A federal judge on Monday ruled Planned Parenthood clinics nationwide must continue to be reimbursed for Medicaid funding as the nation’s largest abortion provider fights President Donald Trump’s administration over efforts to defund the organization in his signature tax legislation.

The new order replaces a previous edict handed down by U.S. District Judge Indira Talwani in Boston last week. Talwani initially granted a preliminary injunction specifically blocking the government from cutting Medicaid payments to Planned Parenthood members that didn’t provide abortion care or didn’t meet a threshold of at least $800,000 in Medicaid reimbursements in a given year.

“Patients are likely to suffer adverse health consequences where care is disrupted or unavailable,” Talwani wrote in her Monday order. “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.”

A provision in Trump’s tax bill instructed the federal government to end Medicaid payments for one year to abortion providers that received more than $800,000 from Medicaid in 2023, even to those like Planned Parenthood that also offer medical services like contraception, pregnancy tests and STD testing.

In its lawsuit, Planned Parenthood had argued that they would be at risk of closing nearly 200 clinics in 24 states if they are cut off from Medicaid funds. They estimated this would result in more than 1 million patients losing care.

“We’re suing the Trump administration over this targeted attack on Planned Parenthood health centers and the patients who rely on them for care,” said Planned Parenthood’s president and CEO Alexis McGill Johnson. “This case is about making sure that patients who use Medicaid as their insurance to get birth control, cancer screenings, and STI testing and treatment can continue to do so at their local Planned Parenthood health center, and we will make that clear in court.”

The federal department of health did not immediately respond to requests for comment.

Previously, the department said it strongly disagreed with the judge’s initial order that allowed some Planned Parenthood members to receive Medicaid funding.

“States should not be forced to fund organizations that have chosen political advocacy over patient care,” said the department’s communication director, Andrew Nixon. Doing so, he said, “undermines state flexibility” and “concerns about accountability.”