A volunteer clinic escort holds a sign outside a Planned Parenthood clinic in Columbia, South Carolina, March 28, 2025. (Photo by Skylar Laird/SC Daily Gazette)
WASHINGTON — Republicans celebrated last year when they banned Planned Parenthood’s Medicaid operate for a year, predicting that the financial fallout would devastate the organization.
A year later, as part of the “big, beautiful” law expires on July 4, GOP lawmakers are trying to find a way to keep the nationwide ban in place, though they won’t be able to do so before the deadline.
This means states will now decide whether people enrolled in the lower-income program can again receive routine health care services at Planned Parenthood clinics that are still open.
Nora Walsh-DeVries, vice president of policy and legislative affairs at Planned Parenthood Action Fund, said the law forced the organization to close nearly 30 health care centers.
“The consequences for us are truly terrible, and some of them are unfortunately irreversible,” she said. “It’s also difficult to deal with what happened last year knowing that Republicans are going to permanently defund us.”
She said some Planned Parenthood clinics tried to find ways to continue treating people enrolled in Medicaid, but that ultimately proved “unsustainable” and not something any facility could handle.
The result meant that “tens of thousands of patients were denied access to essential care services like cancer screenings, which I think we can all agree is something we should want people to get when they need it, where they need it and how they need it,” Walsh-DeVries said.
Ultimately, the impact was less widespread than Planned Parenthood had originally anticipated when its president announced statement just days before the bill goes into effect, “nearly 200 Planned Parenthood health clinics in 24 states across the country are at risk of closure.”
The expiration will not impact abortion access for those enrolled in Medicaid because a decades-old appendix to government spending laws that, with confined exceptions, blocks the operate of taxpayer dollars for abortions, remains in effect.
Republicans see the closures as a victory and are trying to extend the provision in an attempt to close more Planned Parenthood clinics. They believe that any health care organization that provides abortions, even if they are not largely funded by taxpayer dollars, should not be covered by any federal health programs.
Pressure from conservatives
The House Freedom Caucus, a collection of far-right Republicans, wrote to Speaker Mike Johnson in overdue June urging him to include a similar ban in another party-line bill.
“Americans rightly expect a Republican-led Congress to deliver real results, not excuses or half-measures,” they wrote. “After years of broken promises, voters trusted us with majorities in both the House and Senate. This is our last and best chance to prove they were right to send us here to fight for them.”
They added that the next reconciliation bill must prohibit “federal funding of abortion providers to ensure that taxpayer dollars are not used to subsidize the radical abortion industry.”
Susan B. Anthony Pro-Life America President Marjorie Dannenfelser and other anti-abortion organizations are lobbying Republicans to again block Medicaid funding for Planned Parenthood.
“Condemning big abortion is now the default expectation of the pro-life movement,” Dannenfelser said in a statement. “Back in Washington, Republicans must do everything they can through reconciliation to once again block taxpayer revenue from going to Planned Parenthood and abortion providers.”
Republicans used a intricate budget reconciliation process to pass their “big, beautiful” law and a $70 billion package to fund immigration enforcement. The special process allowed GOP leaders to bypass procedural Senate votes that would otherwise require bipartisanship, as long as each provision affects federal revenues or spending that is not deemed “merely incidental” by that chamber’s parliamentarian.
A tight system
Subasri Narasimhan, director of research at the Center for Reproductive Health, Law and Policy at the University of California, Los Angeles, says there are often no other health centers that can cover the gaps left by the closure of Planned Parenthood or the failure to reimburse a person enrolled in Medicaid.
“We have a pretty tight health care system in many different ways, but we have an extremely tight system when it comes to reproductive health care,” Narasimhan said.
She said some state governments have tried to plug budget holes created over the past year, although they ultimately were unable to fully offset the loss of federal funds.
She said Republicans’ reinstatement of the same ban on Medicaid payments for non-abortion health care services would likely cause more people in the program to delay or skip preventive care altogether.
“We’re looking at people who are quite vulnerable and often rely on Planned Parenthood as their primary source of care,” she said. “So there is no way to look for another health center.”
Kathleen Adams, a professor at the Rollins School of Public Health at Emory University, said that if the program can vary by state, it will, and this was no exception.
“I see states finding contingency funds, other ways to give funds to Planned Parenthood, to kind of keep that part of their system active,” she said.
There are also other programs and clinics, such as federally qualified health centers and safety net providers, that Adams said could play a role in filling some of the gaps.
“I remain heartened about the Planned Parenthood provisions because states are aware of these issues,” she said. “And if they don’t provide access to contraceptives, they are more likely to experience unintended pregnancies or pregnancies among uninsured women.”
State action
– wrote Laurie Sobel, deputy director of women’s health policy at KFF post that after the nationwide moratorium expires, a overdue June 2025 Supreme Court ruling will allow state governments to block certain health care providers, such as Planned Parenthood, from participating in their Medicaid programs.
“This ruling marked a significant departure from established interpretations of the Medicaid ‘free choice of provider’ provision, which guarantees enrollees the right to obtain care from any qualified and willing Medicaid provider,” Sobel wrote.
Sobel’s analysis found that Alabama, Arizona, Arkansas, Florida, Iowa, Kansas, Louisiana, Mississippi, Missouri, Nebraska, Oklahoma, South Carolina and Texas have blocked or attempted to block Medicaid reimbursements to Planned Parenthood.
She wrote that other states “may follow suit” after the nationwide Medicaid ban expires on July 4.
