With a new law cutting Medicaid funding to certain clinics, Planned Parenthood estimated 200 of its clinics in 24 states are at risk of closure with the cuts, and nearly all of those clinics — 90% — are in states where abortion is legal. (Photo by Kayla Bartkowski/Getty Images)

Planned Parenthood had already begun the arduous task of closing some clinics and curtailing services immediately after Congress passed the massive budget reconciliation bill that included a new law cutting Medicaid funding to certain clinics on July 3.

Now that a federal judge only partially blocked the enforcement of the bill, that situation may only get worse in the coming weeks and months.

The provision – which the organization said directly targeted their services for defunding and fulfills a longstanding goal of anti-abortion advocates and many Republican elected officials – prohibits Medicaid funding for clinics that provide abortion care and billed Medicaid more than $800,000 in fiscal year 2023. Federal Medicaid dollars cannot be used for abortion care, except in cases of rape, incest or certain medical conditions, and are instead most often used to provide standard reproductive health care at little to no cost. That includes treatment for sexually transmitted infections, cancer screenings and contraception. Planned Parenthood provides services for about 2 million patients every year, and 64% of clinics are in rural areas or places with health care provider shortages.

Within days of President Donald Trump’s signature on the bill, Planned Parenthood and affiliates in Utah and Massachusetts sued federal authorities, quickly winning a temporary restraining order. But on Monday, U.S. District Judge Indira Talwani’s order only blocked enforcement against one of the affiliates that filed the lawsuit, Planned Parenthood Association of Utah, and affiliates “who will not provide abortion services” as of Oct. 1. Clinics that didn’t bill Medicaid more than $800,000 in fiscal year 2023 are also protected from cuts.

On Tuesday afternoon, attorneys for the Trump administration filed a notice of appeal to the 1st Circuit Court of Appeals seeking to reverse the preliminary injunction decision.

Clinic and affiliate leaders say the fallout from the funding measure has already resulted in chaos, and they are still trying to determine what it means for their operations.

Clinics were already hampered by frozen Title X funding

Erica Wilson-Domer, president and CEO of Planned Parenthood of Greater Ohio, told States Newsroom on Thursday that they temporarily paused Medicaid services after the bill became law, but were back to regular operations under the restraining order. She acknowledged it will vary by state and county, and it’s unclear how the clinics will respond to Monday’s preliminary injunction.

“We have a saying that if you’ve seen one Planned Parenthood, you’ve seen one Planned Parenthood,” Wilson-Domer said. “We sort of all have to independently make a decision based on our financial situation and what’s going on in our states.”

Each affiliate operates as an independent nonprofit organization that can make its own financial and administrative decisions. Similar to the landscape for abortion access after the U.S. Supreme Court’s Dobbs decision in 2022, the availability of services for Medicaid patients at Planned Parenthood and other high-volume reproductive health clinics now largely depends on where someone lives.

The national group estimated 200 of its clinics in 24 states are at risk of closure with the cuts, and nearly all of those clinics — 90% — are in states where abortion is legal. In 12 states, approximately 75% of abortion-providing Planned Parenthood health centers are threatened. The entire organization has about 600 clinics in 48 states.

Wilson-Domer said even before the budget bill became law, the clinics limited what contraceptives they could offer after the U.S. Health and Human Services Department froze Title X funds for specific clinics that the agency said provided care to undocumented immigrants and promoted messages of diversity, equity and inclusion. The loss of that funding increased the costs of obtaining contraception such as Nexplanon from $425 to more than $1,200, and no longer made it feasible for the clinics to offer.

Two clinics in rural Ohio that did not provide abortion services will close on Aug. 1, the Planned Parenthood Southwest Ohio Region announced on Thursday. Those clinics provided contraception, cancer screenings, testing and treatment for sexually transmitted infections and other wellness services.

“Our challenge isn’t just the federal lawsuit, but we’re in a state … where the state legislature pays no attention to the needs of its community,” said Nan Whaley, president and CEO of the Ohio affiliate, during a press conference on Thursday. She added that Ohio also passed a budget bill that allows the rollback of Medicaid expansion if federal support for the program drops by even 1%.

Although the affiliate’s four other clinics will remain open, they are no longer accepting or billing Medicaid for services. In an emailed statement, spokesperson Maya McKenzie said the restraining order wasn’t enough.

“For many smaller affiliates, the risk of the federal government requesting back pay if the order or an injunction expires is too great,” McKenzie said.

In a court brief filed by the U.S. Department of Justice on July 14 opposing Planned Parenthood’s request for an injunction, DOJ attorneys said, “an injunction won’t provide the certainty that Planned Parenthood wants, because the government will be able to deny (or claw back) payments if and when it ultimately succeeds.”

Some Pennsylvania clinics limited contraception options

In Pennsylvania, Planned Parenthood Keystone said it temporarily paused Medicaid billing for contraceptive devices such as IUDs, Nexplanon, and Depo Provera, among other services, while it assessed the legal risks of the new law. Instead, sliding scale fees and referrals to other providers were made. After the restraining order, CEO Melissa Reed said they resumed billing.

“That court order is set to expire soon, and the legal landscape remains uncertain,” Reed wrote in an emailed statement. “We’re hopeful for a lasting resolution, but regardless of the outcome, our focus will always be on making sure patients can continue getting the care they need.”

Elsewhere, Planned Parenthood of Western Pennsylvania said they could not share internal protocols but remained committed to protecting access to care for every patient.

Affiliates in the West, including Planned Parenthood Columbia Willamette in Oregon and Washington, said their nine health centers are providing the full scope of usual services. That includes the Ontario Health Center, which is a critical border clinic for patients in western Idaho, which has a near-total abortion ban. Christopher Coburn, the affiliate’s chief of external affairs, said they are not limiting appointments for patients covered by Medicaid either. Planned Parenthood Great Northwest, which has health centers in Idaho, Alaska, Hawaii, Indiana and Kentucky, also said it is not limiting services.

Like many others who provide family planning services, Planned Parenthood of Greater Ohio CEO Wilson-Domer said the cuts to Medicaid won’t affect abortion rates, and will likely increase them further by cutting off contraception access.

“What I hope people are really thinking about is that statistic that 1 in 4 women will visit Planned Parenthood in their lifetime, and … preventative care is what’s actually being defunded here,” she said. “If the intention is to reduce abortion, this is the exact opposite of that.”

A Planned Parenthood clinic in Salt Lake City is pictured on Wednesday, July 31, 2024. (Photo by McKenzie Romero/Utah News Dispatch)

This report has been updated.

WASHINGTON — A federal judge issued a preliminary injunction Monday, blocking a provision in Republicans’ “big, beautiful” law that would have barred Medicaid funding from going to Planned Parenthood for one year.

District Court Judge Indira Talwani wrote in a 36-page opinion that Planned Parenthood established “a substantial likelihood of success on their equal protection claim” since the new law “burdens” the organization’s First Amendment rights. But she limited the protections to only certain Planned Parenthood clinics.

“A preliminary injunction maintains Planned Parenthood Members’ ability to seek Medicaid reimbursements—and maintain their status quo level of service to patients,” Talwani wrote. “And an injunction requiring Defendants to continue funding Medicaid reimbursements in accordance with the status quo imposes no additional Medicaid costs on Defendants, where there is no dispute that Medicaid funds will still be provided only for reimbursable healthcare services.”

Congress has barred federal taxpayer dollars from going to abortion services with limited exceptions for decades. But GOP lawmakers used their sweeping tax and spending cuts package to eliminate Medicaid funding from going to Planned Parenthood for other types of health care, like annual physicals and cancer screenings.

The original House version of the bill included a 10-year moratorium on Medicaid reimbursements to Planned Parenthood, but that was changed to a one-year prohibition in the Senate.

Planned Parenthood filed a lawsuit challenging the new law just days after President Donald Trump signed it during a ceremony on the Fourth of July.

Talwani, who was nominated to the bench by former President Barack Obama, issued a temporary restraining order the same day the case was filed, blocking that provision’s implementation.

The Trump administration argued against the court issuing a preliminary injunction, writing in a 58-page motion submitted last week that Planned Parenthood’s “constitutional claims are utterly meritless.”

“All three democratically elected components of the Federal Government collaborated to enact that provision consistent with their electoral mandates from the American people as to how they want their hard-earned taxpayer dollars spent,” the brief states. “But Plaintiffs—Planned Parenthood Federation of America (“PPFA”) and its members (together, “Planned Parenthood”)—now want this Court to reject that judgment and supplant duly enacted legislation with their own policy preferences.”

Talwani wrote in her ruling that it would apply to “Planned Parenthood Association of Utah and other Planned Parenthood Federation of America Members who will not provide abortion services as of October 1, 2025, or for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act for medical assistance furnished in fiscal year 2023 made directly to them did not exceed $800,000.”

Planned Parenthood Federation of America, Planned Parenthood League of Massachusetts and Planned Parenthood Association of Utah — the three organizations that filed the suit — issued a written statement after the ruling that they were “disappointed that not all members were granted the necessary relief today.”

“Patients across the country should be able to go to their trusted Planned Parenthood provider for birth control, cancer screenings, and STI testing and treatment,” they wrote. “This is about patients and their right to get care — no matter their insurance. The court has not yet ruled on whether it will grant preliminary injunctive relief to other members. We remain hopeful that the court will grant this relief. There will be nothing short of a public health crisis if Planned Parenthood members are allowed to be ‘defunded.’”

The Department of Justice declined to comment whether it would appeal the preliminary injunction, though a spokesperson for the Department of Health and Human Services said it doesn’t agree with the ruling.

“We strongly disagree with the court’s decision,” HHS Director of Communications Andrew Nixon wrote in a statement. “States should not be forced to fund organizations that have chosen political advocacy over patient care. This ruling undermines state flexibility and disregards longstanding concerns about accountability.”

The Trump administration filed a notice later Tuesday it intends to appeal the preliminary injunction to the United States Court of Appeals for the 1st Circuit.