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Supreme Court Greenlights Republican Crusade to Defund Planned Parenthood
On Thursday, the Supreme Court delivered a decision that could be a death knell for Planned Parenthood health centers across the nation.
In a 6-3 decision authored by Justice Neil Gorsuch, the court’s conservative supermajority decided that the federal Medicaid Act does not give an individual the right to bring a civil rights lawsuit challenging the termination of a specific Medicaid provider from that state’s network.
The Supreme Court’s ruling in Medina v. Planned Parenthood South Atlantic is its latest assault on reproductive health care. The case also marks another victory for the Alliance Defending Freedom, the Christian conservative litigation shop behind the Dobbs decision, in which the high court reversed Roe v. Wade and ended the federal right to an abortion. (ADF lawyers represented the South Carolina Department of Health and Human Services in Medina.)
Supporters of Planned Parenthood have long feared that the case could pave the way for states across the country to kick the largest provider of women’s health care nationwide out of their Medicaid networks too. Now, that seems like a distinct possibility.
Seven years ago — before Roe v. Wade was overturned, before President Donald Trump was elected again, and before a Republican-controlled Congress was poised to approve the largest-ever cuts to federal funding for Planned Parenthood — South Carolina Republican Gov. Henry McMaster sought to kick the organization out of his state’s Medicaid network.
There are two Planned Parenthood health centers in South Carolina; together they serve an estimated 6,000 patients a year. But back in 2018, McMaster issued an executive order directing South Carolina’s Medicaid agency to look for ways to keep Planned Parenthood — which provides birth control, STI testing, and cancer screenings, in addition to abortion services — from receiving any public money at all. “Taxpayer dollars must not directly or indirectly subsidize abortion providers,” he said at the time.
Federal law already bars Medicaid money from going toward abortion care except in the most limited set of circumstances, and abortion is now banned in South Carolina at 6 weeks gestation with very few exceptions, but McMaster continued his crusade — even after court after court ruled against him.
Back in 2018, a South Carolina woman — a Medicaid recipient who received her health care at a Planned Parenthood center — sued, saying that McMaster’s order deprived her of her right to choose her own health care provider, a right that was guaranteed by the federal Medicaid Act. Two years later, in 2020, the woman, Julie Edwards, won and the fight McMaster picked with Planned Parenthood looked to be over.
But, two years after that, a new decision from the Supreme Court revived the case, and on Thursday, the Court’s majority ruled against Planned Parenthood.
In a dissenting opinion, Justice Ketanji Brown Jackson wrote, “Today’s decision is likely to result in tangible harm to real people.” She was joined in her opinion by Justices Elena Kagan and Sonia Sotomayor.
“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,” Jackson added. “And, more concretely, it will strip those South Carolinians — and countless other Medicaid recipients around the country — of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.’”
Thursday’s loss before the Supreme Court was a first for the plaintiffs. Susanna Birdsong, the general counsel and vice president of compliance for Planned Parenthood South Atlantic, tells Rolling Stone that prior to this decision, “We won at every stage of the litigation.” Most recently, the Fourth Circuit re-examined the case and reached its original conclusion: that the federal Medicaid act allows patients to choose their provider — any qualified provider — and the state of South Carolina couldn’t arbitrarily tell a person like Julie Edwards that she cannot choose an otherwise qualified provider.
Now, Birdsong says that Planned Parenthood is “looking at all of our options” — legally and otherwise — “to continue to fight for our patients.”
“While I’m deeply disappointed that the court ruled the way that they did — and I think wrongly decided that the Medicaid Act does not confer this right… There are other potential ways to challenge what the state is trying to do here,” Birdsong adds.
Condemnation of the decision, meanwhile, was swift and loud from reproductive rights advocates across the country.
Destiny Lopez, CEO of the Guttmacher Foundation, a reproductive policy institute, called the decision “a grave injustice.”
“At a time when health care is already costly and difficult to access, stripping patients of their right to high-quality, affordable health care at the provider of their choosing is a dangerous violation of bodily autonomy and reproductive freedom,” Lopez added, citing Guttmacher data that showed that one in three patients who sought out birth control in 2020 received it from a Planned Parenthood.
“Today’s decision favors extremists who’d rather let someone die of cancer than let them get a cancer screening at Planned Parenthood,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement. “The decision will put fuel on the fire of the multi-year campaign to deny Medicaid patients their right to see Planned Parenthood providers for contraceptives, STI testing, and other non-abortion services. Right now, Congress is seeking to replicate South Carolina’s ban nationwide, putting politics above patients in making health care decisions.”
Planned Parenthood has previously estimated that if South Carolina won the case, nearly 200 of their health centers in 24 states across the country would be threatened with closure, with the vast majority — 90 percent — of those closures to occur in states where abortion is legal.
The state of Texas has already removed Planned Parenthood from both its publicly-funded family planning program and its Medicaid network. The results have been stark. According to a report released earlier this month, the percentage of enrollees accessing care dropped from 90 percent in 2011 to 59 percent in 2023. Over the same 12-year period, the use of birth control accessed through the program declined by 56 percent.
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Washington state braces for dangerous flooding as thousands could face evacuation orders
Residents began packing up and fleeing rising rivers in western Washington state Wednesday as a new wave of heavy rain swept into a region still reeling from a storm that triggered rescues and road closures a day earlier.
In the Pacific Northwest, an atmospheric river was swelling rivers toward record levels, with major flooding expected in some areas including the Skagit River, a major agricultural valley north of Seattle. In the town of Mount Vernon, officials ordered residents within the river’s floodplain to evacuate.
Earlier in the day, dozens of vehicles were backed up at a sandbag-filling station in the town as residents prepared for what Mayor Peter Donovan described as “what increasingly appears to be a worst-case scenario here.”
Washington Gov. Bob Ferguson declared a statewide emergency Wednesday, saying, “Lives will be at stake in the coming days.” He estimated that as many as 100,000 Washington residents may soon face evacuation orders.
“We expect rivers to hit historic levels as early as 4 a.m. tomorrow, lasting into Friday morning,” Ferguson wrote on social media.
Ferguson later posted that the National Oceanic and Atmospheric Association’s National Weather Prediction Service had predicted 18 major floods and 15 moderate floods in the state.
The National Weather Service warned of the possibility of “catastrophic flooding,” specifically along the Skagit and Snohomish rivers.
“Landslides are likely in areas of steep terrain within the considerable and catastrophic regions,” the weather service said.
Gent Welsh, adjutant general of the Washington National Guard, said hundreds of Guard members will be sent to help communities.
In the Mount Rainier foothills southeast of Seattle, Pierce County sheriff’s deputies rescued people at an RV park in Orting, including helping one man in a Santa hat wade through waist-deep water. Part of the town was ordered to evacuate over concerns about the Puyallup River’s extremely high levels and upstream levees.
A landslide blocked part of Interstate 90 east of Seattle, with photos from Eastside Fire & Rescue showing vehicles trapped by tree trunks, branches, mud and standing water, including a car rammed into the metal barrier on the side of the road.
Officials also closed a mountainous section of U.S. 2 due to rocks, trees and mud. The state transportation department said there were no detours available and no estimated time for reopening.
The Skagit River is expected to crest at roughly 47 feet in the mountain town of Concrete early Thursday, and roughly 41 feet in Mount Vernon early Friday.
Those are both “record-setting forecasts by several feet,” Skagit County officials said.
Flooding from the river long plagued Mount Vernon, the largest city in the county with some 35,000 residents. In decades past, residents would form sandbagging brigades when floods threatened, but businesses were often inundated. Flooding in 2003 displaced hundreds of people.
The city completed a floodwall in 2018 that helps protect the downtown. It passed a major test in 2021, when the river crested near record levels.
But the city is on high alert. The historic river levels expected Friday could top the wall, and some are worried that older levees could fail.
“The concern about that kind of pressure on the levy and dike system is real,” said Ellen Gamson, executive director of the Mount Vernon Downtown Association. “It could potentially be catastrophic.”
Gamson said many business owners were renting tables to place their inventory higher off the floor. Sheena Wilson, who owns a floral shop downtown, said she stacked sandbags by the doors and cleared items off the floor.
“If the water comes in above table height I’ve got bigger problems than my merchandise,” she said.
Jake Lambly, 45, added sandbags, tested water pumps and moved valuables to the top floor of the home he shares with his 19-year-old son. Lambly said he was concerned about damage in his neighborhood, where people “are just on the cusp of whether or not we can be homeowners.”
“This is my only asset,” he said from his front porch. “I got nothing else.”
Harrison Rademacher, a meteorologist with the weather service in Seattle, described the atmospheric river soaking the region as “a jet stream of moisture” stretching across the Pacific Ocean “with the nozzle pushing right along the coast of Oregon and Washington.”
Authorities in Washington have knocked on doors to warn residents of imminent flooding in certain neighborhoods, and evacuated a mobile home park along the Snohomish River. The city of Snohomish issued an emergency proclamation, while workers in Auburn, south of Seattle, installed temporary flood control barriers along the White River.
In Sumas, a small city along the U.S.-Canada border, a flood siren rang out at city hall and residents were told to leave. The border crossing was also closed to southbound commercial vehicles to leave more room for evacuations, according to the Abbotsford Police Department.
Climate change has been linked to some intense rainfall. Scientists say that without specific study they cannot directly link a single weather event to climate change, but in general it’s responsible for more intense and more frequent extreme storms, droughts, floods and wildfires.
Another storm system is expected to bring more rain starting Sunday, Rademacher said. “The pattern looks pretty unsettled going up to the holidays.”
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Trump’s immigration data dragnet
“I’ve seen the apps and I don’t like them,” says a DHS official who left this year. “It’s rife for abuse. I imagine they’re being used in ways they were not intended.”
He highlighted the risks of misidentification, noting that facial recognition often has elevated error rates for people of colour. “I have no confidence that there’s any oversight from people who are serious and understand” the tech, he adds.
In September, ICE renewed its access to a facial recognition search engine called Clearview AI, which has been banned in some states. Earlier contracts and privacy documents state that it would be used for “child sexual exploitation cases”, but this year’s contract added “assaults against law enforcement” — which former officials fear might extend to protestors. The company declined to comment.
Clearview AI
ICE and Customs and Border Protection also collect DNA from detainees and asylum applicants, according to a privacy disclosure. One attorney says he was representing a US citizen who was given a cheek swab while incorrectly detained. Samples are stored in an FBI database where they are queryable by a range of law enforcement agencies.
ICE has also signed a contract with BI² Technologies, a vendor selling handheld eye scanners. Former officials questioned the need for the devices, noting that the agency held few, if any, iris scans to search. “My first question is why?” a former privacy official says. “What do you expect to get out of this? If they’re just out there collecting irises and biometrics, that’s a problem for me.”
BI²’s registered lobbyist, Ballard Partners, has close ties to the Trump administration, raising money for its campaign and previously employing Attorney General Pam Bondi and White House chief of staff Susie Wiles.
BI² Technologies
Lobbying disclosures show that Ballard also works on behalf of a host of other tech firms doing business with ICE, including Palantir; DNA testing firm SNA International; cell-phone intercept vendor L3Harris; open-source data broker Babel Street; and the Thomson Reuters subsidiary selling Clear. Ballard declined to comment.
“They’re spending a lot of money on things they might not even use, to benefit people who are maybe close to the administration,” says Dave Maass, director of investigations at the Electronic Frontier Foundation, a digital privacy nonprofit monitoring ICE’s surveillance purchases. “They’re moving very fast.”
Procurement records also show that ICE has obtained tools previous administrations found problematic.
In August, ICE removed a hold on a $2mn contract with the Israeli spyware firm Paragon Solutions, which sells a phone-hacking tool called Graphite. It has been used by the Italian government to target European journalists with iMessage and WhatsApp attacks, according to researchers at CitizenLab.
The contract was paused by the Biden White House, which had banned the use of spyware sold by foreign companies with human rights concerns. Paragon was subsequently acquired by US-based private equity firm AE Industrial Partners, which also controls Department of Defense contractor REDLattice.
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Afghan CIA fighters, like National Guard attack suspect, face stark reality in U.S.
Pictures of National Guard members Andrew Wolfe and Sarah Beckstrom, who were shot on Nov. 26 in Washington, D.C., are displayed next to a picture of the suspect in the shooting, Afghan national Rahmanullah Lakanwal, on the day of a news conference in Washington, D.C., on Nov. 27.
Nathan Howard/REUTERS
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Nathan Howard/REUTERS
They survived some of the Afghanistan War’s most grueling and treacherous missions, regularly battling the Taliban in nighttime raids and urban gun battles. But once evacuated to the U.S., many Afghan fighters who served in “Zero Units” led by the CIA found themselves spiraling into despair because of what they saw as bureaucratic neglect and abandonment by the U.S. government, a former CIA operative and a former Afghan fighter involved in the units told NPR.
Among their ranks was Rahmanullah Lakanwal, the man charged with killing one National Guard soldier and seriously injuring a second after opening fire on them in Washington, DC on Thanksgiving Eve.
The sense of betrayal and frustration cut so deep, some Afghan soldiers living in the U.S. began threatening self-harm.
“Unfortunately, four people took their lives,” said Davud, who served as a combat translator in a Zero Unit for more than a decade.

Davud, who lives now on the West Coast, agreed to be interviewed about the struggles of his fellow soldiers only if NPR identified him by his first name and concealed his identity. He said he fears for the safety of his family still living under Taliban rule in Afghanistan.
Despite their service to the U.S., many Zero Unit fighters have struggled to gain asylum or permanent residency in the U.S., according to Davud. He condemned Lakanwal’s alleged actions, but spoke of the overwhelming mental health and emotional challenges fighters face living in exile.
While fighting under CIA leadership, thousands of soldiers like Davud and Lakanwal faced some of the most harrowing battles of the 20-year Afghanistan war, often carrying out two or even three combat missions a night. Their tactics were often brutal, and groups like Human Rights Watch accused them of engaging in torture and illegal killings.
“I almost got killed by a grenade,” Davud told NPR, describing one firefight when an American CIA agent saved his life. “He grabbed me from my body armor and pulled me back.”
In this Aug. 22, 2021, file photo provided by the U.S. Air Force, Afghan passengers board a U.S. Air Force C-17 Globemaster III during the Afghanistan evacuation at Hamid Karzai International Airport in Kabul, Afghanistan.
MSgt. Donald R. Allen/U.S. Air Force via AP
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MSgt. Donald R. Allen/U.S. Air Force via AP
After being evacuated to the U.S. in 2021, when the Taliban swept into Kabul, many Zero Unit soldiers came to feel they had been abandoned by CIA officials. Despite years of service — which Davud described as “a brotherhood” — he now believes the agency failed to help his comrades navigate America’s complex immigration system.
“It’s that feeling of like you did something that nobody is appreciating,” he said. “That promise that was given to you by your employer was a fake promise.”
NPR sent detailed questions to the CIA and to the U.S. Immigration and Citizenship and Immigration Services, asking for comment. Both agencies declined to comment on the record for this story.
But many aspects of Davud’s account of growing tension and frustration among Zero Unit fighters living in the U.S. were confirmed by Geeta Bakshi, a former CIA agent who spent four years in Afghanistan.
“These guys were the tip of the spear,” Bakshi said, describing the CIA’s Afghan Zero Unit program in an interview with NPR. “They were out on the front, so that American personnel didn’t have to be. They were the ones facing the maximum danger on the battlefield.”
Bakshi now leads a refugee resettlement program, called FAMIL, that focuses on helping Zero Unit soldiers rebuild their lives inside the U.S. She says her organization grew alarmed about rising rates of self-harm among former Afghan soldiers beginning in 2023.
“Individuals from the Zero Units unfortunately suffered deaths by self-harm,” Bakshi told NPR. “We raised this issue with the Biden administration and it was one that we were very concerned about. Again, we saw a direct connection to prolonged immigration delays.”
Bakshi and Davud described struggling to help a growing number of Afghan soldiers in the U.S. who were spiraling into depression. Davud described one instance where a friend felt increasingly hopeless because his immigration status made it difficult for him to work.

“He was like, ‘I’m going to go kill myself,’ that’s how bad it was,” Davud said. “I was very worried for him, but we helped him.” That meant offering friendship, counseling, and support.
Bakshi described a separate incident where a Zero Unit fighter appeared to be unraveling because of repeated bureaucratic snafus by U.S. officials reviewing his immigration paperwork. “He was told, ‘We don’t have you in the system.’ This was a man who was in severe distress. What happened in his case is there was an error in the spelling of his name.”
That individual eventually received a Green Card, Bakshi said, adding that with proper support many Afghan soldiers are adapting well to life in America. In rare cases where Zero Unit soldiers ended their lives, the community has held memorials.
“We usually do a religious funeral for them, on their behalf, saying a prayer,” Davud said.
Lakanwal, the Zero Unit fighter accused of fatally shooting one National Guard soldier and seriously wounding another, also struggled with his immigration status. He only received asylum protection from the Trump administration in April of this year, nearly four years after coming to the U.S.
Like others who fought alongside the CIA in Afghanistan, Lakanwal appeared to be experiencing a personal crisis which began at least as early as January 2024, according to a refugee resettlement volunteer who worked with the Lakanwal family in Bellingham, Wash. Emails shared with NPR show he, too, struggled to find stable employment.

“My biggest concern was that he would harm himself,” the volunteer told NPR. “I worried he would be suicidal because he was so withdrawn.”
The volunteer spoke with NPR on condition of anonymity because they said they feared for their safety, as well as the safety of others in their volunteer community, because of possible retaliation for having worked with the Lakanwals and other Afghan refugees.
Homeland Security Secretary Kristi Noem has said that U.S. officials believe Lakanwal was “radicalized” while living in the United States, but the volunteer said they saw no signs of radicalization. Noem offered no evidence that Lakanwal was radicalized.
Davud, the Zero Unit fighter, said he didn’t know Lakanwal personally. He voiced sorrow that his community of Afghan soldiers wasn’t able to help him in time.
“We had worse cases [of emotional distress] than Lakanwal but we found solutions for them,” he said.
Lakanwal has pleaded not guilty to first degree murder and other charges. In the wake of the attack in Washington, D.C., the Trump administration has frozen all Afghan asylum cases and officials say the legal status of refugees from Afghanistan living in the U.S. is being reexamined.
People pay their respects to the fallen National Guardsman outside Farragut West Metro Station in Washington, DC, on November 28, 2025.
Andrew Thomas/NurPhoto via Reuters
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Andrew Thomas/NurPhoto via Reuters
CIA director John Ratcliffe suggested in a statement that Lakanwal and his fellow soldiers weren’t properly vetted “This individual — and so many others — should have never been allowed to come here,” Ratcliffe said.
FBI director Kash Patel also said the Biden administration failed to properly vet “in any way, shape or form this individual and countless others.”
That account was disputed by Davud., and Biden administration officials who said the Afghans underwent rigorous vetting.
“What they said about Mr. Lakanwal wasn’t vetted? We were all vetted,” he said, describing years of scrutiny, including polygraph tests and detailed interviews by the CIA and other federal agencies, in Afghanistan and in the United States.
“We worked with them for twenty years,” Davud said. “I was really shocked by the CIA director’s comment. I felt so betrayed.”
If you or someone you know is struggling with thoughts of suicide, you can dial or text 988 and be connected to help.
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