If you’re on Medicaid, you’re supposed to be able to choose your own doctor. That right still technically exists, but now you can’t go to court to enforce it if states take that choice away. The U.S. Supreme Court made that decision in Medina v. Planned Parenthood South Atlantic, ruling that Medicaid beneficiaries no longer have an enforceable right in court if they are denied the provider of their choice. This is a big deal, especially for people with disabilities who rely on doctors they trust to understand their complex needs. Here’s what the case was about, what the Court decided, and what it means moving forward.

What does the Medina v. Planned Parenthood Case Address?

This case asked a simple question: can people on Medicaid sue in court if they’re not allowed to choose their doctor or clinic? Under the Medicaid Act’s “free choice of provider” provision, Medicaid recipients are supposed to be able to go to any qualified and Medicaid-approved provider they choose. But if the ability to bring a lawsuit when their choice of provider is denied is taken away, they can no longer ask a court to step in for a remedy or solution.

What Are the Facts of the Case?

Julie Edwards is a Medicaid recipient with Type 1 diabetes. After being advised by her doctors that pregnancy would pose serious health risks, she sought contraceptive care at a Planned Parenthood clinic in South Carolina. There, she received the care she needed and follow-up treatment for her high blood pressure. She had such a positive experience at the clinic that she wanted to receive all her gynecological and reproductive care there if Medicaid would cover it.

Planned Parenthood South Atlantic serves both Medicaid and non-Medicaid patients and provides a broad range of services including contraception, cancer screenings, physical exams, and more. The clinics are known for offering more accessible, timely care—short wait times, same-day appointments, and extended hours—which is especially important for low-income patients, many of whom rely on Medicaid.

But in July 2018, South Carolina’s Governor issued an executive order instructing the state’s Department of Health and Human Services (DHHS) to stop making Medicaid payments to Planned Parenthood South Atlantic. The reason was to prevent the state from “subsidizing” abortion care, even though Medicaid already restricts funding for that service. Two weeks later, Julie and Planned Parenthood South Atlantic sued the Director of DHHS in federal district court, arguing that South Carolina had violated the federal Medicaid Act by ignoring the “free choice of provider” provision.

Both the U.S. District Court and the U.S. Court of Appeals for the Fourth Circuit agreed with the plaintiffs: Medicaid’s “free choice of provider” provision gives patients the legal right to choose any qualified provider, and that right can be enforced in federal court. South Carolina then asked the U.S. Supreme Court to overturn that interpretation.

What Did the Supreme Court Decide?

In a 6-3 ruling, the U.S. Supreme Court ruled that Medicaid’s “free choice of provider” provision doesn’t clearly give patients the right to sue if a state blocks their doctor choice. Instead, the Court explained that only the federal government can step in if states don’t follow Medicaid rules, not individual patients. This means if your state tells you that you can’t see a certain doctor using Medicaid, you can’t challenge it in federal court anymore.

Justice Ketanji Brown Jackson dissented, joined by Justices Sotomayor and Kagan. She warned that this decision would cause “tangible harm to real people. At a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them. And, more concretely, it will strip…countless other Medicaid recipients around the country of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.'”

The Arc’s Position

The Arc, along with the National Health Law Program and other partners, filed an amicus brief in this case. In it, we explained that, “allowing patients to choose a doctor who they trust and with whom they feel comfortable… is a critical component of patient autonomy, satisfaction, and even health outcomes… freedom of access to qualified providers compliments Medicaid’s primary goal of increasing access to health care for all.” Many people with disabilities need providers who understand their communication style, respect their autonomy, and can provide appropriate accommodations. When states remove that choice, it risks eroding access to quality care.

The Arc’s position statement on Human and Civil Rights states that the rights within federal laws like Medicaid must be protected and enforced by all levels of society. People with disabilities must be able to sue to enforce their rights when a state denies them. In our position statement on Health we add: “All people, including people with IDD, should have timely access to high quality, comprehensive, accessible, affordable, appropriate health care that meets their individual needs.”

How Does This Impact People with Disabilities?

This decision is a serious setback for the disability community and Medicaid beneficiaries nationwide. Many people with disabilities depend on Medicaid for health care, many of whom are unable to obtain coverage elsewhere. Disabled patients often face discrimination in health care settings and need doctors who understand their unique needs and communication styles. Being forced to see unfamiliar providers or providers who lack the training to accommodate disability-related needs can lead to worse care or no care at all. Now, under Medina, if states decide to force people with disabilities who are on Medicaid to use specific providers, patients wouldn’t be able to challenge that in court. The Court’s ruling overturns decades of precedent that protected this right in most lower federal courts.

Bottom line: You’re still allowed to choose your doctor on Medicaid. But if your state takes that choice away, it’s now impossible to fight back in court. People with disabilities deserve more control over their health care, not less.

Further Reading:

• Medina Case Page
• NHELP Explainer

On June 12, 2025, the U.S. Supreme Court released its decision in A.J.T. v. Osseo Area Schools, a case that could’ve shook the very foundation of disability civil rights. The Court ruled that students with disabilities have the right to seek justice for discrimination in schools without facing legal barriers that don’t exist in workplaces, housing, or other areas of public life. Here’s why this case matters and what you need to know.

What is the A.J.T. v. Osseo Area Schools Case About?

This case is about whether federal disability rights laws require children with disabilities to meet a strict “bad faith or gross misjudgment” standard when suing because they experienced discrimination in K-12 public schools. This standard means that families would have to prove that school districts and/or administrators acted with a level of intent beyond negligence or indifference, requiring evidence of dishonesty, ill will, or a conscious disregard for the student’s rights This high standard is not required to prove disability discrimination in any other context, including in the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act, which only require showing that the defendant acted with “deliberate indifference.”

What Laws Protect Students With Disabilities?

The Individuals with Disabilities Education Act (IDEA) guarantees a free, appropriate public education for eligible students who have disabilities and need specialized instruction and related services. These services are established in an individualized education plan (IEP) that is created by the child’s parents and the school.

Section 504 of the Rehabilitation Act of 1973 prohibits discrimination in places that receive federal funding. Most, if not all, public schools receive federal funding. Section 504 requires schools to provide reasonable accommodations for students with disabilities. Reasonable accommodations can include allowing a child with diabetes to eat whenever necessary and not be limited to snack of lunch time.

The Americans with Disabilities Act bars discrimination in services provided by state and local governments. Public schools are operated by state or local governments. Like Section 504, the ADA requires schools to provide reasonable accommodations to students with disabilities.

What Are the Facts of the Case?

Ava is a student with epilepsy who needed evening instruction due to her seizures, which are so severe in the morning that she can’t go to school until noon. Due to this delayed start, she receives half the educational time as her peers do. Her parents asked for evening instruction to make up for these lost learning opportunities, but the school district denied their requests. Ava’s parents then sued, alleging violations of Section 504 of the Rehabilitation Act (Section 504) and the ADA.

Both the District Court and the Court of Appeals decided that a school district’s failure to provide reasonable accommodations is not enough to establish a violation of Section 504 and the ADA. Instead, the lower courts look to see if the school acted with “bad faith or gross misjudgment.” This is a hard standard to meet, and is only applied in certain jurisdictions. It is not applied to other ADA or Section 504 claims outside of school settings. After losing at the District Court and the Court of Appeals, Ava appealed to the U.S. Supreme Court.

What Did the U.S. Supreme Court Decide?

In a unanimous decision, the U.S. Supreme Court held that students should not have to show that a school acted in bad faith or with gross misjudgment in order to bring a Section 504 or ADA claim. The Court held that “ADA and Rehabilitation claims based on educational services should be subject to the same standards that apply in other disability discrimination contexts.”

The Court explained that the text of Section 504 and the ADA indicate that courts should not apply a higher standard for discrimination in the K-12 education context than they would in any other disability discrimination case. The ADA and Section 504 plainly applies to “qualified individuals with disabilities” without any reference to where the disabled person obtains a covered service. The U.S. Supreme Court acknowledged that students with disabilities “face daunting challenges. . . those challenges do not include having to satisfy a more stringent standard of proof than other plaintiffs to establish discrimination under” the ADA and Section 504.

The Court also refused to consider a sweeping argument seeking to gut federal disability rights laws by requiring people with disabilities to prove intent in every case of discrimination. That position is flatly inconsistent with the law and would have stripped millions of people with disabilities of the protections Congress put in place to prevent systemic discrimination. The very foundation of disability civil rights was on the line.

The Court made clear that schools cannot be held to a lower standard of accountability than other public institutions. Students with disabilities should not have to fight an uphill battle just to hold their schools accountable for unlawful discrimination.

The Arc’s Position

The Arc of the United States has a storied history with federal education laws. In 1971, before federal protections for people with disabilities existed, states were free to exclude children with disabilities from their public schools—and many did. Millions of children were denied an education, not because they couldn’t learn, but because our society didn’t believe they were worth educating. That changed because of federal action. Parents, led by The Arc, fought in court and won. Their victory laid the foundation for the IDEA, which secured the right to a free, appropriate public education for students with disabilities, regardless of the nature or severity of their disability

The Arc’s position statement on education states that all students ought to receive the education to which they are legally entitled; that is a free appropriate public education that includes fair evaluation, the right to progress, individualized supports and services, high quality instruction, and access to the general education curriculum in age-appropriate inclusive settings. All those involved in the education of students with disabilities must ensure that their individualized needs are taken into consideration, that they are challenged and have ambitious goals, and that their families have meaningful participation in the design and monitoring of their Individualized Education Programs (IEPs).

The Arc, alongside other disability rights organizations, submitted an amicus brief in support of the disabled student Plaintiff in A.J.T. The brief gave several case examples where a higher standard of proof enabled schools to freely discriminate against students with disabilities.

How Does This Case Impact People With Disabilities?

This case is important to both students and parents of students with disabilities. The ADA and Section 504 provide relief from education-related discrimination, but many courts applied the gross misjudgment standard. This standard made it harder for students to seek relief in federal court. By overturning that standard, the U.S. Supreme Court’s common-sense decision in A.J.T. v. Osseo Area Schools will allow more disabled people to vindicate their rights in a court of law. The Court restored the full protection of federal disability nondiscrimination law to millions of disabled students. This case was a victory for students with disabilities and their families.

Where Can I Learn More?

AJT v. Osseo Area Schools Case Page

Oklahoma Statewide Charter School Board v. Drummond/St. Isadore of Seville Catholic Virtual School v. Drummond

In May 2025, the U.S. Supreme Court couldn’t agree on a big case about whether a religious school in Oklahoma should get public money. Because the justices were split 4 to 4, the lower court’s decision stayed in place. That means the school won’t get state funding.

This case matters for students with disabilities. When public money goes to private or religious schools, those schools don’t always have to follow the same laws that protect students with disabilities. That can take away important rights and supports kids need to learn.

Here’s what you need to know.

What Is This Case About?

The U.S. Supreme Court was asked to weigh in on whether states can use taxpayer money to fund religious charter schools. Under the U.S. Constitution’s First Amendment, there are limits on government involvement with religion—including funding.

What Are the Facts of the Case?

In this case, Oklahoma approved a charter for St. Isidore of Seville Catholic Virtual School, a religious school funded with public dollars. Private charter schools are outside of a traditional public school system, as a public school district contracts with a private entity to create the school. However, many charter schools are funded by public tax dollars, just like a traditional public school. Thus, these public charter schools are public schools under Oklahoma law and must follow federal civil rights laws. They also must not promote any one religion. So, the state of Oklahoma sued to cancel its contract with the school. The Oklahoma Supreme Court agreed and ruled that the religious charter school was unconstitutional. St. Isidore appealed to the U.S. Supreme Court.

What Did the Supreme Court Decide?

In May 2025, the U.S. Supreme Court issued a 4-4 split decision. Because Justice Amy Coney Barrett recused herself and the remaining justices were evenly divided, the lower court’s ruling stood. That means that the Oklahoma Supreme Court’s decision remains in effect: that the religious charter school was unconstitutional and public money cannot be used to fund this religious charter school.

The Arc’s Position

The Arc’s position statement on education states that every student deserves a quality education—and the law is clear that students with disabilities have the right to:

• A free and appropriate public education
• Individualized supports and services
• Inclusion in general education classrooms
• Equal access to academics, extracurriculars, and more

When schools receive public funding—whether traditional, charter, or when a private school enrolls a student with a disability who is publicly placed in that private school—The Arc maintains that they are required to follow federal civil rights laws like the Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act, and the Americans with Disabilities Act (ADA).

Traditional private and religious schools that do not receive public funds are largely not required to follow these laws. As explained in an amicus brief on behalf of the National Center for Learning Disabilities, religious charter schools receiving public funding would be required to serve students with disabilities to the same extent as other public schools but would likely be unable to meet their full range of needs The impact would be compounded by the overall inexperience of religious schools in accommodating the needs of students with disabilities. Religious schools may also seek First Amendment exemptions from these requirements.

Because traditional public schools must be open to all, requiring them to share funding with religious charter schools while still educating the majority of students with disabilities would further strain their resources and jeopardize the quality of the education they can provide.

That’s why The Arc strongly opposes the use of public money for schools that may be more likely to deny students with disabilities their rights.

How Does This Case Affect Students With Disabilities?

This decision protects students in Oklahoma—but it also sends a national message. Letting public dollars flow to religious private charter schools without ensuring full civil rights protections and adequate funding would harm students with disabilities.

Families should never have to give up their child’s legal rights just to find a school that works for them. But that’s what can happen when private charter programs don’t guarantee equal access. Money is taken from public schools—where federal protections apply—and given to schools where they often don’t or offer more limited protections. That can mean no individualized education plan, no supports, no recourse.

This case helps stop that from happening in Oklahoma. And it’s a win for the rights of students with disabilities.

Further Reading

• SCOTUSBlog Case Page
• Amicus Brief of Public School Organizations and Advocates
• National Council on Disability, Charter Schools— Implications for Students with Disabilities

The Arc of the United States joined hundreds of stakeholders from across the political and faith spectrums to call on President Biden to commute federal death sentences before he leaves office. Several men on death row have intellectual disabilities, despite U.S. Supreme Court rulings that prohibit their execution.

Below is our full letter that was sent to President Biden on December 2, 2024.

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Dear President Biden,

The Arc of the United States, founded in 1950, is the largest organization of and for people with intellectual and developmental disabilities in the country. Together with nearly 600 statewide and local chapters, The Arc promotes and protects the human and civil rights of people with intellectual and developmental disabilities, supporting their full inclusion and participation in the community throughout their lifetimes.

President Biden, we address you with urgency regarding the decision you must make about exercising your power to review the records of and grant sentence commutation to any individual on federal death row who has demonstrated a diagnosis of intellectual disability. Based on what we know about the federal death penalty as it affects people with intellectual disability, we urge you to show mercy and, consistent with the platform on which you ran for President, act to spare the lives of those with intellectual disability currently on federal death row.

The Arc has long advocated for capital defendants with intellectual disability. We were encouraged when the Supreme Court, in Atkins v. Virginia, recognized their vulnerability to wrongful conviction and excessive punishment and held that the Constitution prohibits executing people with intellectual disability. We were optimistic when, in subsequent decisions like Hall v. Florida and Moore v. Texas, the Court rejected reliance on arbitrary IQ cutoffs and stereotypes for diagnosis and when it held that determinations of intellectual disability must be made in accordance with the best medical science and well-established clinical standards.

However, we have seen first-hand that these safeguards often fail. In both state and federal courts, people with intellectual disability are repeatedly tried, convicted, sentenced to death, and – tragically – executed, notwithstanding the constitutional bar. In 2020 and 2021, The Arc was dismayed to see the federal government execute Corey Johnson and Alfred Bourgeois, who had both been diagnosed with intellectual disability by highly regarded experts in the field; men whose disabilities were entirely overlooked or inadequately investigated by their trial counsel.

These men’s deaths – these executions by our federal government – were breaches of constitutional safeguards. And unless you act, President Biden, we are poised to see deaths like these again, because similar problems exist on federal death row today.

For example, Chadrick Fulks, who is currently on federal death row, has structural brain damage stemming from prenatal alcohol exposure and has suffered from significant cognitive and adaptive deficits since birth. At the time his initial § 2255 motion was filed, six mental health experts had concluded that Mr. Fulks had significant impairments, but that his IQ was just above the then-imposed cutoff score for a formal diagnosis of intellectual disability to be made under the diagnostic standards in place at that time. As a result of advancements in the fields of IQ testing and intellectual disability, diagnostic standards have since rejected hard IQ-score cutoffs in the diagnosis of intellectual disability. Additionally, current diagnostic standards now require that these scores be corrected for the inflation that occurs as IQ tests age. Under these current standards, Mr. Fulks’s IQ score falls squarely within the range for intellectual disability, he meets all other criteria for the diagnosis, and multiple experts have diagnosed him as a person with intellectual disability. However, because the courts have refused to hear Mr. Fulks’s intellectual disability claim on procedural grounds, he will be eligible for execution should executions resume even though he is a person with intellectual disability and his execution should be prohibited under Atkins.

Several other men currently under federal death sentence have been diagnosed with intellectual disability by developmental disability experts. Others have amassed strong evidence of cognitive deficits that point to such a diagnosis, but the posture of their case precludes review of their claim. Although the Supreme Court has rejected scientifically unreliable diagnostic standards, federal prosecutors nevertheless stand by findings that were based on such methods, as in the example above, and consistently oppose any court review on procedural grounds or rely on those same antiquated standards to rebut the claim. Even when judges would like to grant relief, or just a hearing, they find that their hands are tied and they cannot provide the relief the constitution requires.
At this time, then, there are men on federal death row with well-established diagnoses of intellectual disability and others with strong but unreviewed claims of intellectual disability. You would not subject any of these men to execution, but they will die if you do not act. It happened when Corey Johnson and Alfred Bourgeois were executed. Morally, ethically, and legally, we believe this calls for the mercy that is your executive prerogative.

We know that the men on federal death row caused terrible, irreparable harm. The Arc has deep sympathy for the victims of these crimes and for their families and friends. The Arc supports, without reservation, the appropriate prosecution and punishment of all responsible parties. The Arc does not seek to eliminate punishment of people with disabilities but, rather, to ensure that justice is served and the rights of all are protected, so that any punishment is consistent with the constitutional restrictions of the Eighth Amendment.

Because of our work and expertise in this area, we are aware that a person’s disability is sometimes not discovered until a later stage of their case, and that it can be misunderstood or overlooked by the judges and juries who are making decisions about their lives – and sometimes even by their own lawyers. We are concerned that this creates a great risk that a capital defendant will not have their ID properly identified and acknowledged in time for the courts to intervene.

We write to express our concern with this risk, as well as our hope that whatever actions you choose to take regarding the federal death row are done with respect for the spirit of the Atkins decision.

President Biden, you can ensure that those with intellectual disability are removed from the risk of wrongful execution. This would be a significant step toward addressing the systemic flaws that have allowed the execution of people with intellectual disability, contrary to the Constitution and federal law. It would be a proud legacy for you and for the American people.
We are grateful for your consideration and for your service as our President.

Respectfully,

Katy Neas
Chief Executive Officer
The Arc of the United States