Federal judge orders Medicaid money released to Planned Parenthood in Pa., 21 other states and D.C., pending 1st Circuit appeal

Department of Health and Human Services “disappointed,” appeals.

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  As the democracy reporter for WITF, I will cover any kind of story that has to do with how we govern ourselves. That will include doing a lot of election coverage about how to access the ballot, how public officials administer elections, the technology used to run and secure elections, and the laws that govern it all.
  
  My work will also include accountability coverage for elected officials that use their positions to then undermine democratic institutions, like the legislators that voted against the certification of the presidential election results on January 6, 2021. If that weren’t enough, I foresee covering some local government decisions, fights over public records and transparency, and some candidate coverage around the major elections. As seen in my coverage of immigrant of LGBTQ+ communities, I also report on the consequences of elections for minority groups.

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The door to Planned Parenthood in Harrisburg, part of the Keystone network, listing hours and security measures on Sept. 30, 2025.

Editor’s note: This story has been updated to include the U.S. Department of Health and Human Services’ appeal of the district court decision. 

Update: After appeal by the U.S. Department of Health and Human Services, a three-judge panel of the federal 1st Circuit Court of Appeals on Dec. 30, 2025, stayed the district court’s approval of the preliminary injunction. The decision means the federal government will not be required to release the Medicaid funding while the lawsuit is ongoing.

Gov. Josh Shapiro and Planned Parenthood Keystone are praising a preliminary ruling from a federal court judge in Boston that orders the federal government to restore funding to health care centers that also provide abortions. 

Shapiro joined 21 other states and Washington, D.C., in jointly suing the U.S. Department of Health and Human Services over a provision in the Republican tax and funding package passed in July. The bill prohibits federal health care money allocated through Medicaid from going to health care centers that provide abortions for one year.

“Governor Shapiro firmly believes women deserve to make their own health care choices about their own bodies, and he will continue to be the backstop to protect reproductive care here in Pennsylvania,” said Kayla Anderson, a spokesperson for the governor’s office.

Anderson called the ruling “a win for Pennsylvanians” and said it “protects critical access to the lifesaving care provided by Planned Parenthood,” but the win may be short-lived. 

Planned Parenthood previously sued over the same provision and won a similar injunction at the district court level, only to have a federal appeals court put a hold on that order while the full case plays out. Melissa Reed, who leads Planned Parenthood Keystone, which runs centers in central Pennsylvania, said she expects a similar dynamic to happen in this case. 

U.S. Department of Health and Human Services press secretary Emily G. Hilliard said the department is “disappointed” in the decision. The agency filed a notice of appeal on Thursday, meaning it will ask the 1st Circuit Court of Appeals to review the district court’s decision.

“We remain committed to protecting the integrity of Medicaid programs to ensure full compliance with the law and conditions set by Congress,” Hilliard said. 

The White House did not respond to questions about the case. 

Regardless of the case’s outcome, Reed said Planned Parenthood Keystone would continue to provide care. 

“We are currently serving Medicaid patients at no charge,” Reed said. “If the defund is ultimately upheld, we will still provide care to Medicaid patients through our self-pay sliding scale.”

People who access Medicaid, in addition to being poor, are typically young and disproportionately people of color, per federal data. 

According to Planned Parenthood, its Pennsylvania clinics saw 17,577 Medicaid patients in the 2024 fiscal year, with Keystone serving 5,253 patients. Previously, a clinic would provide care to a person on Medicaid then bill the program for reimbursement. The ban has created a $1.7 million hole in Planned Parenthood Keystone’s budget, or about 5% of total operations, Reed said in September.

The Republican funding ban blocks federal reimbursement for prenatal care, birth control, breast and cervical cancer screenings and testing for sexually transmitted diseases, as well as other family planning, maternal health care and sexual health services provided at Planned Parenthood centers. 

Federal funding cannot be used to pay for abortions unless the medical procedure is needed to save the life of the pregnant person or the pregnancy results from rape or incest, according to the 1977 Hyde Amendment passed by Congress. 

Likely unconstitutional 

In U.S. District Judge Indira Talwani’s order Tuesday evening, she said the ban on funding disbursement is likely unconstitutional and the Department of Health and Human Services must restore the regular distribution of Medicaid funding. 

She ruled on a legal tool called a “preliminary injunction.” Lawsuits can take years to complete, so when a group believes it likely will win a case and is immediately facing harm, it can ask the court to “enjoin,” or prohibit, the harmful act until the full case is decided. 

Here, Talwani ruled that Congress likely violated the Spending Clause of the U.S. Constitution. Section 71113 of the One Big Beautiful Bill Act is too vague about which entities should be banned from receiving Medicaid funding, Talwani wrote. Because states administer Medicaid along with the federal government, they also are entitled to prior notice of a major change to the program, per the ruling.

Under the new federal law, states that do not stop Medicaid payments to certain health care providers that provide abortions would have to return all spent federal funds. Because the federal government typically covers 90% of Medicaid reimbursements for family planning, that financial burden would be significant, according to a declaration filed in the case from Sally Kozak, state Medicaid director at the Pennsylvania Department of Human Services.

Additionally, because Planned Parenthood clinics provide many Medicaid-covered services, “other health facilities within a state’s care system would need to drastically expand their coverage to meet demand, which, in some instances, state systems are unequipped to do,” Talwani wrote. 

Planned Parenthood’s health centers are mainly located in rural areas of Pennsylvania, Kozak stated in her declaration, and the state does not have capacity to replace Planned Parenthood’s services should their centers close. 

“The result is likely to be an increase in unplanned pregnancies, shortened spacing between pregnancies leading to poor outcomes for both parent and baby, and lack of treatment and spread of sexually transmitted infections,” the declaration says.

A collection of interviews, photos, and music videos, featuring local musicians who have stopped by the WITF performance studio to share a little discussion and sound. Produced by WITF’s Joe Ulrich.

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