This Wednesday, a federal appeals court is set to deliberate on whether a spending law enacted in July, which halted Medicaid reimbursements to Planned Parenthood, should remain in place amid ongoing legal battles.

The legislation, part of President Donald Trump’s tax and spending reduction initiative, specifically targets organizations that both conduct abortions and receive over $800,000 annually in Medicaid reimbursements. Planned Parenthood contends that this law infringes upon constitutional rights, while it has garnered support from those opposing abortion.

The 1st Circuit Court of Appeals in Boston previously allowed the law to take effect in September, during the ongoing examination of Planned Parenthood’s legal objections by a lower court. A panel of three judges will oversee the arguments on Wednesday in Boston.

In anticipation of the hearing, Planned Parenthood released a report indicating that the legislation resulted in a $45 million deficit in September alone. This shortfall occurred as clinics nationwide were compelled to cover the costs of Medicaid patient care out of their own budgets, a situation the organization deems unsustainable.

Approximately half of Planned Parenthood’s clientele depends on Medicaid for healthcare services unrelated to abortion, a procedure already excluded from federal insurance coverage for low-income and disabled Americans under Medicaid.

Legal fight

Planned Parenthood Federation of America and its member organizations in Massachusetts and Utah, as well as a major medical provider in Maine, filed lawsuits against Health and Human Services Secretary Robert F. Kennedy Jr. in July. The Maine provider has been forced to stop it’s primary care services while its lawsuit works its way through the courts.

In the meantime, seven states — California, Colorado, Massachusetts, New Jersey, New Mexico, New York and Washington — have directed state funds to compensate for lost federal Medicaid reimbursements.

That has covered roughly $200 million of the $700 million that the organization spends annually on Medicaid patients, according to Planned Parenthood.

In light of the shortfall, some clinics will force Medicaid patients to pay out of pocket while others will close altogether, adding to the 20 Planned Parenthood affiliated clinics that have closed since July and the 50 total that have closed since the start of Trump’s second term.

Abortion at the heart of the debate

Carol Tobias, president of the National Right to Life Committee, said Trump’s legislation is a step in the right direction. Even though federal tax dollars aren’t used for abortions directly, she said taxpayers are contributing to abortion services even if they are morally or religiously opposed since Medicaid reimbursements help organizations that provide them stay afloat.

“To be forced to pay for that is just very objectionable,” Tobias said.

She suggested Planned Parenthood could stop offering abortions if it wanted to keep providing medical care to vulnerable populations.

Planned Parenthood’s president has doubled down on the organization’s commitment to providing abortions.

“The government should not play a role in determining any pregnancy outcomes,” Johnson said.

A range of services hit

Planned Parenthood is the country’s largest abortion provider, but abortions only constituted 4% of all medical services in 2024, according to the organization’s annual report. Testing for sexually transmitted infections and contraception services make up about 80%. The remaining 15% of services are cancer screenings, primary care services and behavioral health services.

Jenna Tosh, CEO of Planned Parenthood California Central Coast, said in an interview that the Medicaid cuts threaten abortion and non-abortion medical care in equal measure. Roughly 70% of patients who use Planned Parenthood California Central Coast rely on Medicaid, she said.

“Many of our patients, we are their primary provider of health care,” Tosh said. “You really start pulling at the thread of the entire health care safety net for the most vulnerable people.”

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The story has been corrected to show that the hearing Wednesday is before a judicial panel of the 1st Circuit Court of Appeals, not before a federal judge.