The move may come as a surprise to some, given the high court’s conservative tilt after the addition of Justice Brett Kavanaugh to the bench. But a closer look at the details of the case reveals that there’s more to it than that.

At issue was whether people insured by Medicaid can access Planned Parenthood’s services, including screenings, ultrasounds, and counseling. (The case does not cover abortion-related services; federal law prohibits people to use Medicaid money for abortion.) The court’s refusal means two lower-court decisions will remain in place. Both argue that states are in violation of federal law if they terminate Medicaid contracts with Planned Parenthood affiliates who offer preventive care for low-income women.

Three justices from the court’s conservative wing—Samuel Alito, Neil Gorsuch, and Clarence Thomas—voted to hear the case. Four were needed to proceed, a possible sign that Chief Justice John Roberts and Justice Brett Kavanaugh seek to avoid unnecessarily controversial cases. In November, Roberts took the unusual step of rebuking President Donald Trump for describing a judge hostile to his policies as “an Obama judge,” arguing that the federal judiciary’s integrity rests on its independence from the executive branch.

Defunding Planned Parenthood has long been a priority for the Republican Party and canceling federal dollars for the organization became a point of discussion ahead of Kavanaugh’s confirmation this fall.

This latest case emerged after an anti-abortion group released a number of since-discredited videos in 2015 that allegedly showed Planned Parenthood officials discussing selling fetal tissue. Louisiana and Kansas consequently cut Medicaid-provider agreements with Planned Parenthood affiliates, leading the parent organization to file suit.