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The legal battle over the defunding of Planned Parenthood reached a new milestone this week, with a federal order blocking enforcement of a key provision of President Donald Trump’s One Big Beautiful Bill. Planned Parenthood had previously won an injunction blocking enforcement of the measure, which would defund the organization, only to see that order reversed by the 1st Circuit Court of Appeals. In a suit brought by 22 states, the same federal judge issued an entirely different order blocking the defunding. The argument in the states’ case seems stronger than the one made by the Planned Parenthood plaintiffs. That’s hardly a guarantee if—and when—the Supreme Court’s conservative supermajority gets involved, but the ruling, and the publicity it might draw, can still make a difference. The longer the state plaintiffs can keep funding for Planned Parenthood alive, and make sure the issue remains in the public eye, the more likely it becomes that Republicans will use the abortion issue to shoot themselves in the foot in 2026.
The One Big Beautiful Bill represents the anti-abortion movement’s most significant win in Trump’s second term. The bill bars Medicaid funding for certain “prohibited entities,” which are defined to include 1) nonprofits that 2) qualify as “essential community providers” under federal law, 3) offer abortion, and 4) primarily engage in reproductive health, family planning, and related medical care. The defunding measure is scheduled to expire before the 2026 midterms.
The provision almost immediately sparked legal challenges. Planned Parenthood’s separate lawsuit asserts that the provision improperly penalizes affiliates that don’t provide abortions for aligning with an organization that does (and that advocates for reproductive rights). Arguments in this vein persuaded Judge Indira Talwani, an Obama nominee, to issue an injunction earlier this year, but the 1st Circuit reversed that decision. Since then, at least 20 Planned Parenthood affiliates have been forced to close.
This week, Talwani issued an injunction in an entirely different case brought by more than 20 state plaintiffs. The states don’t focus on the idea that the bill targets or punishes Planned Parenthood. Instead, the plaintiffs claim that it is hard to figure out exactly what the One Big Beautiful Bill requires them to do. They rely on doctrine developed under the spending clause of the Constitution. When Congress relies on the spending clause to pass legislation, the Supreme Court has held that lawmakers must make clear any conditions on federal funding. That’s because the clause is supposed to operate like a contract: Congress offers federal funds subject to certain terms, and states can make an informed choice by identifying which strings are attached to the money.
The states argue that the One Big Beautiful Bill doesn’t make its conditions clear enough because it’s hard to determine who falls into the category of prohibited entities. The legislation doesn’t define reproductive health or family planning or explain how to determine whether a provider “primarily” offers this kind of service. The bill also has a funding threshold for prohibited entities, which must have had at least $800,000 in Medicaid expenses in 2023. The states point to this requirement too, arguing that it would be difficult to calculate such expenditures for interstate organizations like Planned Parenthood when they usually track only their own Medicaid expenditures.
The Trump Department of Health and Human Services responds that it really isn’t that hard to identify such providers, especially when they’re affiliated with Planned Parenthood. But in the Planned Parenthood litigation, the administration has stressed that the One Big Beautiful Bill targets not just Planned Parenthood. Talwani is convinced that Congress didn’t provide clear enough guidance to states about who else is subject to the defunding measure—and forced states to shoulder Medicaid expenses themselves if a provider guessed incorrectly about whether they fell into the category Congress had in mind.
The state plaintiffs might not do any better than Planned Parenthood as this case heads for a potential reckoning at the Supreme Court. The Trump administration argues that at most, Congress needs to make clear that there is a condition on spending; it doesn’t specify that legislators spell out exactly what it is or how states can fulfill it. The argument isn’t a slam dunk: In litigation about the Biden administration’s COVID-era American Rescue Plan Act, some circuit courts held that the spending clause required that the precise obligations of a funding condition be apparent too. Ironically, SCOTUS hasn’t made especially clear under the clause precisely how clear a condition needs to be.
If the case lands before the court, the conservative supermajority may ultimately reject the states’ argument. But the more this litigation can preserve funding for providers like Planned Parenthood, and the more the issue remains in the news, the worse that will be for the congressional Republicans whose votes would be needed to extend defunding.
Planned Parenthood facilities have devised a number of strategies to weather defunding before 2026. Some states have announced additional funding; other providers have surrendered their status as essential community providers or hoped to cover some lost funds through private donations. There’s no question that the longer defunding lasts, the harder it will be for Planned Parenthood to manage.
There’s the rub for congressional Republicans. Months before the midterms, they will have to decide whether to extend defunding or allow the related provision to expire. The Republicans who passed the One Big Beautiful Bill may have hoped to avoid this political Hobson’s choice by making defunding temporary. That way, members running in swing districts could dodge an abortion issue that still could wound the GOP, while the damage to Planned Parenthood would already be done. The more time this litigation can buy, the easier it will be for Planned Parenthood to find ways around the bill, and the higher the stakes will become for a potential defunding vote next year.
Increasingly, it seems that Republicans in Congress will throw caution to the wind and make the defunding permanent. After all, Senate Republicans seem ready to let health care costs skyrocket unless Democrats agree to stringent new abortion regulations for the Affordable Care Act.
All of that suggests that the GOP fundamentally misunderstands what happened in the 2024 election. Stressing abortion wasn’t enough to get Kamala Harris across the line, but it’s a stretch to believe that opposing reproductive rights helped Republicans. Trump, after all, tried to avoid the issue; many congressional Republicans echoed his promise to leave the issue to the states. Ballot-initiative wins and polls suggest that Americans don’t like abortion bans any more than they did in 2023, and special election results have been ominous for the GOP.
Strangely, what the party seems to have taken from all of this is that foregrounding its opposition to abortion will help it win. Whatever else comes of the defunding litigation, it has set a political trap for congressional Republicans, and from the looks of it, they may be ready to walk right in.
