In a surprise move Thursday, the First Circuit Court of Appeals allowed the budget reconciliation law provision designed to “defund” Planned Parenthood to take effect. The provision was written so as to make many of Planned Parenthood’s regional affiliates, along with some other large abortion providers, ineligible for the Medicaid program, threatening their ability to keep their doors open. All three judges on the panel were appointed by former President Joe Biden.
Planned Parenthood had previously warned that, if the “defund” took effect, 200 of its clinics could close across 24 states—most in states where abortion is still legal. The organization referred to the bill as a “backdoor” abortion ban. On Friday morning, Planned Parenthood Federation of America (PPFA) president and CEO Alexis McGill Johnson said on a press call that PPFA “created an option” for some of its 47 affiliates to stop providing abortions in order to “preserve as much Medicaid funding for reimbursement” as possible.
An appeals court is letting the Trump administration “defund” Planned Parenthood by icing it out of Medicaid. In a press call, I asked Planned Parenthood CEO Alexis McGill Johnson if the group is considering letting affiliates stop providing abortions to preserve federal funding. She confirmed it:
— Carter Sherman (@cartersherman.bsky.social) 2025-09-12T14:16:30.157Z
McGill Johnson’s comments appeared to confirm our previous reporting from June about allowing affiliates to halt abortions, though at the time PPFA suggested our story was “misleading” and “false.”
However, hours later, a PPFA spokesperson walked back the CEO’s statement in response to questions from Autonomy News. “Planned Parenthood providers will continue to provide abortion everywhere it is lawful to do so,” the spokesperson said. They added that McGill Johnson should have used the past tense to convey that the national organization had previously considered allowing affiliates to opt out of providing abortion care to preserve Medicaid eligibility. They also claimed that the appeals court decision made the entire discussion moot.
"The decision last night applies to every single affiliate, whether they provide abortion or not,” a second spokesperson said. “There's not a world in which someone could change what services they offer in order to maintain that eligibility, because it is the act of being a Planned Parenthood that makes them ineligible in the eyes of the bill." The Department of Health and Human Services has advanced this argument in court, but neither the law’s text (see page 230) nor the judges’ two-page ruling say that all 47 affiliates are ineligible to participate in Medicaid. PPFA is an umbrella organization that oversees the affiliates but does not provide medical care.
The budget provision targets abortion providers that received more than $800,000 in Medicaid reimbursement in fiscal year 2023 and makes them ineligible to participate in Medicaid for one year starting on October 1. The Hyde Amendment already prohibits federal funds from being used to pay for abortions except in cases of rape, incest, or to save the life of the pregnant person, so abortion providers typically only receive Medicaid reimbursement for non-abortion services like birth control, STI testing, cancer screenings, and vaccinations. Many Planned Parenthood health centers also provide gender-affirming care. Nearly 40 Planned Parenthood clinics have already closed this year, and these closures—with more expected—will wreak havoc on people’s ability to access basic medical care.
McGill Johnson told us: "Planned Parenthood reaffirms its commitment to providing abortion in every state where it is still legal to do so, which is core to the Planned Parenthood mission." That commitment comes after the appeals court foreclosed other options in the eyes of the organization.
In June, Autonomy News was the first to report that PPFA had announced a plan to allow affiliates to stop providing abortion care in a bid to remain eligible for Medicaid. At the time, the working draft of the budget reconciliation bill would have “defunded” abortion providers for 10 years, rather than just one. Currently, abortion care is considered a “core service,” meaning that every PPFA affiliate with clinics located in states where abortion is legal is required to offer abortion care at at least one site. A new accreditation waiver would have allowed affiliates to apply for an exemption from this requirement. A separate waiver would have allowed affiliates still providing abortion care to advertise those services in other affiliates’ territory, something that’s usually forbidden. It’s possible that Planned Parenthood Direct, a standalone telemedicine service that does not accept insurance, may have also come into play to fill gaps in care under such a plan.
At the time, PPFA repeatedly denied plans to move away from abortion care broadly, but never directly denied our reporting about the waivers. “There are many potential options we are interrogating to move forward with preserving our Medicaid patients’ access to care, and none of them would result in a voluntary reduction in access to abortion for patients,” PPFA told Autonomy News in June. “Providing abortion care everywhere it’s still legal is not up for negotiation."
Following publication of our original story, Autonomy News received additional information confirming our reporting, including a tip that PPFA had conversations with philanthropists to secure funding for a new framework.
We also obtained an internal email sent hours after our story was published with the subject line “Combatting Misleading & Inaccurate Reporting on PPFA & Planned Parenthood Affiliates.” The email was sent to national office staff as well as the CEOs, medical directors, and media teams at affiliates. It offered message guidance and talking points for responding to “tricky” questions from donors and supporters, and directed recipients who receive questions from reporters to involve communications staff from the national office. In that email, PPFA accused Autonomy News of “falsely alleging that Planned Parenthood would step back from abortion provision in an attempt to preserve Medicaid.” We never reported that the entire federation would halt abortions; we reported that affiliates would be given the option to drop abortion care. They attached a PDF of our story to the email and said that it contained “false accusations.”
When asked about the email, the spokesperson said “we cannot comment on internal correspondence.”
The internal email mirrors PPFA’s public communications referencing the “defund” provision and our reporting. When Autonomy News contacted PPFA for comment about the waivers, the organization sent a statement to other members of the media before responding to our questions. The self-described “unusual” statement, which was also posted online, said that “there is not now, and has never been, a plan to stop providing abortion care in the hopes of preserving federal funding. Any claims to the contrary are an outright lie.” PPFA made similar claims in social media posts shared that day.
Planned Parenthood swiftly sued the Trump administration over the “defund” attempt in federal court. In late July, a federal district judge issued two injunctions blocking enforcement of the provision. This week, the appeals court overturned those two injunctions. Maine Family Planning, another abortion provider affected by the law, sued the administration separately. A federal judge declined to grant them a temporary injunction.
Autonomy News will continue to follow this story, including possible appeals to the Supreme Court.
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