A federal judge in Massachusetts issued a preliminary injunction on a federal provision targeting Planned Parenthood and other reproductive health care providers’ Medicaid funding for some states starting next week. The Trump administration is expected to appeal. (Photo by Sarah Ladd / Kentucky Lantern)
A federal judge has once again blocked a controversial provision barring federal Medicaid funding for Planned Parenthood and other nonprofit reproductive health providers. But this time, she’s ruling in a different case with a different set of arguments.
U.S. District Judge Indira Talwani on Tuesday, Dec. 2, granted a preliminary injunction starting next week for 22 states that, along with the District of Columbia, sued the federal government in July.
The states’ attorneys general argue that the federal government violated the spending clause of the U.S. Constitution by not providing clear guidelines and time to comply with the conditions laid out in the budget reconciliation package passed by Congress and signed by President Donald Trump this summer.
The Medicaid provision primarily affects Planned Parenthood clinics, as well as a couple of other reproductive health care providers who also offer legal abortion services.
Lawyers for the Trump administration argue that other states haven’t found the provision unclear.
This week, Talwani, who was appointed by Democratic President Barack Obama, ordered that while the states’ case unfolds, federal Medicaid funding should continue flowing, including to Planned Parenthood clinics, in the states involved in this lawsuit.
The federal government “shall take all steps necessary to ensure that Medicaid funding continues to be disbursed in the customary manner and timeframes” to the states that filed the lawsuit “without regard to whether the claims were filed by entities that may be ‘prohibited entities’” under the megalaw’s provision, she wrote.
The court issued a seven-day administrative stay preventing the preliminary injunction from taking effect immediately, and the ruling will likely be appealed.
“Allowing the Defund Provision to take effect would mean that our people will get sicker and lose access to critical healthcare services they need,” said coplaintiff Attorney General Rob Bonta of California in a statement, praising the judge’s decision. “We should be clear-eyed about what the Defund Provision represents: A scorched-earth offensive by the Trump Administration and Congressional Republicans against Planned Parenthood and other health centers that provide essential reproductive care to those with the least among us.”
As States Newsroom has reported in The Unraveling Safety Net series, the fallout of this Medicaid provision in the One Big Beautiful Bill Act has been significant for reproductive health clinics and their patients throughout the country. While some have committed to continue seeing Medicaid patients, many others have had to redirect patients, oftentimes in regions with diminished care options. According to Planned Parenthood, at least 20 of their clinics have closed since the Medicaid ban became law, in addition to dozens of clinics that shuttered earlier this year due to other federal funding cuts.
Attorneys for the federal government have argued that the states don’t have standing in this case, because they can’t argue on behalf of health organizations and citizens. But the judge wrote that the plaintiff states made the case that there are increased costs for them directly in complying with the provision — and because of fallout from those clinic closures.
Talwani ruled the plaintiffs have standing and demonstrated “a substantial likelihood of success.”
She also ordered that defendants provide a copy of this decision to all HHS personnel and state agencies involved with the disbursement of Medicaid funding. And she granted a nominal bond relief of $100 to be posted within seven days, but not the full amount sought by plaintiffs: $600,000 per month while the injunction is in place.
“The district court again recognized the ‘defund’ law for what it is: unconstitutional and dangerous,” said a Planned Parenthood spokesperson in a written statement. “Planned Parenthood won’t stop fighting until everyone is free to get the care they need, when and where they need it.”
Planned Parenthood and Maine Family Planning also sued over the provision in separate lawsuits. In Planned Parenthood’s case, Talwani ordered the provision blocked, but in September, the 1st Circuit Court of Appeals allowed the Medicaid provision to take effect while litigation continues.
The arguments in the states’ case are quite different from the arguments in Planned Parenthood’s lawsuit, which center on whether the federal government unlawfully targeted clinics and violated their freedom of association.
Abortion legal expert Mary Ziegler said the states’ arguments are stronger.
“The court, I think correctly, said Congress is allowed to change the Medicaid program, but to do that, it has to provide clear notice to the states of what it’s doing, so that they can make their own decisions about whether they want to continue participating in Medicaid on the same terms,” said Ziegler, referring to Talwani’s Tuesday ruling.
She noted that the Supreme Court has previously ruled that under the spending clause, conditions must be unambiguous, and states must have advance notice if they change.
“Clarity arguments are sort of in the eye of the beholder,” she added, “You know, the Supreme Court could say, Is it the most clear thing in the world? No, but it’s clear enough for us, sort of thing. But it’s definitely not as, I think, much of a stretch as was the basis for Judge Talwani’s ruling earlier this year.”
In this past year, Planned Parenthood has been embroiled in legal disputes over public funding in multiple federal and state cases and lost a major court battle related to an executive order in South Carolina in June, when the U.S. Supreme Court ruled that the state could remove the organization from its list of Medicaid providers. Also on Tuesday, Planned Parenthood dropped a lawsuit challenging the state’s ability to remove its clinics from the list.
Anti-abortion organizations, which have long lobbied for Planned Parenthood to lose funding, have celebrated the federal budget provision, set to expire July 2026. They have framed it as being about abortion, despite federal funding for abortion care already being outlawed, except in limited circumstances. And as States Newsroom reported, anti-abortion lawmakers and advocates are searching for new ways to try to permanently prevent Planned Parenthood from receiving federal resources.
“The Democrats and their radical activist judges are desperately seeking to thwart the will of the people and bail out the Big Abortion industry,” said Susan B. Anthony Pro-Life America President Marjorie Dannenfelser in a statement. “This fight is not over. The pro-life movement will work tirelessly to ensure the Democrats do not prevail and taxpayers are never forced to pay a dime to prop up Big Abortion businesses.”
The federal Medicaid provision could expire before litigation is resolved in these cases, unless Congress extends it or makes it permanent. Ziegler said this policy is likely to be a major campaign issue for Democrats in upcoming elections.
“The more we have rulings like this one, and the more time that’s bought for Planned Parenthood affiliates to not go out of business, I think the harder that question is going to become for Republicans,” Ziegler said. “As much as the abortion issue didn’t carry Kamala Harris over the line in 2024, I still don’t think there’s really polling to support the idea that abortion is a good issue for Republicans.”
This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes NC Newsline, and is supported by grants and a coalition of donors as a 501c(3) public charity.
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