On Wednesday, November 12, 2025, a pivotal legal battle unfolded in federal courtrooms across the United States as judges weighed the future of Medicaid reimbursements for Planned Parenthood. The hearings, sparked by a controversial spending law passed in July, have thrown the nation’s largest reproductive health provider and millions of low-income Americans who depend on its services into the political and legal crossfire.
At the heart of the dispute is a provision in the One Big Beautiful Bill Act—a sweeping tax and spending package championed by President Donald Trump during his second term. The law, which took effect in September after an appeals court ruling, targets organizations that both provide abortions and receive more than $800,000 annually in Medicaid reimbursements. Planned Parenthood, which serves millions of patients nationwide, quickly became the primary focus of the legislation.
According to The Associated Press, nearly half of Planned Parenthood’s patients rely on Medicaid for healthcare services other than abortion, which the federal insurance program does not cover. “The consequence is for patients who are going to be forced to make impossible choices between essential services,” said Alexis McGill Johnson, President and CEO of Planned Parenthood Federation of America. She described the financial fallout as unsustainable, noting that clinics across the country spent $45 million out of pocket in September alone to continue serving Medicaid patients.
Planned Parenthood, along with its member organizations in Massachusetts and Utah and a major medical provider in Maine, filed lawsuits against Health and Human Services Secretary Robert F. Kennedy Jr. in July. The Maine provider has already been forced to halt its primary care services while its legal challenge moves forward. Meanwhile, seven states—California, Colorado, Massachusetts, New Jersey, New Mexico, New York, and Washington—have stepped in to fill part of the funding gap, allocating state funds to cover roughly $200 million of the $700 million Planned Parenthood spends annually on Medicaid patients. But this stopgap measure is far from enough, and some clinics are now requiring Medicaid patients to pay out of pocket or are closing their doors altogether.
Since the law’s passage, the toll has been severe: 20 Planned Parenthood-affiliated clinics have shut down since July, bringing the total number of closures to 50 since the start of Trump’s second term. Jenna Tosh, CEO of Planned Parenthood California Central Coast, underscored the gravity of the situation. “Many of our patients, we are their primary provider of health care,” she told The Associated Press. “You really start pulling at the thread of the entire health care safety net for the most vulnerable people.” Tosh added that 70% of her region’s patients depend on Medicaid, and the cuts threaten both abortion and non-abortion medical care alike.
Planned Parenthood’s annual report reveals that abortions accounted for just 4% of all medical services in 2024. The vast majority—about 80%—were for testing and treatment of sexually transmitted infections and contraception services, while the remaining 15% included cancer screenings, primary care, and behavioral health services. Nevertheless, the organization has become a lightning rod in the ongoing national debate over abortion rights and public funding.
Opponents of Planned Parenthood, including Carol Tobias, president of the National Right to Life Committee, have applauded the legislation as a necessary step. Tobias argues that even though federal tax dollars are not used directly for abortions, Medicaid reimbursements help organizations that provide them stay afloat. “To be forced to pay for that is just very objectionable,” she stated. Tobias suggested that Planned Parenthood could choose to stop offering abortions if it wished to continue receiving Medicaid funds for other healthcare services.
Planned Parenthood, for its part, remains unwavering in its mission. “The government should not play a role in determining any pregnancy outcomes,” Johnson asserted, doubling down on the organization’s commitment to providing abortions as part of comprehensive reproductive healthcare.
In court, Planned Parenthood’s legal team contended that the One Big Beautiful Bill Act is the “culmination of a decade-long effort to unlawfully target and punish” the organization. They argue that the law violates the Constitution, specifically the First Amendment, and constitutes a bill of attainder—a legislative act that singles out and punishes an individual or group without a trial. The Massachusetts district court previously agreed, ruling in July that the government had unfairly targeted Planned Parenthood and its affiliates, some of which do not even provide elective abortions.
But the Trump administration and its allies remain steadfast. Health and Human Services Secretary Robert F. Kennedy Jr. and Medicare and Medicaid Services Administrator Mehmet Oz, both named in the lawsuits, responded that Planned Parenthood’s arguments lack merit. In their written response, they insisted that “the enactment of Section 71113 reflects a determination by our elected representatives that the benefits of the statute outweigh any adverse impact on access to care.” They further argued, “It would be a special kind of judicial hubris to declare that the public interest has been undermined by the public.”
Planned Parenthood countered that the law “devastates” access to “lifesaving” healthcare for vulnerable Americans, particularly in underserved communities where the organization is often the sole provider of sexual and reproductive health services. The organization’s written arguments detailed how members have been forced to scale back services, lay off staff, and close clinics—affecting not only Medicaid patients but also others who depend on these centers for care.
As the appeals court deliberated, the case drew sharp lines between competing visions for the nation’s healthcare future. Supporters of the law, many of whom are Republican lawmakers and anti-abortion activists, argue that federal funding for abortion services—directly or indirectly—violates the conscience of taxpayers who oppose abortion on moral or religious grounds. Critics, however, warn that the law’s reach extends far beyond abortion, threatening access to a broad range of essential health services for millions of Americans.
The legal battle is far from over. Planned Parenthood has urged appellate justices to uphold the district court’s earlier ruling, emphasizing that the government would not be harmed by reimbursing the organization for non-abortion healthcare services. “Planned Parenthood Members have scaled back services, laid off staff, and closed clinics – impacting not only Medicaid patients but also others who depend on these centers for care,” the organization wrote in its filings. “This is especially devastating in the many underserved communities where Planned Parenthood is the sole provider of sexual and reproductive health services.”
With the fate of Medicaid reimbursements for Planned Parenthood hanging in the balance, the outcome of these court cases will have profound implications—not just for the organization itself, but for the millions of Americans who rely on it for vital healthcare. As the judges consider their ruling, the nation watches closely, aware that the decisions made in these courtrooms will ripple through communities for years to come.
