How this term's health-related Supreme Court rulings could ripple through Massachusetts

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We’re in the final days of a Supreme Court term, and some of the most hotly anticipated decisions are rolling off the presses (or, perhaps, onto the court's website).

Last week, the court upheld state bans on gender-affirming medical care for minors, noting the “fierce” scientific and policy debates about these treatments. More than half of U.S. states have adopted limits on this care, including medications that delay the start of puberty, and hormone treatment. The justices in the majority ruled the bans do not violate the equal protection clause of the Constitution.

Parents of transgender kids told WBUR’s Martha Bebinger the decision was heartbreaking. Rosie Emrich, a mom from New Hampshire, was trying to figure out how to tell her 9-year-old child about the ruling.

“I think I’m just trying to remember that the Supreme Court has gotten it wrong before, and that lawmakers — nobody defines who anybody is. We get to do that ourselves,” Emrich said.

Massachusetts allows gender-affirming care for minors, and the state’s public health commissioner vowed to continue fighting for access, calling it “lifesaving.” But New Hampshire lawmakers are moving to ban it. At the federal level, President Trump has urged Congress to pass a nationwide ban, and promised to strip federal funding from organizations that provide the care.

Opponents of gender transition treatment for children hailed the court’s decision as common sense, and said it supports the president’s policy on federal funding.

“That could certainly have an impact on Massachusetts as one of the epicenters, really of pediatric interventions,” said Sam Whiting, general counsel for the Massachusetts Family Institute, in an interview with Martha. “So we do hope to see aggressive federal action in light of this really encouraging decision.”

Clinics, meanwhile, are already seeing patients from the more than 20 states with bans in place. Dallas Ducar at Boston-based Fenway Health said they’re prepared for that demand to increase.

“I expect that we’re going to see more need in all of the health care facilities in Massachusetts that provide this care, and so we have to work together,” she said.

In the coming days, two more decisions could have profound impacts on other aspects of health care. The court is expected to rule in a case involving preventive care guaranteed by the Affordable Care Act. The case challenges a requirement in the law that says insurers must offer certain vaccinations and cancer screenings for free, as well as treatment to prevent AIDS.

“These preventive treatments have benefited millions of people since the ACA went into effect 11 years ago — a sufficiently long time for most people to take the free coverage for granted,” NPR’s Supreme Court aficionado Nina Totenberg wrote. “But if the court rules for the groups challenging the law, the benefits could disappear.”

The high court also has not yet ruled on a health care case out of South Carolina. The Palmetto State wants to stop providing Medicaid coverage for cancer screening, general exams and other services at Planned Parenthood clinics. South Carolina's Republican leaders argue such coverage amounts to indirect support for abortion care.

Martha, who’s also monitoring this case, explained that federal law already bans funding for abortions, and the implications for Massachusetts from any ruling in this case are not yet clear. The state’s Medicaid program isn’t expected to try and strip Planned Parenthood from its list of providers. But nationally, the decision could have a financial impact for Planned Parenthood and for Medicaid patients’ right to choose their doctor.