Saanvi Arora: No Voice, No Justice.
By Saanvi Arora
I have seen distrust kill. I’ve lost friends to suicide, and I’ve nearly lost myself. I know firsthand that the difference between a young person seeking help and suffering in silence often comes down to one thing: whether they trust that the healthcare system will protect them, not expose them to political interference, retaliation, or judgment.
One of the most fundamental principles of healthcare is that patients should be able to consent to their preferred method of care and, by extension, choose their providers. But the Supreme Court’s 6-3 ruling in Medina v. Planned Parenthood in June creates a two-tiered system. If you can afford private healthcare, you get choice and legal protection. If you rely on Medicaid, as millions of young adults like me do, politicians can override your medical decisions, and you have no legal remedy.
While Planned Parenthood on its face grabbed headlines, the implications of this decision extend far beyond reproductive health and should not be conflated with other ongoing political debates around the right to an abortion. It is about something entirely different: whether patients have any legal recourse when politicians interfere with their healthcare choices. If states can cut Medicaid funding to any provider based on ideological disagreements, and patients can’t challenge these decisions, it will further normalize the idea of political control trumping medical judgment in our healthcare systems.
Consider the scenarios that this decision makes possible. States could defund mental health clinics that provide LGBTQ+-affirming care. They could cut funding to pediatric practices that recommend vaccines. They could block reimbursement to providers who treat gender dysphoria or substance abuse. Under this ruling, state politicians essentially have veto power over individual healthcare decisions, with no legal recourse offered to those most affected.
For young people, who often lack the political influence of older, wealthier demographics, access to the courts has been a crucial equalizer. When politicians ignore our needs, litigation has historically provided a pathway to justice. The Supreme Court has now closed that pathway, leaving young people like me with fewer options to challenge government overreach in our personal healthcare decisions.
This is particularly devastating for the 18-24 age demographic, which has one of the highest rates of Medicaid enrollment. Young adults already face unprecedented economic challenges, including often unmanageable student debt, skyrocketing housing costs, rising food costs, stagnant wages, and limited job benefits. Many rely on Medicaid not by choice, but by necessity. The Supreme Court’s ruling now adds another layer of economic coercion: not only are young people limited in their healthcare options by financial constraints, but they’re also denied the legal right to challenge further restrictions.
This ruling arrives at a moment when young Americans, especially those from racially marginalized backgrounds, already express historically low levels of trust in government institutions, including healthcare services that are government-adjacent. Healthcare depends fundamentally on trust between patients and providers, but this ruling inserts political considerations into what should be private medical relationships. Patients begin to wonder: Is my doctor recommending this treatment because it’s best for me or because it’s what the state will reimburse?
I’ve watched friends avoid seeking help because they didn’t trust that their conversations would remain private or because they’d had bad experiences with providers who seemed more concerned with institutional policies than their well-being. This ruling doesn’t just limit healthcare choices. It also forces young people to view their government as a potential threat to their well-being, fundamentally altering their relationship with democratic institutions. But, perhaps most damaging is the way we are now forced to consider a state’s political climate when making basic life decisions. Should I take that job offer in a place that might cut funding to providers I trust? Can I afford to go to college in a state that politicizes healthcare access?
Most Americans grew up being told that the courts provide equal justice under law. This ruling exposes that promise as hollow for anyone who relies on government programs, and the stakes here extend far beyond policy debates or legal precedents. Distrust kills. The friends I’ve lost didn’t just need medical care—they needed to trust that seeking help wouldn’t make their situations worse. This decision makes that trust even harder to build, at a time when young people desperately need reasons to believe their government works for them.
While the Supreme Court has closed certain doors, state governments can still choose to protect their residents’ healthcare rights. States can strengthen their civil rights laws to explicitly guarantee Medicaid patients the right to choose qualified providers without political interference. They can create robust private rights of action under state law, ensuring that patients like me can sue when politicians block access to our chosen healthcare providers. States can also expand Medicaid eligibility and strengthen provider networks, giving us real options for our care rather than the illusion of choice.
But these changes won’t happen without effective advocacy in state legislatures to demand these protections. We must share our experiences with Medicaid, mental healthcare, and provider choice to put human faces on these policy debates. The Supreme Court may have silenced us in federal court, but our democracy still gives us the power to fight for our access to healthcare at the state level.
Saanvi Arora is an undergraduate student at UC Berkeley and a leading youth advocate and policy expert, as well as the Executive Director of the Youth Power Project.
