A divided Supreme Court allowed states to cut off Medicaid money to Planned Parenthood in a ruling handed down Thursday amid a wider Republican-backed push to defund the country’s biggest abortion provider.

The U.S. Supreme Court cleared the way on Thursday for South Carolina to strip Planned Parenthood of funding under the Medicaid health insurance program in a ruling that bolsters efforts by Republican-led states to deprive the reproductive healthcare and abortion provider of public money.

The ruling limits the rights of Medicaid patients to choose their own health care provider. It could have consequences far beyond South Carolina.