The US supreme court has paved the way for South Carolina to kick Planned Parenthood out of its Medicaid program over its status as an abortion provider, a decision that could embolden red states across the country to effectively “defund” the reproductive healthcare organization.

The case, Medina v Planned Parenthood South Atlantic, centers around a 2018 executive order from South Carolina’s governor, Henry McMaster, that blocked clinics that provide abortions from receiving Medicaid reimbursements. Medicaid is the US government’s main health insurance program for low-income people. About 80 million people rely on it.