A volunteer clinic escort holds a sign in front of a Planned Parenthood clinic in Columbia, South Carolina, on March 28, 2025. (Photo by Skylar Laird/SC Daily Gazette)
WASHINGTON — Republicans celebrated last year when they banned a year of Medicaid payments to Planned Parenthood, predicting the financial impact would gut the organization.
A year later, with that section of the “big, beautiful” law set to expire on July 4, Republican lawmakers are trying to find a way to keep the statewide ban in place, although they won’t be able to do so before the deadline.
That means states will now decide whether people enrolled in the lower-income program can resume receiving routine health care services at Planned Parenthood clinics that remain 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 of its health centers.
“The effects are really terrible for us and, unfortunately, partly irreversible,” she said. “And it’s difficult to deal with what happened last year when you also know that Republicans intend to permanently defund us.”
Some Planned Parenthood clinics, she said, tried to find ways to continue treating Medicaid participants, but ultimately that was “untenable” and not something each partner could handle.
The result meant that “tens of thousands of patients were denied access to basic care services like cancer screenings. I think we can all agree that we should want people to get it when they need it, where they need it, how they need it,” Walsh-DeVries said.
The impact ended up being less far-reaching than Planned Parenthood originally predicted when the president said a statement Just days before the law took effect, it said that “nearly 200 Planned Parenthood health centers in 24 states across the country are at risk of closure.”
The phaseout will have no impact on abortion access for Medicaid enrollees because a decades-old amendment in state spending bills that, with few exceptions, prevents taxpayer dollars from being used for abortions remains in place.
Republicans see the closures as a victory and are trying to renew the provision to close more Planned Parenthood clinics. They believe that any health organization that performs abortions should not be included in federal health programs, even though most of them are not funded by taxpayer dollars.
Pressure from conservatives
The House Freedom Caucus, a coalition of far-right Republicans, wrote to Speaker Mike Johnson in overdue June urging him to include a similar ban in another party bill.
“The American people rightly expect a Republican-led Congress to deliver real results, not excuses or half-measures,” they wrote. “After years of broken promises, voters have entrusted 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 another reconciliation bill “must ban government funding of abortion providers to ensure that taxpayer dollars are not used to subsidize the radical abortion industry.”
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, and other anti-abortion organizations are calling on Republicans to again block Medicaid funding for Planned Parenthood.
“Eliminating funding for major abortions is now the standard expectation of the pro-life movement,” Dannenfelser wrote in a statement. “When they return to D.C., Republicans must do everything they can through reconciliation to once again block taxpayer dollars from Planned Parenthood and abortion businesses.”
Republicans used the sophisticated budget reconciliation process to pass their “big, beautiful” bill and the $70 billion immigration enforcement funding package. The special procedure allowed GOP leaders to bypass procedural votes in the Senate that would otherwise require a bipartisan vote, as long as each provision has an impact on federal revenue or spending that is not considered “merely incidental” by that chamber’s parliamentarian.
Tense system
Subasri Narasimhan, research director at the Center on Reproductive Health, Law, and Policy at UCLA Law School, said there are often no other health centers that can fill the gaps that arise when a Planned Parenthood closes or a Medicaid enrollee’s care is no longer reimbursed.
“We have a pretty strained health system in many ways, but when it comes to reproductive healthcare, we’re dealing with an extremely strained system,” Narasimhan said.
Some state governments, she said, tried to plug budget holes created last year but ultimately were unable to fully replace the loss of federal funding.
Republicans reinstating the same ban on Medicaid payments for health care services other than abortion, she said, would likely cause more people enrolled in the program to delay or skip preventative care.
“We are dealing with people who are very vulnerable and who often use Planned Parenthood as their primary source of care,” she said. “Therefore, there is no option to look for another health center.”
Kathleen Adams, a professor at Emory University’s Rollins School of Public Health, said if a program can vary from state to state, it will, and this is no exception.
“What I’m seeing is states finding emergency funds, other ways to funnel money 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 support fill some of the gaps.
“I don’t lose heart as much as we might otherwise over these Planned Parenthood regulations because states are aware of these issues,” she said. “And when they don’t provide access to contraceptives, uninsured women are more likely to have an unwanted pregnancy or become pregnant.”
State action
Laurie Sobel, associate director of women’s health policy at KFF, wrote in: a contribution that after the nationwide moratorium expires, a Supreme Court ruling in overdue June 2025 will allow state governments to exclude certain health care providers, such as Planned Parenthood, from participating in their Medicaid programs.
“This ruling represented a significant departure from longstanding interpretations of the Medicaid ‘free choice of provider’ provision, which guarantees enrollees the right to receive care from any qualified and willing Medicaid provider,” Sobel wrote.
According to Sobel’s analysis, Alabama, Arizona, Arkansas, Florida, Iowa, Kansas, Louisiana, Mississippi, Missouri, Nebraska, Oklahoma, South Carolina and Texas have either blocked or tried to prevent Medicaid reimbursements to Planned Parenthood.
Other states, she wrote, “could follow suit” once the statewide Medicaid ban expires on July 4.
