The Trump administration must continue to provide Medicaid funding to Planned Parenthood affiliates, a Massachusetts federal judge ruled on Monday.
Congressional Republicans, as part of the so-called One Big Beautiful Bill enacted earlier this month, included a provision that blocks federal Medicaid payments for one year to abortion providers that receive at least $800,000 in funding. Those payments did not directly pay for abortions but went to reimburse other services such as contraception and pregnancy tests.
Planned Parenthood Federation of America, which advocates for abortion rights and does not provide medical care, sued the administration on behalf of all of its 47 regional affiliates, along with its Utah and Massachusetts chapters. U.S. District Judge Indira Talwani in Boston ruled that the law likely violates the Constitution and issued a preliminary injunction.
“Patients are likely to suffer adverse health consequences where care is disrupted or unavailable,” she wrote. “In particular, restricting members’ ability to provide health care services threatens an increase in unintended pregnancies and attendant complications because of reduced access to effective contraceptives, and an increase in undiagnosed and untreated STIs.”
Talwani said injunction prevents the administration from "targeting a specific group of entities -- Planned Parenthood Federation members -- for exclusion from reimbursements under the Medicaid program" when they showed "substantial likelihood" that such a targeted exclusion is unconstitutional. “A preliminary injunction maintains Planned Parenthood Members’ ability to seek Medicaid reimbursements and maintain their status quo level of service to patients,” she wrote.
The law's text and structure made clear that it was crafted to cover every member of Planned Parenthood Federation of America, even if they were not named, Talwani ruled. This specificity likely transformed the provision into an unconstitutional bill of attainder, an act of Congress that wrongly seeks to inflict punishment without a trial, the ruling said. "Plaintiffs are likely to establish that Congress singled them out with punitive intent," she wrote.
The order came after Talwani last week froze a funding ban in the law for a subset of Planned Parenthood clinics that receive less than $800,000 from Medicaid annually or that don't perform abortions. Because an earlier temporary restraining order was expiring, Planned Parenthood said many health centers were forced to stop billing for Medicaid services ahead of "catastrophic" consequences for its nearly 600 health centers, putting nearly 200 of them in 24 states at risk of closure.
The U.S. Department of Health and Human Services disagreed with Monday’s decision.
“States should not be forced to fund organizations that have chosen political advocacy over patient care,” spokesperson Andrew Nixon told The Hill. “This ruling undermines state flexibility and disregards longstanding concerns about accountability.”
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