private parties to enforce the law through
civil litigation. In §1983, Congress did just that, authorizing
individuals to sue anyone who, under color of state law, deprives
them of “rights, privileges, or immunities secured by the
Constitution and laws” of the United States.
Historically, individuals brought §1983 suits to
vindicate rights protected by the Constitution. But, in 1980, this
Court recognized that §1983 also authorizes private parties to
pursue violations of their federal statutory rights.
Maine
v.
Thiboutot,
448 U.S.
1. Still, this Court has emphasized, statutes create
individual rights only in “atypical case[s].”
Talevski, 599
U. S., at 183. Routinely, of course, federal legislation seeks
to
benefit one group or another. (Why pass legislation
otherwise?) But §1983 provides a cause of action “only for the
deprivation of ‘rights, privileges, or immunities,’ ” not
“ ‘benefits’ or ‘interests.’ ”
Gonzaga, 536
U. S., at 283.
To prove that a statute secures an enforceable
right, privilege, or immunity, and does not just provide a benefit
or protect an interest, a plaintiff must show that the law in
question “clear[ly] and unambiguous[ly]” uses “rights- creating
terms.”
Id., at 284, 290. In addition, the statute must
display “ ‘an unmistakable focus’ ” on individuals like
the plaintiff.
Id., at 284 (emphasis deleted); accord,
Talevski, 599 U. S., at 183. We have described this as
a “stringent” and “demanding” test.
Id., at 180, 186;
accord,
post, at 9 (Jackson, J., dissenting) (describing
Gonzaga as setting forth “a restrictive test”). And even for
the rare statute that satisfies it, this Court has said, a §1983
action still may not be available if Congress has displaced §1983’s
general cause of action with a more specific remedy.
Rancho
Palos Verdes v.
Abrams,
544 U.S.
113, 120 (2005).
These rules seek to “vindicat[e] the separation
of powers.”
Talevski, 599 U. S., at 183. To be sure,
there was a time in the mid-20th century when “the Court assumed it
to be a proper judicial function to provide” whatever “remedies” it
deemed “necessary to make effective a statute’s purpose.”
Ziglar v.
Abbasi, 582 U.S. 120, 131–132 (2017)
(internal quotation marks omitted). But, as this Court has since
come to appreciate, no statute pursues any single “purpos[e ]
at all costs.”
American Express Co. v.
Italian Colors
Restaurant,
570 U.S.
228, 234 (2013) (internal quotation marks omitted). And, often
enough, Congress may “not wish to pursue [a] provision’s purpose to
the extent of authorizing private suits.”
Hernández v.
Mesa, 589 U.S. 93, 100 (2020). After all, the decision
whether to let private plaintiffs enforce a new statutory right
poses delicate questions of public policy. New rights for some mean
new duties for others. And private enforcement actions, meritorious
or not, can force governments to direct money away from public
services and spend it instead on litigation. See
ibid. The
job of resolving how best to weigh those competing costs and
benefits belongs to the people’s elected representatives, not
unelected judges charged with applying the law as they find it. See
Alexander v.
Sandoval,
532 U.S.
275, 286 (2001);
Gonzaga, 536 U. S., at
285.[
1]
B
Though it is rare enough for any statute to
confer an enforceable right, spending-power statutes like Medicaid
are especially unlikely to do so. The reasons why take a little
unpacking.
When Congress passes a law, say, regulating
commerce between the States or outlawing piracy, it can point for
authority to the Commerce Clause, U. S. Const., Art. I, §8,
cl. 3, or the Piracies Clause, cl. 10. In enumerated
areas like those, the Constitution vests Congress with the power to
regulate conduct. But when Congress distributes money, its
authority rests on a different footing.
The Constitution has no “Spending Clause,”
strictly speaking. Instead, we usually trace Congress’s spending
power to Article I, section eight, clause one, which gives Congress
the “Power To lay and collect Taxes, Duties, Imposts and Excises,
to pay the Debts and provide for the common Defence and general
Welfare of the United States.” Unlike other enumerated powers, this
provision does not expressly endow Congress with the power to
regulate conduct. Nor does it include “the power to issue direct
orders to the governments of the States.”
Murphy v.
National Collegiate Athletic Assn., 584 U.S. 453, 471
(2018).
As the Court observed in
United States v.
Butler, the meaning of Article I’s “general welfare”
language provoked fierce debate right from the start.
297 U.S.
1, 65–67 (1936). At one extreme, Gouverneur Morris thought it
authorized Congress to tax, spend, and regulate broadly in pursuit
of the “general Welfare.” D. Schwartz, Mr. Madison’s War on the
General Welfare Clause, 56 U. C. D. L. Rev. 887, 915
(2022). Alexander Hamilton took a more modest view. He thought the
language gave Congress the power to raise and “appropriate money”
for “objects” of “General” (as opposed to “local”) importance.
Report on the Subject of Manufactures (Dec. 5, 1791), in 10 Papers
of Alexander Hamilton 230, 303–304 (H. Syrett ed. 1966) (emphasis
deleted). But he denied that those powers included as well “a power
to do whatever else should appear to Congress conducive to the
General Welfare.”
Ibid. James Madison advanced a narrower
position still. As he saw it, the language authorized Congress to
spend money only in support of its other enumerated powers. A.
LaCroix, The Interbellum Constitution: Federalism in the Long
Founding Moment, 67 Stan. L. Rev. 397, 407 (2015)
(LaCroix).
Over time, Hamilton’s view gained ground. So,
for example, as Justice Story saw it, Congress may raise and
“appropriat[e] . . . money” to advance the “general
welfare.” 3 J. Story, Commentaries on the Constitution of the
United States §1269, p. 150 (1833). But nothing in Article I,
section eight, clause one endows Congress with a power to regulate,
for if it did, the “enumeration of specific powers” elsewhere in
Article I would be rendered largely pointless, and the Nation would
trade a limited federal government for “an unlimited” one. 2
id., §§904, 906, pp. 367, 369; see also
Butler, 297
U. S., at 66 (Justice Story’s “reading . . . is the
correct one”); J. Monroe, Message From the President of the United
States 32–33 (1822); E. Corwin, The Spending Power of
Congress—Apropos the Maternity Act, 36 Harv. L. Rev. 548, 564–566
(1923).
Consistent with this understanding, early courts
described federal grants not as commands but as contracts.
Consider, for example, how this Court approached a dispute
concerning the first major federal highway. The Cumberland Road
once supplied a vital link between the East Coast and the old
Northwest. LaCroix 420. Starting in the 1830s, the federal
government gradually transferred control of the road to several
States. J. Young, A Political and Constitutional Study of the
Cumberland Road 78–98 (1902). One transfer to Ohio came with a
condition: The State could not charge tolls on wagons carrying
federal property.
Id., at 96–98. When a disagreement arose
about the scope of that toll exemption, this Court looked to “the
expectations of the parties,” a familiar feature of contract law,
to resolve it.
Neil, Moore & Co. v.
Ohio, 3 How.
720, 741 (1845). In doing so, the Court emphasized that it was
enforcing requirements “well known” to the parties when the
“compact was made.”
Ibid.; see also
McGee v.
Mathis, 4 Wall. 143, 155 (1866) (“It is not doubted that the
grant by the United States to the State upon conditions, and the
acceptance of the grant by the State, constituted a contract”).
At the same time, the Court recognized that
agreements between state and federal governments are not exactly
the same as contracts “between individuals.”
Searight v.
Stokes, 3 How. 151, 167 (1845). In many respects, the Court
suggested, federal-state agreements are really more like treaties
“between two sovereignties.” See
Neil, Moore & Co., 3
How., at 742. And, while treaties may seek to benefit the citizens
of the compacting nations, they generally do not confer
individually enforceable rights against a sovereign, but
“depen[d ] for the enforcement of [their] provisions on
. . . the governments which are parties to” them.
Head
Money Cases,
112 U.S.
580, 598 (1884).[
2]
Adapting this logic to the context of federal grants, the Court
concluded that, as a rule, “Congress alone has the power to
enforce” the conditions it attaches to its grants.
Emigrant
Co. v.
County of Adams,
100 U.S.
61, 69 (1879); see also
Mills County v.
Railroad
Cos.,
107 U.S.
557, 566 (1883).
C
For much of the Nation’s history, the Court
had little occasion to employ these ideas. Congress rarely granted
money to States and, when it did, those grants rarely came with
many conditions. See D. Currie, The Constitution in Congress:
Democrats and Whigs, 1829–1861, pp. 42–45 (2005). But that began to
change during the New Deal. And when disputes about those grant
conditions arose, this Court returned to the old contract and
treaty analogies to ensure that spending-power legislation did not
pass the “point at which pressure turns into compulsion.”
Steward Machine Co. v.
Davis,
301
U.S. 548, 590 (1937); see also
Massachusetts v.
Mellon,
262 U.S.
447, 480 (1923);
Butler, 297 U. S., at 73–75;
Oklahoma v.
Civil Serv. Comm’n,
330 U.S.
127, 143–144 (1947). The same analogies guided the Court, too,
after federal grants exploded in the 1960s, generating “an
unprecedented” wave of litigation in which private parties sought
to challenge state compliance with federal grant conditions. E.
Tomlinson & J. Mashaw, The Enforcement of Federal Standards in
Grant-In-Aid Programs: Suggestions for Beneficiary Involvement, 58
Va. L. Rev. 600, 630 (1972).[
3]
Take
Pennhurst. There, private plaintiffs
sought to sue the Commonwealth of Pennsylvania for failing to
fulfill the terms of a federal healthcare grant. 451 U. S., at
6. In assessing whether the suit could proceed, the Court began by
observing that “legislation enacted pursuant to the spending power
is much in the nature of a contract: in return for federal funds,
the States agree to comply with federally imposed conditions.”
Id., at 17. And the “typical remedy for state noncompliance”
with a federal grant’s conditions is an “action by the Federal
Government to terminate funds to the State.”
Id., at 28.
Given these principles, the Court reasoned, whether a private party
may sue to enforce the terms of a federal grant depends on “whether
the State voluntarily and knowingly” consented to answer private
claims as part of its bargain with the federal government.
Id., at 17. And to satisfy this standard, the Court held, a
plaintiff must show, at a minimum, that Congress alerted the State
in advance, “clear[ly]” and “unambiguously,” that responding to
private enforcement suits was a condition of its offer.
Ibid.[
4]
In
Gonzaga, the Court restated these
principles and explored how they interact with §1983.
Spending-power legislation, the Court explained, cannot provide the
basis for a §1983 enforcement suit unless Congress “speaks with a
clear voice, and manifests an unambiguous intent to confer
individual rights.” 536 U. S., at 280 (alteration and internal
quotation marks omitted). Only that kind of “unmistakable” notice,
the Court said, suffices to alert grantees that they might be
subject “to private suits . . . whenever they fail to
comply with a federal funding condition.”
Id., at 286–287,
and n. 5 (internal quotation marks omitted). And, the Court
concluded, because the statute at issue before it did not clearly
and unambiguously confer a “right to support a cause of action
under §1983,” the plaintiff ’s suit could not proceed.
Id., at 283, 290.[
5]
Just two Terms ago, we reaffirmed these points.
In
Talevski, the Court faced another private §1983 suit
alleging that recipients of federal funding had violated grant
conditions. To decide whether the plaintiffs could proceed, we
turned to
Gonzaga, recognizing that it “sets forth our
established method” for analyzing suits like that.
Talevski,
599 U. S., at 183. In doing so, we reiterated that the
relevant “[s]tatutory provisions must
unambiguously confer
individual federal rights” before a §1983 claim might proceed.
Id., at 180. That standard, we emphasized, is a “demanding
bar” and a “significant hurdle” that will be cleared only in the
“atypical case.”
Id., at 180, 183–184. And, applying that
test, we found the statutes in question satisfied it precisely
because they “expressly” employed the sort of clear and unambiguous
“rights-creating language”
Gonzaga demands. 599 U. S.,
at 184, 186 (internal quotation marks omitted).
Admittedly, this Court briefly experimented with
a different approach, and that fact has given rise to some
confusion in the lower courts. For a time, as we have seen, the
Court sometimes took an expansive view of its power to imply
private causes of action to enforce federal laws. See Part II–A,
supra. Moved by the same spirit, the Court sometimes took a
broad view of its authority to confer new rights under
spending-power statutes that did not expressly provide them. In
Wilder v.
Virginia Hospital Association, for example,
the Court suggested that spending-power legislation can give rise
to an enforceable right under §1983 so long as the legislation is
“intended to benefit the putative plaintiff ” and the
plaintiff ’s interest in the statute is not “too vague and
amorphous.”
496 U.S.
498, 509 (1990) (alteration and internal quotation marks
omitted); see
Wright v.
Roanoke Redevelopment and Housing
Authority,
479 U.S.
418, 423–424, 431–432 (1987). Building on those same ideas in
Blessing v.
Freestone, the Court outlined a
three-factor test for recognizing new privately enforceable rights.
520 U.S.
329, 340–341 (1997). Some lower court judges, including in this
case, still consult
Wilder,
Wright, and
Blessing when asking whether a spending-power statute
creates an enforceable individual right. See,
e.
g.,
95 F. 4th, at 163–165;
id., at 170 (Richardson, J.,
concurring in judgment).
They should not.
Gonzaga “reject[ed]” any
reading of our prior cases that would “permit anything short of an
unambiguously conferred right to support a cause of action brought
under §1983.” 536 U. S., at 283.
Armstrong
“repudiate[d]” any other approach. 575 U. S., at 330, n. And
Talevski reaffirmed that “
Gonzaga sets forth our
established method” for determining whether a spending-power
statute confers individual rights. 599 U. S., at 183.
All of these warnings came for now-familiar
reasons. Because spending-power legislation is “in the nature of a
contract,” a grantee must “voluntarily and knowingly” consent to
answer private §1983 enforcement suits before they may proceed.
Pennhurst, 451 U. S., at 17; see
id., at 28. And
that consent cannot be fairly inferred if the federal
spending-power statute fails to provide “clear and unambiguous”
notice that it creates a personally enforceable right.
Gonzaga, 536 U. S., at 290. To the extent lower courts
feel obliged, or permitted, to consider the contrary reasoning of
Wilder,
Wright, or
Blessing, they should
resist the impulse.
III
With these principles in hand, we turn to the
question whether the plaintiffs before us may maintain a §1983 suit
to enforce Medicaid’s any-qualified-provider provision. To succeed,
they must show, at a minimum, that §1396a(a)(23)(A) does not just
seek to benefit them or serve their interests but “clear[ly] and
unambiguous[ly]” gives them individual federal rights.
Gonzaga, 536 U. S., at 290.[
6]
Since
Pennhurst, this Court has
identified only three sets of spending-power statutes that confer
enforceable rights under §1983—those at issue in
Wright,
Wilder, and
Talevski. But given this Court’s
longstanding repudiation of
Wright and
Wilder’s
reasoning, the statutes at issue in
Talevski supply the only
reliable yardstick against which to measure whether spending-power
legislation confers a privately enforceable right.
Talevski addressed two provisions of the
Federal Nursing Home Reform Act (FNHRA). See 599 U. S., at
181–182. The first obliged nursing-home facilities to “protect and
promote” residents’ “
right to be free from” unnecessary
“physical or chemical restraints.” 42 U. S. C.
§1396r(c)(1)(A)(ii) (emphasis added). The second appeared in a
subparagraph titled “[t]ransfer and discharge
rights.”
§1396r(c)(2)(A) (emphasis added). And both provisions sat in a
subsection called “[r]equirements relating to residents’
rights.” §1396r(c) (emphasis added).
The any-qualified-provider provision before us
looks nothing like those FNHRA provisions. Section 1396a(a)(23)(A)
indicates that state Medicaid plans must “provide that
. . . any individual eligible for medical assistance
(including drugs) may obtain such assistance from any institution,
agency, community pharmacy, or person, qualified to perform the
service or services required . . . who undertakes to
provide him such services.” Doubtless, this language speaks to what
a State must do to participate in Medicaid, and a State that fails
to fulfill its duty might lose federal funding. Doubtless, too,
this provision seeks to benefit both providers and patients. But
missing from §1396a(a)(23)(A) is anything like FNHRA’s clear and
unambiguous “rights-creating language.”
Talevski, 599
U. S., at 186 (internal quotation marks omitted).
To be sure, Congress could have taken a
different approach when drafting §1396a(a)(23)(A). In fact, FNHRA
offers an example almost perfectly on point. One of its provisions
gives nursing-home residents the right to choose their own
attending physicians. Here is the provision in context:
“
(c) Requirements relating to
residents’ rights
“
(1) General rights
“
(A) Specified rights
“A nursing facility must protect and promote
the
rights of each resident, including each of the following
rights:
“
(i) Free choice
“The
right to choose a personal attending
physician . . . .” §1396r(c) (emphasis added).
As this language shows, Congress knows how to
give a grantee clear and unambiguous notice that, if it accepts
federal funds, it may face private suits asserting an individual
right to choose a medical provider. Tellingly, too, Congress
adopted this FNHRA provision in legislation that also amended
§1396a(a)(23). Yet Congress’s work in the two provisions could not
have been more different. See 101Stat. 1330–152;
Talevski,
599 U. S., at 181, n. 10. Someday, Congress might choose
to revise §1396a(a)(23) to resemble FNHRA. But that is not the law
we have. Cf.
Feliciano v.
Department of
Transportation, 605 U. S. ___, ___ (2025) (slip op., at
6).
The remainder of §1396a(a)(23) only serves to
confirm our conclusion. After announcing that state Medicaid plans
must allow individuals to obtain care from any qualified provider,
the provision proceeds to carve out various exceptions to that
rule. So, for example, the statute allows States to exclude from
their Medicaid programs certain providers “convicted of a
felony”—and, what is more, to “determin[e ]” which felony
convictions qualify for that exclusion. §1396a(a)(23)(B). All that
makes perfect sense if §1396a(a)(23)(A) speaks only to a State’s
duties to the federal government. But it is an arrangement a good
deal harder to understand if §1396a(a)(23)(A) also confers an
individually enforceable right, for that would mean Congress sought
to convey a right against the States in one breath but let States
control its scope in the next.
Expanding our view beyond §1396a(a)(23) to the
surrounding statutory context yields similar clues. To continue
receiving federal funding, the Medicaid Act says, a State need only
“comply substantially” with the any- qualified-provider mandate.
§1396c. And, as this Court recognized in
Gonzaga, that focus
on “ ‘aggregate’ ” compliance suggests that a statute
addresses a State’s obligations to the federal government, not the
rights “ ‘of any particular person.’ ” 536 U. S., at
288. Sometimes, we appreciate, a provision may overcome this
weighty statutory evidence. In
Talevski, after all, the
Court found two FNHRA provisions to confer individual rights even
though that statute also speaks of “substantial compliance.” See
Brief for Respondents 35–36. But, at risk of repetition, the
provisions at issue there employed explicit and unmistakable
“ ‘rights- creating language,’ ” 599 U. S., at 186,
and §1396a(a)(23)(A) does not.
Notable, too, is where Congress placed the
any-qualified-provider provision. It appears in a subsection titled
“Contents.” §1396a(a). That subsection outlines scores of things a
state plan must include to qualify for federal funding.
Ibid. Those requirements do not appear in any discernible
order, and the any-qualified-provider provision does not crop up
until paragraph 23 of 87. All of §1396a(a)’s requirements are
directed to the Secretary of Health and Human Services, who must
“approve any plan” that meets them. §1396a(b); see
Armstrong, 575 U. S., at 331–332 (plurality opinion).
None of this may suffice to prove that the any-qualified-provider
provision is unenforceable under §1983. See §1320a–2. But it does
show, once more, that the statute before us stands in stark
contrast to the ones we faced in
Talevski, where Congress
set its rights-creating provisions apart from others and, in doing
so, helped alert grantees that accepting federal funds comes with a
duty to answer private suits.
Observe, as well, what it would mean if
§1396a(a)(23)(A) did create an individually enforceable right. Many
other Medicaid plan requirements would likely do the same. And
instead of remaining “atypical” exceptions, as our cases have said
they are, rights-creating provisions might more nearly become the
rule.
Talevski, 599 U. S., at 183.
Take one example. See Brief for United States as
Amicus Curiae 27–29 (offering others). Section 1396a(a)(32)
follows several paragraphs down from the any-qualified-provider
provision. It requires state Medicaid plans to “provide,” with
certain exceptions, “that no payment under the plan for any care or
service provided to an individual shall be made to anyone other
than such individual or the person or institution providing such
care or service.” As the plaintiffs acknowledge, this provision
“uses language with some similarities to” §1396a(a)(23)(A). Brief
for Respondents 38–39. Both speak in mandatory terms (“must
. . . provide”; “shall”). Both discuss “individual[s].”
Neither mentions “rights.” Yet, while the plaintiffs insist that
paragraph (23)(A) clearly and unambiguously creates an individual
right, they suggest that a court could reasonably “determine” that
paragraph (32) “does not.”
Ibid. (citing
Polk v.
Yee, 36 F. 4th 939, 945–946 (CA9 2022)). Rather than
try to square that circle, we think the better course is the one
our precedents suggest: Neither paragraph uses clear and
unambiguous rights-creating language, so neither supports a private
suit under §1983.
IV
Seeking to persuade us otherwise, the
plaintiffs and dissent offer four principal counterarguments.
First, the plaintiffs and dissent appeal to
legislative history. The hearings and committee reports leading to
§1396a(a)(23)(A)’s adoption, they say, reveal that Congress meant
for the statute to secure an individual right. See Brief for
Respondents 30–32; see also
post, at 3, 13 (Jackson, J.,
dissenting). But that does not move the needle. When it comes to
interpreting the law, speculation about what Congress may have
intended matters far less than what Congress actually enacted. See
Epic Systems Corp. v.
Lewis, 584 U.S. 497, 523 (2018)
(“[L]egislative history is not the law”). And that goes double for
spending-power statutes, where “the key is not what a majority of
the Members of both Houses intend but what the States are clearly
told.”
Arlington Central School Dist. Bd. of Ed. v.
Murphy,
548 U.S.
291, 304 (2006).[
7]
Second, the plaintiffs and dissent contend,
Congress modeled §1396a(a)(23)(A) on a Medicare provision titled
“ ‘Free choice by patient guaranteed.’ ” 79Stat. 291, 42
U. S. C. §1395a. It reads: “Any individual entitled to
insurance benefits under this subchapter may obtain health services
from any . . . person qualified to participate under this
subchapter if such . . . person undertakes to provide him
such services.” §1395a(a). And because that Medicare provision
“confer[s] an individual right,” the plaintiffs and dissent reason,
its Medicaid offshoot must as well. Brief for Respondents 34; see
post, at 13 (Jackson, J., dissenting).
This argument stumbles out of the gate. Its
premise—that §1395a(a) confers an enforceable right—is
questionable. As the plaintiffs admit, “[n]o court has addressed
whether a Medicare beneficiary can enforce this provision under
Section 1983.” Brief for Respondents 34, n. 7. Even
overlooking that deficiency, another quickly emerges. While the
title of §1395a(a) “guarantee[s]” a patient’s “free choice” of
provider—and while the plaintiffs and dissent insist this language
can create a right—the any-qualified- provider provision never uses
“guarantee” or its equivalent. So if the comparison between the
Medicaid and Medicare provisions reveals anything, it is that
Congress did not include in §1396a(a)(23)(A) the language from
§1395a that the plaintiffs and dissent think most likely to confer
enforceable rights.
Third, instead of grappling meaningfully with
the test our precedents provide, the dissent proposes to rewrite
it. In the dissent’s view, a statute confers a privately
enforceable right whenever it uses “compulsory” and
“individual-centric terminology,” as long as it also evokes
“language classically associated with establishing rights.”
Post, at 12 (opinion of Jackson, J.). When it comes to that
last requirement, the dissent reasons this way: Congress enacted
§1396a(a)(23)(A) under the title “free choice by individuals
eligible for medical assistance,” 81Stat. 903 (capitalization
omitted); the phrase “free choice” calls to the dissent’s mind a
phrase from the First Amendment (“free exercise” of religion); that
Amendment declares rights; so §1396a(a)(23)(A) likely must as well.
Post, at 12 (opinion of Jackson, J.).
Our precedents do not authorize anything like
the dissent’s approach—and for good reasons. To start, while a
title may underscore that the statutory text creates a right, “[i]t
has long been established that the title of an Act cannot enlarge
or confer powers” by itself.
Pennhurst, 451 U. S., at
19, n. 14 (internal quotation marks omitted); see A. Scalia
& B. Garner, Reading Law: The Interpretation of Legal Texts
221–224 (2012). That must be especially so where, as here, Congress
chose
not to enact into the U. S. Code the very title
on which the dissent relies. See 81Stat. 903 (enacting the title of
a different section, but not “free choice by individuals eligible
for medical assistance,” into the U. S. Code (capitalization
omitted)).
Even beyond that, the dissent’s test would risk
obliterating the longstanding line between mere benefits and
enforceable rights. See
supra, at 6, 13, 15. If, as the
dissent says, §1396a(a)(23)(A) creates an enforceable right because
it contains “compulsory” and “individual-centric terminology” plus
an iffy analogy to the Bill of Rights, then many other provisions
(in Medicaid and elsewhere) previously thought to confer only
benefits would suddenly create rights instead.
Supra, at
18–19. All despite
Talevski’s insight just two Terms ago
that, while many statutes supply benefits, only “atypical” statutes
confer enforceable rights under §1983. 599 U. S., at 183. To
be sure, the dissent assures us that other Medicaid provisions are
distinguishable from this one.
Post, at 19 (opinion of
Jackson, J.). How? Not based on their text (which the dissent never
addresses) but, it seems, based on an unspoken judicial intuition
that the provision before us is just more important than others.
So, on top of all its other flaws, the dissent’s approach would
leave States guessing about the terms of their deals with the
federal government and invite courts to revive their long-abandoned
approach of usurping Congress’s role in creating rights and
remedies.
Supra, at 7.[
8]
Fourth and finally, the plaintiffs and dissent
advance a policy argument. Only §1983 litigation, they submit, can
give the any-qualified-provider provision the teeth it needs. Yes,
they acknowledge, the federal government can audit States’
compliance with §1396a(a)(23)(A) and withhold some or all Medicaid
funds from noncompliant States. Brief for Respondents 44. But, the
plaintiffs and dissent insist, the federal government has neither
the capacity nor the appetite for taking that “drastic step.”
Ibid.; see Tr. of Oral Arg. 110; see also
post, at
2–3 (Jackson, J., dissenting).
This argument suffers from a number of problems.
For one, this Court has specifically rejected the notion that “the
cut-off of funding” is “too massive” a remedy “to be a realistic
source of relief ” for violations of §1396a(a) provisions.
Armstrong, 575 U. S., at 331. To the contrary, this
Court has called funding cutoffs “the typical remedy” when a grant
recipient violates the terms of spending-power legislation.
Pennhurst, 451 U. S., at 17.
For another, funding cutoffs may not be the only
way to enforce §1396a(a)(23)(A). Like other States, South Carolina
has an administrative process that lets providers challenge their
exclusion from the State’s Medicaid program. See Brief for United
States as
Amicus Curiae 30;
Gillespie, 867
F. 3d, at 1038. That process can culminate with state judicial
review—and, if necessary, with a petition for certiorari to this
Court. See S. C. Code Ann. §1–23–380 (Cum. Supp. 2024).
Indeed, Planned Parenthood itself pursued just such an
administrative claim at one point. See App. 61–63.
For another thing still, if existing remedies
prove insufficient, Congress can create new ones. So, for example,
it might do as it did in FNHRA and revise §1396a(a)(23)(A) to
provide States with clear and unambiguous notice of an individually
enforceable right. Of course, as we have observed, a decision like
that comes with tradeoffs. At their best, individual suits under
§1983 can vindicate plaintiffs’ rights while pushing States to
fulfill their obligations. But private enforcement does not always
benefit the public, not least because it requires States to divert
money and attention away from social services and toward
litigation. And balancing those costs and benefits poses a question
of public policy that, under our system of government, only
Congress may answer. See
Sandoval, 532 U. S., at 286;
Gonzaga, 536 U. S., at 285–286.[
9]
*
Section 1983 permits private plaintiffs to sue
for violations of federal spending-power statutes only in
“atypical” situations,
Talevski, 599 U. S., at 183,
where the provision in question “clear[ly]” and “unambiguous[ly]”
confers an individual “right,”
Gonzaga, 536 U. S., at
290. Section 1396a(a)(23)(A) is not such a statute. Because the
Fourth Circuit concluded otherwise, its judgment is reversed and
the case is remanded for further proceedings consistent with this
opinion.
It is so ordered.
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