The Trump administration can move forward with its plan to “defund” Planned Parenthood by blocking it from receiving reimbursements from Medicaid, the US government’s insurance program for low-income people, a federal appeals court ruled late on Thursday.
The ruling from the first US circuit court of appeals lifts a lower court’s preliminary injunction, which had stopped the Trump administration from enacting a provision of its tax and spending bill that axed Planned Parenthood’s ability to participate in Medicaid for one year.
Now, the reproductive health giant estimates that up to 200 Planned Parenthood clinics may face closure, given that 1.1 million Planned Parenthood patients are eligible for Medicaid.
“Cancers will go undetected, STIs will go untreated and patients won’t get the birth control that they need to plan their families and futures,” Alexis McGill Johnson, chief executive of Planned Parenthood Federation of America, said in a press call on Friday. “Patients will have to travel further to get care and wait longer to get it as demand surges at health centers.”
More than 60% of the clinics at risk for closure are in rural or “medically under-served areas”, while roughly 90% of the clinics are located in blue states that currently protect abortion rights, McGill Johnson said. Planned Parenthood clinics provide almost 40% of all US abortions, according to a 2024 report from the independent abortion clinic association Abortion Care Network.
“Make no mistake, this is a backdoor abortion ban,” McGill Johnson said.
It is already illegal to use federal dollars, including money from Medicaid, to pay for abortions. In 2024, Planned Parenthood clinics treated people who rely on Medicaid at more than 1.5m visits for services such as STI tests, cancer screenings and contraception. However, because anti-abortion activists see Planned Parenthood as a public enemy, they have spent years trying to convince Republicans to “defund” Planned Parenthood by kicking it out of Medicaid.
During the call, McGill Johnson said Planned Parenthood had developed plans that would permit some regional affiliates to stop providing abortions in states where the procedure remains legal, in order to preserve their ability to receive Medicaid. After the call, a Planned Parenthood Federation of America spokesperson said those plans were no longer being considered.
“That is not an attempt to walk away from abortion,” McGill Johnson said. “Planned Parenthood strongly stands behind our need and ability to provide abortion care wherever it is legal in this country. It is simply an opportunity for us to engage our federation to be able to provide the care and also preserve as much funding for reimbursement for the services, just like any other healthcare provider should be able to do.”
In an emailed statement, the Planned Parenthood Federation of America spokesperson stressed that “Planned Parenthood healthcare clinics will continue to provide abortion care everywhere it is lawful to do so.”
Litigation in the case will continue, as the first circuit is set to hear more substantive arguments in the case in the coming weeks. More than 80 million people in the US use Medicaid, and 11% of female Medicaid beneficiaries who are between the ages of 15 and 49 and who receive family-planning services go to Planned Parenthood, according to an analysis by the non-profit KFF, which tracks healthcare policy.
“There’s no back-up plan. There’s no one waiting in the wings to take care of our patients,” said Dominique Lee, president and CEO of Planned Parenthood League of Massachusetts, one of the regional Planned Parenthood affiliates that helped bring the lawsuit over the Trump administration’s provision.
“Planned Parenthood is the safety net.”