A federal appeals court in the United States has delivered a significant blow to reproductive healthcare access, ruling to allow the Trump administration to cut off vital Medicaid funding from Planned Parenthood clinics across nearly two dozen states.
Legal Battle Over Funding Provision
On Tuesday, a three-judge panel from the Boston-based First US Circuit Court of Appeals put on hold an injunction that had blocked the enforcement of a contentious funding rule. The injunction was originally issued by US District Judge Indira Talwani, an appointee of former President Barack Obama.
The provision in question was passed by Congressional Republicans as part of their One Big Beautiful Bill Act. It specifically bars Medicaid reimbursements to tax-exempt organisations that provide family planning services if they also perform abortions and received more than $800,000 in Medicaid funds during the 2023 fiscal year.
This ruling reverses Judge Talwani's December 2nd decision, where she agreed with Democratic state attorneys general that the law likely placed an unconstitutional retroactive condition on state participation in Medicaid. She argued states lacked clear notice about which entities were covered.
Impact on Healthcare Access and Clinic Closures
The consequences of this funding block are already being felt. Planned Parenthood states the provision, which President Trump signed into law in July, was deliberately crafted to target them. The organisation reports it has already contributed to the closure of at least 20 of its health centres and warns that up to 200 centres could ultimately shut down.
Critically, most of these threatened centres are in so-called 'blue states' where abortion remains legal. Their closure would dramatically reduce access to the procedure, leading advocates to label the measure a "back-door abortion ban".
It is crucial to note that federal dollars are already broadly prohibited from funding abortions. Planned Parenthood uses Medicaid reimbursements to support other essential services, including STI testing, cancer screenings, and contraception provision. In 2024 alone, Planned Parenthood centres facilitated over 1.5 million visits for patients relying on Medicaid.
Ongoing Political and Legal Conflict
The court's decision marks the latest volley in a protracted legal war. The First Circuit panel, which notably comprised only judges appointed by Democratic presidents, found the Trump administration was likely to succeed on appeal, arguing the law was not ambiguous and Congress had the power to enact such changes.
Democratic state attorneys general from California, Connecticut, and New York had co-led the challenge. California Attorney General Rob Bonta called the ruling disappointing but reaffirmed his commitment to ensuring vulnerable residents can access needed healthcare.
Experts warn that if patients can no longer visit Planned Parenthood for reproductive health services, many may be left with nowhere else to turn, creating a significant gap in the public health safety net for low-income individuals across the affected 22 states and Washington DC.
