Supporters attend a rally outside the federal courthouse where a federal appeals court will consider whether U.S. President Donald Trump's administration may implement a provision that would deprive Planned Parenthood and its members of Medicaid funding, in Boston, Massachusetts, U.S., November 12, 2025. / REUTERS/Brian Snyder
A federal appeals court ruled on Dec. 12 that a provision of U.S. President Donald Trump's signature tax and domestic policy bill that deprives Planned Parenthood and local affiliates that perform abortions of Medicaid funding is not an unconstitutional punishment.
The Boston-based 1st U.S. Circuit Court of Appeals overturned a preliminary injunction issued in July by a lower-court judge who had concluded that the law likely violated the U.S. Constitution by targeting Planned Parenthood's health centers as punishment for providing abortions.
Planned Parenthood says at least 20 health centers have closed since Trump signed the measure into law in July. The appeals court allowed it to take effect in September while it considered the administration's appeal of U.S. District Judge Indira Talwani's injunction.
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Talwani recently in a different case also blocked the law's enforcement in 22 Democratic-led states and the District of Columbia that had also challenged it on different grounds. But the appeals court has temporarily stayed that ruling while it considers whether to lift her injunction while it reviews that case.
Alexis McGill Johnson, who heads Planned Parenthood Federation of America, in a statement said Dec. 12's ruling enables the Trump administration's "attempts to block access to care for patients most in need and force Planned Parenthood health centers to the financial brink."
At issue is a provision in the One Big Beautiful Bill Act, passed by the Republican-led Congress, that bars Medicaid funding for non-profits that provide family planning services if they perform abortions and received more than $800,000 from the government healthcare program during the 2023 fiscal year.
In preventing the U.S. Department of Health and Human Services from enforcing the law in July, Talwani held that it amounted to a "bill of attainder" designed to punish Planned Parenthood for providing abortions.
A bill of attainder is a legislative act prohibited by the Constitution that seeks to inflict punishment on a person or group without a trial.
But U.S. Circuit Judge Gustavo Gelpi, writing for a panel of three judges appointed by Democratic President Joe Biden, said the law "simply does not impose 'punishment' as the term has been historically understood."
"It instead uses Congress' taxing and spending power to put appellees to a difficult choice: give up federal Medicaid funds and continue to provide abortion services or continue receiving such funds by abandoning the provision of abortion services," Gelpi said.
The administration on appeal had argued there was nothing unlawful about Congress enacting a law restricting Medicaid funding from flowing to major providers of abortion after the 6-3 conservative majority U.S. Supreme Court in a landmark 2022 ruling overturned the nationwide right to terminate pregnancies.
Talwani had also blocked the law's implementation on the grounds that it burdened the right of some Planned Parenthood affiliates that do not provide abortions to associate with their parent organization in likely violation of the Constitution's First Amendment, which protects the right to free speech.
But the 1st Circuit overturned that holding, narrowly construing the law to cover only affiliates to the extent they operate under common corporate control with prohibited entities.
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