The latest Supreme Court session delivered a series of decisions with far-reaching implications for civil rights, healthcare, and executive power – many of them driven by the Court’s conservative majority. In this update, we break down the results of five key cases, United States v. Skrmetti, Kennedy v. Braidwood Management, Medina v. Planned Parenthood South Atlantic, Trump v. Casa Inc., and Mahmoud v. Taylor, highlighting what was decided, why it matters, and how these rulings could shape future policy.
U.S. v. Skrmetti
On Wednesday, June 18 the Supreme Court released its decision in U.S. v. Skrmetti, the case on Tennessee’s SB1, a ban on medically necessary gender-affirming care for transgender youth in the state. The case, brought by three transgender adolescents, their families, and a Memphis-based medical provider, claimed the law violated the Equal Protection Clause of the U.S. Constitution by discriminating based on sex and transgender status.
In a disappointing 6-3 decision, the justices ruled against trans youth, their families, and their providers, seeking dignity and autonomy as they make medical decisions, free from political agendas. Instead, the Court’s majority opinion found that the ban did not violate the Constitution’s guarantee of equal protection because it does not differentiate by sex. These justices claimed that the law does not make classifications based on sex, but “prohibits healthcare providers from administering puberty blockers and hormones to minors for certain medical uses, regardless of a minor’s sex”, as if denying medical care to all transgender youth instead of just transgender boys or girls made SB1 acceptable.
The decision by the Court is a direct assault on the rights and bodily autonomy of transgender people, and sets a dangerous precedent for continued and future attacks on bodily autonomy of other marginalized communities. While the decision does not affect the law in states that have not passed a ban on gender-affirming care, the Trump Administration has made clear their intentions to continue their assault on transgender people and the broader LGBT+ community by threatening funding to provide gender-affirming care and restricting access to accurate identity documents.
Kennedy v. Braidwood
On Friday, June 27 the Supreme Court released its decision in Kennedy v Braidwood, a case that targeted the Affordable Care Act’s requirement for insurance plans to cover preventive services without cost-sharing, as recommended by the U.S. Preventive Services Task Force. The case was originally brought by Braidwood Management, who objected to covering PrEP for their employees as it “promotes homosexuality” and went against their religious beliefs. It has since developed into a question about the Task Forces’ standing as inferior officers and the constitutionality of their appointment.
In a 6-3 decision, the Court upheld the ACA’s preventive care mandate providing some protection for preventive care services such as cancer screening, heart screening, STI testing, PrEP and much more to be covered without cost sharing by private insurers. This decision was a relief to many health advocacy organizations including AIDS United who understood that free preventive services, like PrEP, are life-saving interventions.
Nevertheless, concerns still remain, as the Court’s decision re-asserted Secretary Kennedy’s control over the appointment and removal of Task Force members. This follows the dismantling of the Advisory Committee on Immunization Practices (ACIP) and subsequent replacement with members that promote widely discredited views on vaccinations.
In addition, the Court remanded the case back to the lower courts which may consider the legality and continued coverage of recommendations issued between June 2010 and June 2023.The most recent USPSTF recommendation for PrEP should not be impacted by this as it was issued in August 2023.
Advocacy will be needed to ensure that preventive services continue to be safe-guarded against future litigation and that the Secretary continues the Task Force continues to make recommendations for preventive care based on medical science and peer-reviewed evidence.
Medina v. Planned Parenthood South Atlantic
On Thursday, June 26, the Supreme Court released its decision in Medina v. Planned Parenthood South Atlantic, a case that examined Medicaid’s “free-choice of provider” provision. The provision is supposed to give Medicaid recipients the right to receive care from any qualified and participating health care provider. This case was brought by Medicaid user Julie Edwards who wanted to continue her gynecological care at Planned Parenthood. She was unable to do so because of a 2018 Executive Order from South Carolina’s governor that barred clinics like Planned Parenthood from the state’s Medicaid program if they included abortion care in their services.
In a 6-3 decision, the Court ruled against Edwards and Planned Parenthood. The majority opinion was that the “free-choice of provider” provision did not create an individual enforceable right. The Court stated that in the 2023 Health & Hospital Corporation of Marion County (HHC) v. Talevski case, the explicit use of the word “right” was used to give residents rights, unlike the “free-choice provider” provision that does not include the word “right”. In her dissenting opinion, Justice Jackson criticized the majority’s ruling that the absence of the word “right” in the “free-choice of provider” provision meant that the section did not grant individual rights, and asserted that the 2023 case is not a definitive model.
In states that have decided to exclude Planned Parenthood from their Medicaid programs, Medicaid recipients will no longer be able to receive covered care at Planned Parenthood Clinics. Beyond gender-affirming and reproductive care, Planned Parenthood is an essential health care clinic in many communities. Medicaid recipients in these states will lose access to any preventative services, STI treatments, or cancer screenings at Planned Parenthood clinics.
With the loss of Medicaid revenue that will come from this ruling, many Planned Parenthood clinics will be forced to decrease their service hours or shut down. The Court’s ruling in this case is one in an ongoing series of assaults on gender-affirming care, reproductive rights, and health care in general.
Trump v. Casa, Inc.
On Friday, June 27, the Supreme Court released its decision in Trump v. Casa, Inc., a case that targeted birthright citizenship and the courts’ ability to use universal injunctions. Shortly after coming into his second term, president Donald Trump issued an Executive Order restricting birthright citizenship for individuals whose parents are either not legal US citizens or not permanent residents. States, individuals, and organizations filed lawsuits in response to this unconstitutional order. Three district courts sided with the plaintiffs and issued preliminary universal injunctions to block the order.
In a 6-3 decision, the Court ruled to prohibit the nationwide injunctions from the district courts. The majority opinion claimed that there is no historical precedent for universal injunctions, and that “complete relief” must only be applied to those directly before the court. The decision did not directly address the constitutionality of the Trump Administration’s attacks on birthright citizenship.
In her dissent, Justice Sotomayor argued that the Executive Order was unconstitutional and that without the relief from a universal injunction, those without the ability to sue would be left with virtually no constitutional rights. Justice Jackson also dissented, claiming that the majority decision set a dangerous precedent because it allowed the Executive to violate the rights of anyone who has not yet sued.
Mahmoud v. Taylor
On Friday, June 27, the Supreme Court released its decision in Mahmoud v. Taylor, ruling in favor of allowing parents the right to opt their children out of specific school lessons. Back in 2022, Montgomery County Public Schools in Maryland had approved the use of LGBTQ+ friendly storybooks in its English Language Arts curriculum. In 2023, the school board banned parents from opting their children out of lessons that included these books. Shortly after that ruling, a group of parents from different religious backgrounds sued the school board, citing their religious freedom and parental rights.
In a 6-3 decision, the Court ruled with the Maryland parents. The majority opinion, authored by Justice Alito, claimed that the books, which featured storylines concerning gender and sexual identity, could interfere with the religious teachings of some parents. The decision declared that the school board had placed a pressure to conform to certain beliefs on young students.
In her dissent, Justice Sotomayer reasoned that exposing children to positions that may conflict with certain religious beliefs is not a violation of parental rights. She also argued that this case will create a chaotic slippery slope, and that parents will begin opting out of any lesson that may conflict with their beliefs, such as lessons regarding evolution or civil rights.
Information regarding sexual and gender identity is necessary education, especially for children who may not have access to such information otherwise. The Mahmoud v. Taylor case is another attack on LGBTQ+ rights from the Roberts Court, under the guise of protecting religious freedom. This case both deprives youth of a critical and inclusive education and undermines the authority of democratically elected school boards.