A federal judge on Monday blocked the enforcement of a portion of President Donald Trump‘s One Big Beautiful Bill Act that would have prevented Medicaid reimbursements to Planned Parenthood and other large abortion providers. 

The order from U.S. District Judge Indira Talwani in Boston on Monday permanently blocks the GOP-passed measure cutting off Medicaid reimbursement to Planned Parenthood members. Talwani’s ruling replaces a preliminary injunction she placed on the provision earlier this month.

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Talwani wrote in her Monday ruling that defunding Planned Parenthood will result in the closure of clinics that inevitably will have “adverse health consequences where care is disrupted or unavailable.”

“In particular, restricting Members’ ability to provide healthcare 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 wrote. 

The judge also argued that the Planned Parenthood closures will lead to decreased access to contraceptives in underserved communities. She wrote that this will lead to a “corresponding increase in the number of unintended pregnancies” and therefore “will likely result in an increased number of abortions.” 

The provision in the bill prohibited, for one year, Medicaid reimbursements to any healthcare provider receiving more than $800,000 annually in Medicaid funds that also provides abortion services. That includes both Planned Parenthood and a larger abortion provider, Maine Family Planning, which filed its own lawsuit against the Trump administration.

Although the pre-existing Hyde Amendment prohibits any federal spending directly on abortion provision, anti-abortion advocates have long argued that any funding for abortion providers also subsidizes abortion because of the fungibility of money.

According to Planned Parenthood’s 2023-2024 fiscal report, the organization received just shy of $800 million in federal grants or reimbursements, most of which came from Medicaid. The organization also performed more than 400,000 abortions nationwide. 

Planned Parenthood sued the Trump administration within days of the tax bill being signed, drawing the ire of the Department of Justice.

DOJ chief of staff Chad Mizelle earlier this month derided the temporary injunction as “lawless” and “highly unusual,” considering that the preliminary injunction was granted less than a week after the bill was signed into law.

The injunction against the Planned Parenthood defunding effort will likely add fuel to Republican claims of rampant judicial activism thwarting the Trump administration’s Make America Great Again agenda. 

Lila Rose, president of the anti-abortion organization Live Action, said in a statement that the ruling from Talwani, who was appointed by President Barack Obama in 2014, “is a blatant act of judicial overreach.”

“Congress passed the One Big Beautiful Bill with clear language and intent to stop the forced taxpayer funding of abortion,” Rose said. “This unelected judge has decided that her personal pro-abortion agenda matters more than the law.”

The House version of the GOP tax bill originally prevented Medicaid reimbursements from Planned Parenthood for 10 years, but closed-door negotiations in the Senate resulted in the defunding measure being shortened to only one year, expiring in July 2026. 

It’s still unclear why that happened, but anti-abortion advocates have debated to what degree the one-year defund should be considered a victory for their cause, especially considering the protracted legal fight to come. 

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Rose called on the Trump administration to continue fighting the judge’s injunction and even called on the Supreme Court to intervene if necessary.

“Every day this activist ruling stands, millions of taxpayer dollars are at risk of being funneled into an industry built on violence, deceit, and exploitation,” Rose said.