Defunding Planned Parenthood: Section 71113, Lawsuits, and 2026

Defunding Planned Parenthood took its most consequential form on July 4, 2025, when President Trump signed the One Big Beautiful Bill Act. Section 71113 of that law bars Planned Parenthood and a small number of similar providers from receiving any federal Medicaid reimbursement for one year, through July 3, 2026. The ban covers every service those providers deliver to Medicaid patients, not just abortion. Every legal challenge has been dismissed, no injunction is in place, and 23 Planned Parenthood health centers have permanently closed since the law took effect.¹

What Section 71113 Actually Does

The statute never names Planned Parenthood. It creates a category called “prohibited entity” and blocks federal Medicaid dollars from flowing to any provider that meets all four criteria: 501(c)(3) tax-exempt status, designation as an “essential community provider” primarily engaged in family planning and reproductive health, provision of abortions beyond the Hyde Amendment exceptions (rape, incest, life endangerment), and more than $800,000 in Medicaid funding in fiscal year 2023.²

In practice, three organizations fit the definition: Planned Parenthood, Maine Family Planning, and a Massachusetts-based provider called Health Imperatives.³ The reach is broad because the restriction covers all Medicaid reimbursements to those entities. That means Medicaid patients seeking contraception, cancer screenings, STI testing, or a routine wellness exam at a Planned Parenthood clinic can no longer have those visits paid for with federal Medicaid funds.

One boundary worth stating plainly: federal Medicaid already did not pay for most abortions. The Hyde Amendment has restricted federal abortion funding for decades. Section 71113 is not about abortion coverage. It is about cutting off Medicaid payment for everything else these providers do, unless they stop offering abortion services altogether. Senator Cindy Hyde-Smith framed the provision that way, saying providers wishing to remain in Medicaid “should simply cut elective abortion procedures from its services.”⁴

The restriction runs one year. The original draft called for a ten-year ban, cut to one during reconciliation. A Senate amendment from Patty Murray to remove the provision entirely failed 49–51.⁴

The Supreme Court Ruling That Opened the Door for States

Eight days before the law was signed, the Supreme Court decided Medina v. Planned Parenthood South Atlantic. The 6–3 ruling on June 26, 2025 held that Medicaid’s “any qualified provider” provision does not create an individual right that patients or providers can enforce in federal court.⁵

The case came out of South Carolina, which had excluded Planned Parenthood from its Medicaid program solely because the organization provided abortions. Writing for the majority, Justice Gorsuch reasoned that Medicaid is a spending-power statute, so Congress’s main enforcement tool is withholding federal funds from noncompliant states rather than private lawsuits.⁶ Justice Jackson dissented, pointing to the provision’s title, “Free Choice by Individuals Eligible for Medical Assistance,” and its legislative history as evidence Congress meant to give patients an enforceable right to choose their provider.⁵

The practical effect stacks on top of Section 71113. At least 14 states had already tried to block Planned Parenthood from their state Medicaid programs, including Texas, South Carolina, Louisiana, and Alabama, and many of those efforts had been stopped in federal court under the free-choice-of-provider rule.⁷ After Medina, states can exclude Planned Parenthood without facing those same federal challenges.

The Lawsuits Have All Failed

Planned Parenthood and 22 Democratic-led states plus the District of Columbia filed separate challenges shortly after enactment. Both won early rulings from U.S. District Judge Indira Talwani. In the Planned Parenthood suit, Talwani found the provision likely to be an unconstitutional bill of attainder and a First Amendment retaliation against a specific organization.⁸ In the states’ suit, she ruled on December 2, 2025 that the definitions of “affiliates” and “subsidiaries” were unconstitutionally vague and that states had not received the clear notice the Constitution’s spending clause requires.⁹

Both rulings were reversed. On December 12, 2025, a First Circuit panel held that Section 71113 was neither a bill of attainder nor a violation of equal protection or the right of association, describing it as “a lawful exercise of Congress’ taxing and spending power.”¹⁰ On December 30, 2025, the same court stayed the injunction in the states’ case, allowing enforcement to resume in the 22 states and D.C.³

Planned Parenthood voluntarily dismissed its lawsuit on January 30, 2026, saying that after the First Circuit ruling the case was “no longer the best way to accomplish” its goal.¹¹ California’s separate challenge was dismissed on March 17, 2026. No active litigation remains, and enforcement is proceeding without any court order restraining it.³

What Patients Are Losing

Planned Parenthood operates more than 600 health centers serving over two million patients a year, and more than half of those patients rely on Medicaid. The organization provided an estimated $700 million in care annually to Medicaid patients before the law took effect.¹² Its most recent annual report documented 9.9 million services delivered to 2.09 million patients, including more than 5.5 million STI tests and treatments, nearly 2.3 million contraceptive services, and roughly 389,000 cancer screenings.¹³

Since January 2025, 57 Planned Parenthood clinics across 20 states have closed or consolidated. The driver is the combined loss of Medicaid reimbursements and a separate withholding of Title X family planning grants earlier that year.¹⁴ Sixty-four percent of Planned Parenthood health centers sit in rural or medically underserved areas, and in many of those communities the organization is the only reproductive health provider available.¹²

A March 2026 Senate report authored by Senators Elizabeth Warren, Ron Wyden, Chuck Schumer, and 23 colleagues tracked the service drop in the first six months after enactment. Breast exam visits at Planned Parenthood fell 25% compared to the same period the year before. Birth control pill visits dropped 20% in November 2025, and visits for long-acting reversible contraceptives like IUDs fell 41% that month.¹⁵ Maine Family Planning shut down primary care services at three of its 18 sites.³

Five California clinics closed, in South San Francisco, San Mateo, Gilroy, Santa Cruz, and Madera, affecting 22,000 patients. Planned Parenthood Mar Monte, a major California affiliate, ended primary care, behavioral health, and prenatal care services and faced a projected $100 million loss in Medicaid payments.¹⁶ Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America, said that as a result of the closures, “tens of thousands of people now have few, if any, options to get the lifesaving care they need.”¹⁴

Can Community Health Centers Absorb the Patients?

Supporters of Section 71113 have argued that Federally Qualified Health Centers can pick up the load. A Congressional Research Service analysis pointed to obstacles. Nearly 95% of existing health centers already have clinical vacancies, and research shows they have longer wait times for new Medicaid patients than other facility types.¹⁷

The two provider types also serve different populations differently. Planned Parenthood affiliates specialize in family planning for reproductive-age patients; community health centers deliver comprehensive primary care across the lifespan. In fiscal year 2014, Planned Parenthood affiliates provided 2.9 million contraceptive services, compared with 1.4 million at community health centers the following year. Even where both facility types exist in the same county, national data cannot confirm the health centers are geographically close enough to replace specific Planned Parenthood sites.¹⁷ The Senate Democrats’ report reached the same conclusion, finding that Federally Qualified Health Centers are “unable to replace the care previously provided by the closed Planned Parenthood facilities.”¹

How States Are Backfilling

Eleven states have committed their own money to offset the federal loss, with wide variation in scale. California allocated more than $140 million, and Governor Newsom signed a February 11, 2026 measure providing an additional $90 million emergency grant. New York and Washington committed to cover the full funding gap using state-only dollars for Medicaid claims. Colorado passed legislation guaranteeing state reimbursement for “prohibited entities” with no specified dollar cap.¹⁸

Smaller allocations came from Connecticut ($8.5 million), New Jersey ($8 million), Oregon ($7.5 million), Maine ($6 million with a proposal for $2.25 million more), Illinois ($4 million), New Mexico ($3 million), and Massachusetts ($2 million).¹⁸ Planned Parenthood put the combined state commitments at roughly $200 million and described a remaining “critical gap of hundreds of millions of dollars.”¹² In states that have not stepped in, Medicaid patients at affected providers are largely left without coverage for those services.

What Happens After July 4, 2026

The one-year restriction is scheduled to expire on July 4, 2026, and Republican lawmakers have moved to extend it. In January 2026, the Republican Study Committee released a framework for a 2026 reconciliation package that included permanent defunding of Planned Parenthood.¹⁹ During the week of April 24, 2026, the Senate rejected an amendment from Senator Josh Hawley that would have extended the existing ban, and Republican leaders were reportedly struggling to hold their conference together on the issue.²⁰

A standalone bill, the Defund Planned Parenthood Act of 2025 (H.R. 271), was introduced on January 9, 2025 by Representative Michelle Fischbach with more than 40 cosponsors. It would impose a one-year moratorium on all federal funding to Planned Parenthood and its affiliates unless they certify they will not perform abortions, while authorizing $235 million in additional funding for community health centers. The bill remains in the House Committee on Energy and Commerce and has not been folded into the reconciliation package.²¹²²

A separate funding stream is also on the table. In spring 2025, the Trump administration withheld Title X family planning grant payments to 144 Planned Parenthood sites in 20 states. By June 2026, only 247 Planned Parenthood clinics in 29 states participated in Title X, down from nearly 300 clinics in 34 states the previous year.²³ The withheld funds were released in December 2025, and the ACLU voluntarily dismissed its lawsuit.²⁴ The president’s fiscal year 2027 budget, released April 3, 2026, proposed eliminating Title X entirely by giving it zero funding. Title X is the only federal program dedicated specifically to affordable birth control, cancer screenings, and sexual and reproductive health care.²⁵ Whether the Medicaid ban is extended, made permanent, or joined by a Title X elimination will depend on whether Republican leaders can assemble the votes for a new reconciliation package, which as of spring 2026 remained unresolved.

1
Planned Parenthood. New Senate Report Finds Patients Lost Access to Care After Planned Parenthood Defunding
2
National Health Law Program. OBBBA’s Medicaid Abortion Provider Defund: An Overview
3
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4
U.S. Senate – Senator Cindy Hyde-Smith. Planned Parenthood Defunding Can Stay in Budget Bill, Senate Parliamentarian Rules
5
SCOTUSblog. Court Decides Against Planned Parenthood
6
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7
KFF. SCOTUS Ruling on Medina v. Planned Parenthood Will Limit Access to Care for Patients in South Carolina and Beyond
8
The New York Times. Judge Blocks Trump Administration From Enforcing Planned Parenthood Medicaid Policy
9
Politico. Judge Blocks Provision of Law That Strips Medicaid Funding for Planned Parenthood Affiliates
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Casemine. Planned Parenthood Federation of America v. Kennedy
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13
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24
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