A federal judge has reinforced her injunction preventing the Trump administration from withholding Medicaid funds from Planned Parenthood in light of President Donald Trump’s recently passed domestic policy legislation.

U.S. District Judge Indira Talwani issued a 14-day temporary restraining order (TRO) for Planned Parenthood Federation of America, Inc. and a number of its affiliates on Monday. The judge’s decision followed submissions from employees demonstrating the adverse impact they were experiencing due to the legislation, Section 71113(a) of the One Big Beautiful Bill Act. Nonetheless, despite acting “quickly” on the request, the judge, appointed by Barack Obama, did not elaborate on the legal basis for her decision.

Her explanation – in the form of an amended order after the administration sought to have the TRO dissolved – came on Friday.

“Where Section 71113 creates disruptions to healthcare with its implementation, a Temporary Restraining Order is necessary to prevent irreparable harm pending a hearing on Plaintiffs’ request for a Preliminary Injunction,” the Boston-based judge wrote.

“Further, at this stage, the court finds Plaintiffs are likely to succeed on at least some of their claims that Section 71113 is unconstitutional where the provision excludes ‘affiliates’ from receiving Medicaid funding,” she added, referring to language in the bill and citing the Supreme Court precedent that it has “long understood as implicit in the right to engage in activities protected by the First Amendment a corresponding right to associate with others.”

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While the provision in the new law does not expressly name Planned Parenthood, it targets the organization by barring Medicare reimbursements to nonprofit organizations that provide abortions that also took in more than $800,000 in Medicaid revenue over the course of fiscal year 2023 — meaning Planned Parenthood is likely the only organization to be defunded. The “prohibited entities” barred from receiving federal funds includes their “affiliates, subsidiaries, successors, and clinics.”

But some member organizations – including plaintiff Planned Parenthood Association of Utah – received less than $800,000 in that fiscal year, causing “confusion” among members “that do not independently qualify as a ‘prohibited entity,'” and widening “the scope of immediate harm,” Talwani ruled.

Section 71113 not only “burdens” members’ right to associate with each other and with the larger federation – pointing to the First Amendment complaint in the lawsuit – but it “leaves uncertain what a member can do (short of ending its affiliation with Planned Parenthood Federation and other Planned Parenthood Members)” to avoid this burden, “which makes the law suspect under the Fifth Amendment’s due process clause,” the judge added.

The declarations provided by employees of the Planned Parenthood Association of Utah and Planned Parenthood League of Massachusetts and other medical professionals elaborated on the impacts of their branches being defunded. The law would have forced hundreds – if not thousands – of people to cancel their health care appointments because they could not use their Medicaid coverage.

Planned Parenthood Utah said it already had to turn away patients because of the lack of Medicaid funding.

The defendants – which include the Department of Health and Human Services and its secretary, Robert F. Kennedy, Jr – are not only blocked from enforcing the provision but must “take all steps necessary to ensure that Medicaid funding continues to be disbursed in the customary manner and timeframes” to the federation and its members.

Save for any new court action, the TRO will remain in effect until July 21, when the 14 days are up and a hearing takes place on the plaintiff’s move for a preliminary injunction.

Trump’s sprawling “big beautiful bill” met severe opposition – not least over its proposed changes to Medicaid requirements and the Supplemental Nutrition Assistance Program. But the president and his allies in Congress managed to push it through the Senate and House of Representatives and into law on July 4.

Federal law already bans Medicaid reimbursements for the costs of abortions. But Planned Parenthood’s other services – including cancer screenings, cervical screenings, and much more – remain very much up in the air pending the outcome of this lawsuit.