Health Law Daily Wrap Up, MEDICAID—1st Cir.: 1st Circuit allows HHS to enforce OBBBA’s Medicaid defunding provision against Planned Parenthood, (Sep 12, 2025)

By Sheila Lynch-Afryl, J.D., M.A.

Planned Parenthood responded that the decision “puts as many as 200 Planned Parenthood health centers at risk of closure.”

The First Circuit has allowed the federal government to enforce the provision of the One Big Beautiful Bill Act (OBBBA), Pub. L. No. 119-21 (2025), that blocks Medicaid funding for Planned Parenthood facilities. Staying the lower court’s July 21 and 28 preliminary injunctions despite its “careful consideration of the matter,” the appellate court concluded that the government defendants “have met their burden to show their entitlement to a stay of the preliminary injunctions pending the disposition of their appeals.” After the First Circuit’s decision, it is increasingly likely that this issue will land before the U.S. Supreme Court (Planned Parenthood Federation of America, Inc. v. Kennedy, No. 25-1698 (1st Cir. Sept. 11, 2025)).

Section 71113 of the OBBBA prohibits federal Medicaid funding from July 4, 2025 through July 4, 2026 for entities, including their affiliates, subsidiaries, successors, and clinics, that received more than $800,000 in Medicaid reimbursements during fiscal year 2023 and, as of October 1, 2025: (1) are nonprofit; (2) are essential community providers “primarily engaged in family planning services, reproductive health, and related medical care”; and (3) provide abortions, with exceptions for pregnancies that endanger the life of the woman or result from rape or incest.

The District of Massachusetts issued preliminary injunctions on July 21 and July 28, ultimately prohibiting enforcement of section 71113 against most Planned Parenthood facilities. The court found that the provision violates Planned Parenthood’s First Amendment rights, the Equal Protection Clause, and the Bill of Attainder Clause. On August 29 it denied the government’s motion to stay the injunctions pending appeal.

Planned Parenthood responded that the First Circuit’s decision “blocked more than 1.1 million patients from using their Medicaid insurance at Planned Parenthood health centers” and “puts as many as 200 Planned Parenthood health centers at risk of closure.”

At the end of August the District of Maine declined to block enforcement of section 71113 against a Maine family planning provider that alleged it was “collateral damage” to the provision’s attempt to defund Planned Parenthood. A lawsuit filed by 23 states alleging that the provision violates the Spending Clause is also pending in District of Massachusetts and assigned to the same judge as in the Planned Parenthood case.

The case is No. 25-1698.

Attorneys: Sharon Hogue (WilmerHale LLP) for Planned Parenthood Federation of America, Inc., Planned Parenthood League of Massachusetts and Planned Parenthood League of Utah. Abraham R. George, U.S. Attorney's Office, for Robert F. Kennedy, Jr., U.S. Department of Health and Human Services, Mehmet Oz and Centers for Medicare & Medicaid Services.

Companies: Planned Parenthood Federation of America, Inc.; Planned Parenthood League of Massachusetts; Planned Parenthood League of Utah

MainStory: TopStory CaseDecisions CMSNews CoverageNews MedicaidNews MedicaidPaymentNews ReproductiveHealthCareNews FedTracker HealthCare