In a ruling that has angered pro-life conservatives, the Supreme Court refused to hear two cases related to states terminating the Medicaid contracts for Planned Parenthood.

It would have taken four justices to agree to hear the cases, but only Clarence Thomas, Samuel Alito, and Neil Gorsuch gave their assent.  Brett Kavanaugh and John Roberts joined liberals on the court, whose refusal allowed the lower court decisions to stand.  For now. 

The refusal does not decide the issue at all.  In fact, this was more of a "process" decision than an ideological one.

CNN:

Roberts and Kavanaugh "likely have serious objections," said Steve Vladeck, CNN Supreme Court analyst and professor at the University of Texas School of Law.  "But such votes seem to be a signal that they would rather avoid contentious, high-profile disputes for now, at least where possible."

At issue is not whether states can provide federal funding for abortion.  Instead, the case concerned whether they can block Medicaid funds from offices that provide such women with annual health screens, contraceptive coverage and cancer screening.

Thomas wrote a dissent for the three conservatives, saying the court isn't doing its job.

"What explains the Court's refusal to do its job here?" Thomas wrote.

"I suspect it has something to do with the fact that some respondents in these cases are named Planned Parenthood," he wrote.

Thomas is clearly miffed, and his reaction mirrors that of many in the pro-life community.  But historically, the Court is uncomfortable with taking on an issue before the lower courts have had their say.  The appeals process will continue, and I expect that eventually, the issue will be revisited by the Court.

"But these cases are not about abortion rights," he said.  "They are about private rights of action under the Medicaid Act.  Resolving the question presented here would not even affect Planned Parenthood's ability to challenge the states' decisions; it concerns only the rights of individual Medicaid patients to bring their own suits."

Kansas – one of the states that had asked the Supreme Court to step in – wanted the justices to review a lower court opinion that held that while states have "broad authority" to ensure that Medicaid health care providers are qualified to provide medical services, "the power has limits."

"States may not terminate providers from their Medicaid program for any reason they see fit, especially when that reason is unrelated to the provider's competence and the quality of the health care it provides" a panel of judges on the 10th Circuit Court of Appeals held last February.

This issue is far from being resolved, which is why the states are likely to get a second bite at the apple.  The refusal of the Supreme Court to hear the Planned Parenthood defunding issue is only round 1.  The states involved in this effort are likely to go the distance in asserting their authority over Planned Parenthood and other health care providers who perform abortion on demand.