A federal judge declared on Monday that Planned Parenthood clinics across the nation must continue receiving Medicaid funding. This decision emerges as the largest abortion provider in the country challenges President Donald Trump’s efforts to strip the organization of funds through recent tax legislation.

This new ruling updates a prior directive from U.S. District Judge Indira Talwani in Boston, issued last week. Initially, Judge Talwani had provided a preliminary injunction preventing the government from ceasing Medicaid payments to Planned Parenthood facilities that either did not offer abortion services or did not reach at least $800,000 in a year through Medicaid reimbursements.

“Patients are likely to experience negative health outcomes when care is interrupted or unavailable,” Judge Talwani noted in her order on Monday. “Specifically, restricting Members’ capability to deliver health services could lead to higher rates of unintended pregnancies and related issues due to reduced access to contraceptives, as well as a rise in undiagnosed and untreated sexually transmitted infections (STIs).”

A provision in Trump’s tax bill instructed the federal government to end Medicaid payments for one year to abortion providers that received more than $800,000 from Medicaid in 2023, even to those like Planned Parenthood that also offer medical services like contraception, pregnancy tests and STD testing.

In its lawsuit, Planned Parenthood had argued that they would be at risk of closing nearly 200 clinics in 24 states if they are cut off from Medicaid funds. They estimated this would result in more than 1 million patients losing care.

“We’re suing the Trump administration over this targeted attack on Planned Parenthood health centers and the patients who rely on them for care,” said Planned Parenthood’s president and CEO Alexis McGill Johnson. “This case is about making sure that patients who use Medicaid as their insurance to get birth control, cancer screenings, and STI testing and treatment can continue to do so at their local Planned Parenthood health center, and we will make that clear in court.”

The federal department of health did not immediately respond to requests for comment.

Previously, the department said it strongly disagreed with the judge’s initial order that allowed some Planned Parenthood members to receive Medicaid funding.

“States should not be forced to fund organizations that have chosen political advocacy over patient care,” said the department’s communication director, Andrew Nixon. Doing so, he said, “undermines state flexibility” and “concerns about accountability.”