Justice Jackson, with whom Justice Sotomayor and Justice Kagan join, dissenting.

The Civil Rights Act of 1871 was an exercise in grand ambition. It had to be. In the wake of the Civil War, the American South was consumed by a wave of terrorist violence designed to disenfranchise and intimidate the country’s newly freed citizens and their allies. The threat was existential—not just for the newly liberated, but for democracy itself—and required bold intervention. It was precisely because the goals of the 1871 Act were so ambitious that those most committed to the structures it targeted, including many in South Carolina, opposed the measure so vehemently.

A century and a half later, the project of stymying one of the country’s great civil rights laws continues. In this latest chapter, South Carolina urges our Court to adopt a narrow and ahistorical reading of the 1871 Act’s first section, which is codified today at 42 U. S. C. §1983. That venerable provision permits any citizen to obtain redress in federal court for “the deprivation of any rights, privileges, or immunities secured by the Constitution and laws” of the United States. South Carolina asks us to hollow out that provision so that the State can evade liability for violating the rights of its Medicaid recipients to choose their own doctors. The Court abides South Carolina’s request. I would not. For that reason, I respectfully dissent.

I

This case concerns South Carolina’s obligations under the Medicaid Act. Signed into law by President Lyndon B. Johnson in 1965, the Medicaid Act establishes “a cooperative federal-state program that provides medical care to needy individuals.” Douglas v. Independent Living Center of Southern Cal., Inc., 565 U. S. 606, 610 (2012). “Like other Spending Clause legislation, Medicaid offers the States a bargain: Congress provides federal funds in exchange for the States’ agreement to spend them in accordance with congressionally imposed conditions.” Armstrong v. Exceptional Child Center, Inc., 575 U. S. 320, 323 (2015).

Any State that wishes to receive federal funds under the program must submit a proposed Medicaid plan to the Department of Health and Human Services (HHS). 42 U. S. C. §1396–1. If HHS approves the plan, the State will receive the funding. States enjoy relatively wide discretion in crafting their Medicaid plans. They have significant control, for instance, over who is eligible to receive Medicaid benefits and which types of services are covered. E.g., §§1396a(a)(10)(A)(ii), (70), (86).

Still, the Medicaid Act imposes certain plan requirements on States as a condition of receiving federal funding. If a State “fail[s] to comply substantially” with those conditions, HHS may withhold further funding from that State. §1396c; see also 42 CFR §430.12(c) (2023). In practice, however, HHS rarely invokes its authority to withhold funding because doing so would inevitably harm the program’s beneficiaries.¹

One of the conditions that the Medicaid Act imposes on participating States is the requirement that Medicaid recipients be able to choose their own healthcare providers without government interference. The statute explicitly requires that every State’s Medicaid plan must “provide that  \. \. \. any individual eligible for medical assistance (including drugs) may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.” §1396a(a)(23)(A). Congress enacted that provision, known as the “free-choice-of-provider provision,” in order to prevent States from steering Medicaid recipients to the States’ preferred healthcare providers. See H. R. Rep. No. 544, 90th Cong., 1st Sess., 122 (1967).

The dispute in this case arises from South Carolina’s failure to comply with that provision. In 2018, the State’s Governor issued an executive order deeming all “abortion clinics” unqualified to provide healthcare services and directing the State’s Department of Health and Human Services to terminate them from the State’s Medicaid program. App. to Pet. for Cert. 157a–160a. That executive order would have forced two clinics operated by Planned Parenthood South Atlantic (PPSAT)—one in Charleston and one in Columbia—to stop serving any patients who rely on Medicaid.

One of those patients is respondent Julie Edwards. Before she became a PPSAT patient, Edwards had struggled to find a healthcare provider capable of meeting her needs as a diabetic whose condition heightened the risks associated with pregnancy. At PPSAT, she found doctors who were able to provide her with the services she needed, as well as a respectful and judgment-free environment to receive care.

Edwards filed this lawsuit against state health officials under §1983 seeking to enjoin PPSAT’s termination from the Medicaid program. She asserted that the termination decision violated her rights under the free-choice-of-provider provision to obtain care from her doctors of choice.

The District Court entered summary judgment in Edwards’s favor and enjoined the State from terminating PPSAT from its Medicaid program. Planned Parenthood v. Baker, 487 F. Supp. 3d 443, 448 (SC 2020). The Fourth Circuit affirmed. Planned Parenthood v. Kerr, 27 F. 4th 945, 959 (2022). In a careful opinion authored by Judge Wilkinson, the panel held that the free-choice-of-provider provision conferred an individual right on Medicaid recipients to select their own healthcare providers and that, as such, that right was enforceable under §1983. Rejecting South Carolina’s arguments to the contrary, the court concluded that the “statutory text  \. \. \. unmistakably evinces Congress’s intention to confer on Medicaid beneficiaries a right to the free choice of their provider.” Id., at 956.

South Carolina petitioned for certiorari. While its petition was pending, this Court decided Health and Hospital Corporation of Marion County v. Talevski, 599 U. S. 166 (2023), which considered whether a different provision of the Medicaid Act conferred rights enforceable under §1983. We therefore granted South Carolina’s petition, vacated the judgment below, and remanded the case for the Fourth Circuit to reconsider the parties’ arguments in light of our decision in Talevski. 599 U. S. ___ (2023).

On remand, the Fourth Circuit once again determined that the free-choice-of-provider provision establishes an individual right that can be enforced under §1983. Planned Parenthood South Atlantic v. Kerr, 95 F. 4th 152, 154 (2024). The panel, in another thoughtful opinion by Judge Wilkinson, “conclude[d] that Talevski did not change the law to an extent that would call our previous determinations into question.” Id., at 159. It therefore affirmed the District Court’s order granting summary judgment to Edwards and enjoining the State from terminating PPSAT from its Medicaid program. Id., at 170.

II

Two years ago, in Health and Hospital Corporation of Marion County v. Talevski, 599 U. S. 166, this Court outlined the test for determining whether a federal statute is privately enforceable under §1983. The majority accepts that the touchstone for that inquiry is whether the law in question “unambiguously confer[s] individual federal rights.” Id., at 180 (emphasis deleted); see ante, at 13. But the opinion it hands down today suggests that, as a practical matter, the character of the law—and, in particular, whether it was enacted under Congress’s spending power—is all but dispositive of the required rights determination. That view distorts the unambiguous-conferral test beyond recognition and strains our precedential holding that §1983’s unqualified use of the word “laws” means exactly what it says. As I explain below, under a faithful application of our unambiguous-conferral test, the Medicaid Act’s free-choice-of-provider provision readily creates an enforceable right.

A

The Civil Rights Act of 1871 was designed to bolster the protections of the Civil War Amendments and earlier Reconstruction statutes, which had failed to “preven[t] postbellum state actors from continuing to deprive American citizens of federally protected rights.” Talevski, 599 U. S., at 176. White supremacist violence was spreading across the South, aided at times by state and local officials, and the mayhem posed a fundamental threat to both public safety and the rule of law. E. Foner, Reconstruction: America’s Unfinished Revolution 1863–1877, pp. 442–444 (1988).

The 1871 Act aimed to combat that threat in various ways. One of them, embedded in the Act’s very first section, was to “ope[n] the federal courts to private citizens, offering a uniquely federal remedy against incursions under the claimed authority of state law upon rights secured by the Constitution and laws of the Nation.” Mitchum v. Foster, 407 U. S. 225, 239 (1972).

The text of that provision, now codified at 42 U. S. C. §1983, is straightforward. It authorizes private individuals to sue state or local officials who deprive them of “any rights, privileges, or immunities secured by the Constitution and laws” of the United States. Mindful of the statute’s ambitious goals, the Court has traditionally “given full effect to its broad language, recognizing that §1983 ‘provide[s] a remedy, to be broadly construed, against all forms of official violation of federally protected rights.’” Dennis v. Higgins, 498 U. S. 439, 445 (1991).

Thus, in Maine v. Thiboutot, 448 U. S. 1, 4 (1980), we expressly rejected a State’s contention that the phrase “and laws” refers only to civil rights laws enacted under Congress’s Fourteenth Amendment powers. As we explained, the statute’s “plain language”—and, in particular, the fact that “Congress attached no modifiers to the phrase”—makes clear that the word “laws” “means what it says” and is not “limited to some subset of laws.” Ibid.

At the same time, our cases also recognize that §1983 “speaks in terms of ‘rights, privileges, or immunities,’ not violations of federal law” more generally. Golden State Transit Corp. v. Los Angeles, 493 U. S. 103, 106 (1989). Accordingly, we have held that a plaintiff may not prevail under §1983 merely by identifying a violation of any federal statute; rather, she must identify a violation of a statute that creates “‘rights, privileges, or immunities.’” Ibid.

The test we apply for determining whether a statute creates such “rights, privileges, or immunities” has gradually grown more restrictive over the years. During the 1980s and 1990s, the Court adhered to Thiboutot’s plain-language approach to §1983 and thus freely recognized individual rights in federal “laws,” absent clear congressional intent to the contrary. E.g., Livadas v. Bradshaw, 512 U. S. 107, 132–134 (1994) (holding that employees could use §1983 to enforce a provision of the National Labor Relations Act); Wright v. Roanoke Redevelopment and Housing Authority, 479 U. S. 418, 430–432 (1987) (holding that public-housing tenants could use §1983 to enforce a provision of the Housing Act of 1937 capping their rental payments).

In Wilder v. Virginia Hospital Assn., 496 U. S. 498, 509–510 (1990), for instance, we held that healthcare providers could use §1983 to enforce a provision of the Medicaid Act that required States to reimburse them at “reasonable and adequate” rates. We determined that the provision was enforceable because it left “little doubt that health care providers [were] the intended beneficiaries,” and it was “cast in mandatory rather than precatory terms.” Id., at 510, 512. We also rejected the defendant’s argument that the provision’s “reasonable and adequate” mandate was “too ‘vague and amorphous’ to be judicially enforceable,” observing that the statute provided an “objective benchmark” for States to judge those criteria. Id., at 519.

A few years after Wilder, Congress endorsed our holistic approach to evaluating whether statutes create rights that are enforceable under §1983. In 1994, it passed a statute confirming that a provision may create enforceable rights even if the provision is framed as a directive to States as part of a federal spending program. §555(a), 108 Stat. 4057. Congress enacted that statute in direct response to our decision in Suter v. Artist M., where we had held that a provision of the Adoption Assistance and Child Welfare Act was not enforceable under §1983. 503 U. S. 347, 363 (1992). Our decision in that case had relied, in part, on the fact that the provision at issue appeared in a section of the statute that required States to submit specific plans to HHS as a condition of receiving federal funds. Id., at 358. Rejecting that line of reasoning, Congress adopted what has come to be called the “Suter fix.” The statute it enacted provides that a “provision is not to be deemed unenforceable because of its inclusion in a section of this chapter [of the U. S. Code] requiring a State plan or specifying the required contents of a State plan.” §1320a–2.² The statute explicitly “overturn[ed]” any suggestion in Suter that state-plan requirements cannot be enforced under §1983—an interpretive approach that, in Congress’s view, had “not [been] applied in prior Supreme Court decisions respecting [§1983] enforceability.” Ibid.

The Court decided Blessing v. Freestone, 520 U. S. 329 (1997), three years after Congress adopted the Suter fix. With no mention of §1320a–2, Blessing summarized how the Court had previously approached determining whether a federal law is privately enforceable under §1983. After surveying our past cases on the subject, we identified three key factors that bore on “whether a particular statutory provision gives rise to a federal right.” 520 U. S., at 340. Those three factors were: (1) whether “Congress  \. \. \. intended that the provision in question benefit the plaintiff ”; (2) whether “the right assertedly protected by the statute” is “so ‘vague or amorphous’ that its enforcement would strain judicial competence”; and (3) whether the statute “unambiguously impose[s] a binding obligation on the States.” Id., at 340–341.

Although the Blessing factors aimed merely to synthesize our past decisions, they also struck a balance between §1983’s broad remedial goals and our historical concern that States receive fair notice of their statutory obligations under federal law. That balance began to shift dramatically in the years following Blessing.

B

In Gonzaga University v. Doe, 536 U. S. 273 (2002), the Court adopted a restrictive test for determining whether a federal statute creates rights enforceable under §1983. There, we held that a university student could not use §1983 to enforce a provision of the Family Educational Rights and Privacy Act (FERPA)—a statute that directed the Secretary of Education to withhold federal funds from schools that had failed to maintain the confidentiality of their students’ educational records. We suggested that Blessing had led to “confusion” among some lower courts about how to determine whether a statute confers rights that are enforceable under §1983. Id., at 282–283. Citing a need for greater clarity, Gonzaga stated: “We now reject the notion that our cases permit anything short of an unambiguously conferred right to support a cause of action brought under §1983.” Id., at 283.

To justify that stricter standard, the Court relied heavily on the fact that Congress had enacted FERPA under its spending powers. We noted that, in “‘legislation enacted pursuant to the spending power, the typical remedy for state noncompliance with federally imposed conditions is  \. \. \. action by the Federal Government to terminate funds.’” Id., at 280 (quoting Pennhurst State School and Hospital v. Halderman, 451 U. S. 1, 28 (1981)). For that reason, we explained, recipients of federal funds must have clear notice that their failure to comply with a particular funding condition might “subjec[t] them to private suits for money damages” under §1983. 536 U. S., at 286–287, n. 5. We thus concluded that “if Congress wishes to create new rights enforceable under §1983, it must do so in clear and unambiguous terms.” Id., at 290. And we held that FERPA flunked that test because its confidentiality mandate—which was framed principally as a directive to the Secretary of Education—“lack[ed] the sort of ‘rights-creating’ language critical to showing the requisite congressional intent to create new rights.” Id., at 287.

But while Gonzaga made the test for evaluating the enforceability of statutory rights under §1983 more stringent, it did not close the door on §1983 enforcement altogether. Just two years ago, in Talevski, we applied Gonzaga’s analytical framework and held that a pair of Medicaid provisions created individual rights. 599 U. S., at 183. There, we determined that plaintiffs could use §1983 to enforce two provisions of the Federal Nursing Home Reform Act, or FNHRA—one imposing certain predischarge-notice requirements on nursing facilities and the other barring those facilities from using unnecessary chemical restraints on their residents. Id., at 171.

Talevski’s analysis began by restating “the Gonzaga test.” Id., at 183 (citing Gonzaga, 536 U. S., at 284, 287). As we recounted, that test asks whether “the provision in question is ‘“phrased in terms of the persons benefited”’ and contains ‘rights-creating,’ individual-centric language with an ‘“unmistakable focus on the benefited class.”’” 599 U. S., at 183 (quoting Gonzaga, 536 U. S., at 284, 287). Although we recognized that this test was “stringent,” we held that the two FNHRA provisions at issue satisfied it. 599 U. S., at 186. We cited the fact that both provisions appeared in a list of “[r]equirements ‘relating to residents’ rights.’” Id., at 184. And we outlined how the text of each provision “unambiguously confer[red] rights upon the residents of nursing-home facilities”: The unnecessary-restraint provision required nursing homes to “protect and promote  \. \. \. [t]he right to be free from  \. \. \. any physical or chemical restraints” not needed for treatment, while the predischarge-notice provision referred to “‘transfer and discharge rights’” and stated that nursing homes “‘must not transfer or discharge [a] resident’” without notice. Id., at 184–185.

Perhaps most importantly, our opinion in Talevski also squarely rejected the defendant’s argument that “§1983 contains an implicit carveout for laws that Congress enacts via its spending power.” Id., at 171. The defendant, an Indiana hospital system, had argued that “‘Spending Clause statutes do not give rise to privately enforceable rights under Section 1983’” because such statutes operate like contracts, which “were not ‘generally’ enforceable by third-party beneficiaries at common law.” Id., at 178 (quoting defendant’s brief). In rejecting that attempt to dilute §1983’s power, we affirmed once again that “‘[l]aws’ means ‘laws,’ no less today than in the 1870s.” Id., at 172. Our decision thus preserved §1983’s central remedial aims, even as it faithfully applied Gonzaga’s “demanding” test for whether statutes “unambiguously confer individual federal rights.” 599 U. S., at 180.³

C

Medicaid’s free-choice-of-provider provision easily satisfies the unambiguous-conferral test. To start, the text of the provision is plainly “‘ “phrased in terms of the persons benefited”’”—namely, Medicaid recipients. Id., at 183. The provision states that every Medicaid plan “must  \. \. \. provide that  \. \. \. any individual eligible for medical assistance (including drugs) may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.” §1396a(a)(23)(A) (emphasis added). This “individual-centric” formulation reflects an “‘“unmistakable focus on the benefited class.”’” Talevski, 599 U. S., at 183 (quoting Gonzaga, 536 U. S., at 284).

Congress also used rights-creating language in the heading of the provision when it enacted the original session law. The provision was entitled: “Free choice by individuals eligible for medical assistance,” 81 Stat. 903 (emphasis added).⁴ This phrasing indisputably invokes language classically associated with establishing rights. E.g., U. S. Const., Amdt. 1 (protecting the “free exercise” of religion); Faretta v. California, 422 U. S. 806, 833–834 (1975) (“[W]hatever else may be said of those who wrote the Bill of Rights, surely there can be no doubt that they understood the inestimable worth of free choice”). And Congress reinforced its rights-creating intent by making the provision mandatory—it specifically inserted the word “must” into the statute—to make clear that the obligation imposed on the States was binding. If Congress did not want to protect Medicaid recipients’ freedom to choose their own providers, it would have likely avoided using a combination of classically compulsory language and explicit individual-centric terminology. As the Fourth Circuit rightly put it, it is “difficult to imagine a clearer or more affirmative directive.” Planned Parenthood v. Baker, 941 F. 3d 687, 694 (2019).

The provision’s history confirms what the text makes evident: that Congress intended the provision to be binding. Congress enacted the free-choice-of-provider provision in 1967—just two years after the original Medicaid Act—in direct response to efforts by some jurisdictions to steer Medicaid beneficiaries to specific providers. See H. R. Rep. No. 544, at 122. To prevent States from interfering with Medicaid recipients’ freedom to choose their own providers, Congress adopted nearly identical language from a provision of the Medicare Act that—in both purpose and effect—had guaranteed that right to Medicare beneficiaries. §1395a(a). In other words, Congress made a deliberate choice to protect Medicaid recipients’ ability to choose their own providers by employing statutory language that it knew, based on its Medicare experience, would achieve that end. Congress’s intent could not have been clearer.

That clarity is perhaps why, in the only other case where we have had occasion to construe the free-choice-of-provider provision, we repeatedly used the word “right” to describe the protection it confers. In O’Bannon v. Town Court Nursing Center, 447 U. S. 773 (1980), a group of elderly Medicaid recipients sought to leverage the provision to assert “a constitutional right to a hearing” before Medicaid officials could strip their nursing home of funding. Id., at 775. In rejecting the recipients’ understanding of the provision, we explained what the provision does protect. As we put it, “§1396a(a)(23)  \. \. \. gives recipients the right to choose among a range of qualified providers, without government interference.” Id., at 785 (first emphasis added; citation omitted). We used the word “right” again in the next sentence to elaborate on that description: “By implication,” we said, the provision “also confers an absolute right to be free from government interference with the choice to remain in a home that continues to be qualified.” Ibid. (emphasis added).⁵

Although O’Bannon was not a case about §1983 enforceability, our description of the free-choice-of-provider provision confirms that the most natural and obvious way to read the provision’s individual-centric, mandatory language is as “rights-creating.”

III

The majority’s effort to resist the natural and obvious rights-creating reading of the Medicaid Act’s free-choice-of-provider provision is, ultimately, unpersuasive. The Court holds that the provision does not confer any individual rights on Medicaid recipients, but reaches that conclusion by applying a version of the unambiguous-conferral test that we did not endorse in Talevski or Gonzaga. In doing so, the Court adopts an approach to §1983 that not only undermines the statute’s core function but also stretches our doctrine beyond anything that can be justified as a matter of text, precedent, or first principles.

A

The approach that the Court follows today differs conspicuously from the approach we developed in Gonzaga and reaffirmed in Talevski. To see how, start by observing that the majority chooses not to frame its analysis around the question that guided our thinking in those cases: namely, whether “the provision in question is ‘“phrased in terms of the persons benefited”’ and contains ‘rights-creating,’ individual-centric language with an ‘“unmistakable focus on the benefited class.”’” Taleveski, 599 U. S., at 183 (quoting Gonzaga, 536 U. S., at 284, 287). Instead, the Court builds its analysis around the simplistic premise that Medicaid’s free-choice-of-provider provision “looks nothing like th[e] FNHRA provisions” we upheld in Talevski. Ante, at 15–16.

That approach warps our reasoning in Talevski. Nowhere in our opinion did we single out FNHRA as the sole or definitive model for conferring individual rights. To the contrary, the reason we went out of our way to reaffirm “the Gonzaga test” was to remove any doubts about “our established method for ascertaining unambiguous conferral.” 599 U. S., at 183. Talevski was merely an application of that methodology to the statutory provision at issue in that case.

Yet, now, the majority disregards the established method and, in its place, looks to FNHRA itself as “the only reliable yardstick against which to measure whether spending-power legislation confers a privately enforceable right.” Ante, at 15. In short, the majority construes our requirement that Congress “manifes[t] an ‘unambiguous’ intent to confer individual rights,” Gonzaga, 536 U. S., at 280, as a requirement that Congress manifest an unambiguous intent to imitate FNHRA.

The majority’s hyperfocus on FNHRA also widens the gap between our Gonzaga test and the text of §1983 itself. As noted, §1983 protects against deprivations of “any rights, privileges, or immunities secured by the  \. \. \. laws” of the United States—not just the specific rights secured by FNHRA. (Emphasis added.) It is therefore strange to treat FNHRA as the “only reliable yardstick,” ante, at 15, for assessing whether a statute unambiguously creates enforceable rights per Gonzaga. Cf. Dennis, 498 U. S., at 445 (“[W]e have rejected attempts to limit the types of constitutional rights that are encompassed within the phrase ‘rights, privileges, or immunities’”). Put simply, the fact that FNHRA happens to be the subject of one of the few cases this Court has opted to review concerning §1983 enforceability does not lend it talismanic status.

The majority’s FNHRA-or-bust approach makes even less sense when framed against the Court’s concerns about ensuring that States have fair notice of their statutory obligations. As the majority recognizes, the whole reason we require clear rights-creating language in spending statutes is because “[o]nly that kind of ‘unmistakable’ notice  \. \. \. suffices to alert grantees” that they might be sued under §1983. Ante, at 12. But focusing myopically on a given statute’s resemblance to FNHRA does little to advance the goal of providing fair notice to federal grantees. That is because, as we have often recognized, Congress “need not use magic words in order to speak clearly.” Henderson v. Shinseki, 562 U. S. 428, 436 (2011).

Indeed, if actual notice were the touchstone, this would be an easy case: By the time South Carolina chose to terminate PPSAT as a Medicaid provider in 2018, the State had ample reason to know that it could be sued under §1983—even beyond the clarity of the free-choice-of-provider provision’s text. By that point, the Federal Government had long taken the position that the free-choice-of-provider provision was privately enforceable via §1983.⁶ Our decision in O’Bannon had also explicitly described the provision as “giv[ing] recipients the right to choose” their providers “without government interference.” 447 U. S., at 785 (emphasis added). And Congress itself had reaffirmed, via the Suter fix, that the Medicaid Act’s “State plan requirements” could create enforceable rights. §1320a–2. Our Wilder decision had long since held that a similarly structured provision of the Medicaid Act—codified in the same section as the free-choice-of-provider provision—was enforceable under §1983. 496 U. S., at 524. With all that information, South Carolina could not reasonably claim surprise that its decision to restrict Medicaid recipients’ access to particular healthcare providers might trigger a §1983 suit under the free-choice-of-provider provision.⁷

In any event, the majority’s FNHRA-centric approach to fair notice fails on its own terms. The free-choice-of-provider provision mirrors the FNHRA provisions from Talevski in all respects that matter: both employ individual-centric language that focuses on the relevant beneficiaries and combine it with mandatory language directed at the relevant grant recipients. The provision also employs rights- creating language: As explained above, Congress explicitly used the words “free choice” in the provision’s original heading—words that plainly reflect rights-creating intent. See Part II–C, supra. The fact that the provision does not specifically use the word “right” is not dispositive. We have never required Congress to use specific verbiage to establish individual rights. And forcing Congress to use the specific word “right” would make little sense in this context anyway in light of §1983’s more capacious phrase “rights, privileges, or immunities.” Nor does it matter that FNHRA contains its own free-choice provision protecting the “‘right to choose a personal attending physician.’” Ante, at 16 (quoting §1396r(c)(1)(A)(i)). If anything, that Congress chose to use “Free choice” in the heading of both provisions reflects its understanding that the two provisions would have the same rights-protecting effect.⁸

Congress ultimately has wide discretion to use whatever language it wishes to create individual rights. We require only that it do so unambiguously. As the court below aptly put it, it is not our role “to limit Congress to a thin thesaurus of our own design.” 95 F. 4th, at 166.

B

In typical parade-of-horribles-like fashion, the majority also expresses the concern that, if the Court were to hold that the free-choice-of-provider provision confers an individual right, it would mean that “[m]any other Medicaid plan requirements would likely do the same.” Ante, at 18. But case law from the lower courts demonstrates that this fear is unfounded. Those courts have recognized only a tiny handful of the nearly 90 provisions contained in the Medicaid Act’s list of state-plan requirements as actually conferring individual rights. See Brief for National Health Law Program et al. as Amici Curiae 18–24 (highlighting the small number of provisions in §1396a(a) that lower courts have found to confer individual rights and noting the near unanimity of the Circuits as to each provision’s enforceability). And the lower courts have consistently refused to recognize individual rights in the Medicaid Act’s various other state-plan provisions. Ibid.

Meanwhile, the vast majority of the provisions on the Medicaid Act’s list of state-plan requirements have never generated any §1983 litigation whatsoever. There is thus little reason to think that a decision holding that the free-choice-of-provider provision confers individual rights would unleash a sudden torrent of §1983 suits under the Act’s other state-plan provisions. Indeed, recent history confirms as much: Prior to 2017, every Circuit to consider the question had held that the free-choice-of-provider provision confers an individual right enforceable under §1983. See n. 7, supra. But those decisions did not spawn a bevy of §1983 suits seeking to enforce other state-plan provisions.

Nor were the floodgates opened by this Court’s decisions in Wilder, Blessing, or any other cases that predate the restrictive test for §1983 enforceability that this Court adopted in Gonzaga. As the majority readily acknowledges, prior to Gonzaga, the Court “experimented with a different approach.” Ante, at 13. Indeed, in Gonzaga itself, the Court rationalized its newly restrictive approach to §1983 enforceability by indicating that some lower courts had become too permissive in recognizing enforceable statutory rights. 536 U. S., at 283. Yet, even during the pre-Gonzaga period, there is no evidence that lower courts treated the Medicaid Act—which spans multiple volumes of the U. S. Code—as a wellspring of generally enforceable rights. Rather, the state of affairs before our tightening of the test reinforces that the free-choice-of-provider provision is, in fact, the “atypical” spending statute that creates individual rights, Talevski, 599 U. S., at 183—contrary to the majority’s assertions otherwise. Ante, at 18, 21.

C

Finally, Justice Thomas’s concurrence calls for a “fundamental reexamination of our §1983 jurisprudence” based on his view that the “history of §1983 makes clear that the statute has exceeded its original limits.” Ante, at 1–2, 13. Because his opinion is not tethered to the specific facts or arguments presented in this case, an extensive response is not necessary here. But it is worth pausing briefly to think about whether the historical account he offers reflects the level of depth, nuance, or context needed to support the wholesale reappraisal he is envisioning.

Take his observation that courts decided relatively few cases under §1983 during its first several decades. Ante, at 3. Like other §1983 skeptics, Justice Thomas seems to view the paucity of early §1983 lawsuits as evidence that the statute was originally understood to do very little. But other explanations come to mind, too—such as the fact that filing civil rights lawsuits during the Jim Crow era could be quite perilous, especially for the people whom the statute was originally meant to benefit. Many would-be plaintiffs had reason to fear that filing a lawsuit would lead to physical or economic reprisals.⁹ Add to that the difficulty of finding a lawyer, prevailing before often-hostile juries, and (if successful) enforcing a judgment, and it is not hard to imagine that the dearth of §1983 lawsuits in the wake of Reconstruction might have myriad alternative explanations.¹⁰

Justice Thomas also suggests that the word “rights,” as used in §1983, was originally understood more narrowly than it is today. Ante, at 8–12. But his support for that claim is limited to a handful of late-19th-century cases, mostly about government pensions and employment. If “a statute’s meaning turns on what its words ‘conveyed to reasonable people at the time they were written,’” ante, at 6, a broader—and more inclusive—survey of historical sources would seem to be in order.¹¹

All of which is to say: more caution (and more research) may be warranted before our longstanding precedents in this area can be seriously scrutinized or attacked—especially in cases where no party has made such a claim or presented any such argument.

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Congress enacted the Medicaid Act’s free-choice-of-provider provision to ensure that Medicaid recipients have the right to choose their own doctors. The Court’s decision to foreclose Medicaid recipients from using §1983 to enforce that provision thwarts Congress’s will twice over: once, in dulling the tool Congress created for enforcing all federal rights, and again in vitiating one of those rights altogether.

The Court’s decision today is not the first to so weaken the landmark civil rights protections that Congress enacted during the Reconstruction Era. See, e.g., Civil Rights Cases, 109 U. S. 3 (1883); United States v. Cruikshank, 92 U. S. 542 (1876); Blyew v. United States, 13 Wall. 581 (1872). That means we do have a sense of what comes next: as with those past rulings, today’s decision is likely to result in tangible harm to real people. At a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them. And, more concretely, it will strip those South Carolinians—and countless other Medicaid recipients around the country—of a deeply personal freedom: the “ability to decide who treats us at our most vulnerable.” Kerr, 95 F. 4th, at 169. The Court today disregards Congress’s express desire to prevent that very outcome.