A federal judge has blocked a provision in the recent Big Beautiful Bill Act passed by Congress and signed by the president earlier this month that cut Medicaid funding to Planned Parenthood and other organizations offering abortion services, saying the measure might lead to an “increase in unintended pregnancies.”

U.S. District Judge Indira Talwani of Boston issued a preliminary injunction on Monday, replacing a ruling from last week that protected only specific branches of Planned Parenthood. The new order blocks the implementation of a statute in the law that aimed to strip Medicaid funding from healthcare providers receiving more than $800,000 annually if they also performed abortions.  

“Patients are likely to suffer adverse health consequences where care is disrupted or unavailable,” the judge, who was appointed to the bench by President Obama, wrote in her ruling. “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.”  

Judge Talwani emphasized that the order does not prevent the federal government from regulating abortion nor does it require the government to fund elective abortion procedures. However, the decision prohibits excluding healthcare providers like Planned Parenthood from Medicaid reimbursements when such organizations have demonstrated a strong likelihood of success in challenging the law.

Reaction from conservative voices on social media was swift and savage. “Judge Indira Talwani says your tax dollars MUST continue funding Planned Parenthood, even after Congress cut them off, because of ‘unintended pregnancies,’” Senator Lee of Utah, a Republican, wrote on X. “Where is the ‘too many babies’ clause of the Constitution?”

“Another insane, lawless ruling by another Democrat activist judge,” the founder and president of the Article III Project, Mike Davis, wrote on X. “Boston Obama Judge Indira Talwani held it’s (somehow) unconstitutional for Congress to cutoff funding to Planned Parenthood. The Supreme Court must fix this, if the First Circuit refuses.”

The contested legislation, part of Mr. Trump’s domestic policy package signed into law on July 4, seeks to bar Medicaid funding to providers “primarily engaged in family planning services, reproductive health, and related medical care” if they also offer abortion services. Although the statute does not explicitly mention Planned Parenthood by name, its leaders argue that the measure was intended to target the organization, which operates nearly 600 centers across 48 states.

Judge Talwani’s decision underscores that claim, citing both the legislative history and statements by lawmakers. She wrote that the law’s purpose was “to single out Planned Parenthood Federation and its Members for punishment,” adding that such comments confirmed Congress’s punitive intent. She said the law violates Planned Parenthood’s First and Fifth Amendment rights and amounts to an unconstitutional “bill of attainder” punishing the organization without a trial.

Planned Parenthood officials welcomed the ruling, highlighting the potentially devastating consequences of losing Medicaid funds. According to the organization, nearly 200 clinics in 24 states would be at risk of shutting down, jeopardizing services for more than a million patients. 

Planned Parenthood Federation of America and affiliates in Massachusetts and Utah sued the Department of Health and Human Services secretary, Robert F. Kennedy Jr., earlier this month, not long after the legislation was signed by Mr. Trump.  

“We’re suing the Trump administration over this targeted attack on Planned Parenthood health centers and the patients who rely on them for care,” Planned Parenthood’s president and chief executive, Alexis McGill Johnson, said in a statement. “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 Trump administration previously stated its disagreement with Judge Talwani’s original ruling. “States should not be forced to fund organizations that have chosen political advocacy over patient care. Doing so undermines state flexibility and raises concerns about accountability,” an HHS spokesman, Andrew Nixon, said in a statement earlier this month.