About a year ago, the Supreme Court handed down a baffling decision in Medina v. Planned Parenthood (2025). In Medina, South Carolina committed an obvious violation of federal Medicaid law, but the Court’s Republican majority seemed to bend over backward to prevent the patients affected by this legal violation from suing to enforce their rights. Among other things, the Court’s opinion in Medina was at odds with a decision the justices handed down just two years earlier in Health and Hospital Corporation v. Talevski (2023).

As I wrote at the time, the best explanation for Medina was not legal; it was political. South Carolina broke federal law specifically because it illegally cut off funding to Planned Parenthood. The Republican justices appear to have bent the rules to ensure that an abortion provider would be defunded.

On Thursday, the Supreme Court handed down a new opinion in FS Credit Opportunities v. Saba Capital Master Fund, which only adds to the mystery about why Medina came down the way it did. The facts of FS Credit are quite different from the issues in Medina — FS Credit is a securities law case asking when investors may sue investment funds, while Medina concerned when patients may sue states for violating Medicaid law. But the legal issues in FS Credit and Medina are very similar. They both involve a legal doctrine known as “implied causes of action.”

Although Medina is the Court’s most recent case (prior to FS Credit) that deals with implied causes of action, the FS Credit decision does not cite Medina anywhere. Instead, it quotes heavily from decisions that the Court refused to follow in Medina. And it explicitly embraces a legal rule that the Court seemed to reject in Medina.

The rules governing implied causes of action are complicated enough to reduce even experienced lawyers to tears. But, if you bear with me, it will be difficult to avoid a simple conclusion: The Court appears to be manipulating these rules to achieve outcomes preferred by the Republican justices and the anti-abortion movement.

Justice Amy Coney Barrett’s opinion in FS Credit begins with a simple declarative sentence: “Congress, not the Judiciary, decides who may enforce the law.” Not all federal laws may be enforced through lawsuits, and not all people who may want to sue under a particular federal law are allowed to do so.

In some cases, a federal law explicitly states that it authorizes private lawsuits against violators of that law, or it states who is allowed to bring those suits. In other cases, a right to sue may be implied from statutory text that does not explicitly provide for such suits. These implicit rights to sue are known as “implied causes of action.”

Before Medina, the question of whether a particular federal law creates an implied cause of action was governed by the Court’s decision in Gonzaga University v. Doe (2002), which held that “for a statute to create private rights [to sue], its text must be phrased in terms of the persons benefited.”

Thus, for example, a hypothetical statute stating that “no sweaty person may be denied access to a shower” may be enforced through private lawsuits, because that law is phrased in terms of who benefits from it (sweaty people). A similar statute which provides that “states may not impede access to showers” would not be enforceable through private lawsuits, because that statute lacks the person-focused language demanded by Gonzaga.

Prior to the Medina decision in 2025, the Court repeatedly reaffirmed Gonzaga’s rule. It did so most recently in Talevski, which held that a federal law creates an implied cause of action when it is “‘phrased in terms of the persons benefited’ and contains ‘rights-creating,’ individual-centric language with an ‘unmistakable focus on the benefited class.’”

Under the Gonzaga framework, Medina should have been an open-and-shut case. The case involved a federal law that permits Medicaid patients to choose their health providers. South Carolina violated this law by refusing to allow Medicaid patients to choose Planned Parenthood as their health provider. Here is the relevant statutory text:

This law contains the very kind of “individual-centric language” demanded by cases like Gonzaga and Talevski. It extends a right to “any individual,” providing that these individuals “may obtain” medical care from their chosen provider. It also concludes with a pronoun (“him”) that refers back to the individuals who benefit from the law.

And yet, in Medina, the six Republican justices rendered this statute unenforceable. And they did so in an opinion that didn’t even quote the relevant legal rule. The words “phrased in terms of the persons benefitted” appear nowhere in Justice Neil Gorsuch’s majority opinion.

Gorsuch’s Medina opinion is very difficult to parse, but it appears to create a new rule establishing that no statute may create an implied cause of action unless that statute includes the magic word “right” — as in: an individual’s rights.

Barrett’s majority opinion in FS Credit, however, offers no hint that Medina even happened. Barrett does not at any point suggest that a statute must use any specific magic words in order to authorize private lawsuits. Instead, it relies on the pre-Medina framework established by cases like Gonzaga.

FS Credit holds that “to create a private right, a statute must use ‘rights-creating language’ aimed at protecting ‘a particular class of persons.’” It then quotes the key line from Gonzaga, which states that “statutes create private rights when they are ‘phrased in terms of the persons benefited.’” So Gonzaga is back, baby.

But, if the Court wanted to dispel the impression that Medina was a one-off decision that simply came up with an excuse to deny relief to abortion providers and their patients, Barrett’s FS Credit opinion needed to explain why the new rule that the Court seemed to apply in Medina does not apply in FS Credit. Instead, Barrett’s opinion does not include a single citation to Medina.

One possibility is that the two cases are different because Medina involved Medicaid, which is a federal spending program, while FS Credit involves a statute regulating private businesses. Gorsuch’s opinion in Medina says that “spending-power statutes like Medicaid are especially unlikely” to contain implied causes of action. So maybe the magic word rule that Gorsuch appeared to rely on in Medina only applies to Medicaid and other cases involving government spending programs.

But Talevski, the Supreme Court case decided two years before Medina, didn’t just reject the argument that there are different rules for federal spending programs; it outright mocked this argument. The losing party in Talevski, that decision explained, “urges us to reject decades of precedent” and to “rewrite” a key federal law to exempt federal spending programs from the Gonzaga rule. But Talevski “reject[s]” this “invitation to reimagine Congress’s handiwork (and our precedent interpreting it).”

Another possibility is that Medina is different from FS Credit because Medina involved a “Section 1983” lawsuit — a lawsuit brought under the federal law permitting individuals to bring civil rights claims against state governments and state officials — and FS Credit does not. Gorsuch’s Medina opinion describes the specific issue before his Court in that case as “whether the plaintiffs before us may maintain a § 1983 suit to enforce Medicaid’s any-qualified-provider provision “

But the problem with this distinction is that Gonzaga — the precedent behind the Court’s reasoning in FS Credit — was itself a Section 1983 case. So, for as long as Gonzaga has been the law, the Court has held that its rule applies to cases brought under Section 1983. Medina is the only exception.

Perhaps there is some other way to distinguish between Medina and FS Credit. But, again, the Court did not provide such an explanation in the FS Credit opinion.

And, without such an explanation, it’s hard to escape the same conclusion that I reached a year ago, when Medina was first handed down. Medina was not decided in good faith. The actual holding of Medina is that abortion providers and their patients cannot enforce their rights, because the Republican justices say so.

The central rule in any nation governed by the rule of law is that similar cases must be treated similarly, regardless of whether a group that individual judges dislike — or even view as morally repugnant — benefits from that rule. As Justice Antonin Scalia wrote in a 1989 essay, “when, in writing for the majority of the Court, I adopt a general rule. … I not only constrain lower courts, I constrain myself as well.” Because “if the next case should have such different facts that my political or policy preferences regarding the outcome are quite the opposite, I will be unable to indulge those preferences.”

Medina fails the Scalia test. There cannot be a special carve out for abortion providers or abortion patients that denies them the same right to sue enjoyed by any other litigant.