This shouldn’t be about politics—it’s about whether people can afford cancer screenings, birth control and basic healthcare.
The Republican spending package, signed into law by President Trump on July 4, included a one-year block on Medicaid reimbursements and federal grants for nonprofit health clinics that provide abortions, including Planned Parenthood. In other words, Medicaid recipients must now pay out-of-pocket if seeking healthcare at most reproductive health clinics.
The provision was quickly paused by a federal judge, who found that it violated the First Amendment. However, on Sept. 11, the 1st Circuit Court of Appeals reversed that decision, finding that federal Medicaid funding can be blocked from reproductive health clinics.
This law “defunding” Planned Parenthood—a decades-long goal of the antiabortion movement—is now in effect while legal challenges continue. Hundreds of clinics are expected to close without federal funding, and research shows that when these clinics close, they are not replaced by comparable health centers.
Understanding the Healthcare Landscape
Medicaid is a government health insurance program for disabled and low-income Americans and their children. States administer and partially fund Medicaid in partnership with the federal government, but must follow certain rules to receive federal funding.
For example, the decades-old Hyde Amendment rule already stops Medicaid from covering abortion.
The new Republican budget bill ends Medicaid coverage for non-abortion care at certain clinics, including contraception, cancer screenings and treatment and testing for sexually transmitted infections.
1.1 million Planned Parenthood patients on Medicaid will be blocked from using their insurance at the nonprofit’s health centers, according to the organization—making poor and disabled people seeking non-abortion services one of the largest groups harmed by the antiabortion movement.
Without federal support, 200 Planned Parenthood clinics across 24 states are likely to close, and it will become more difficult for the organization to provide low-cost care on a sliding scale.
In addition to “defunding” reproductive health clinics, the GOP budget implemented sweeping cuts to Medicaid as a whole, removing insurance entirely from at least 10 million current Medicaid recipients when all cuts take effect after the midterms.
According to a 2025 West Health–Gallup Poll, 49 percent of Americans already cannot afford or access quality healthcare. Without coverage and facing clinic closures, many will not be able to afford out-of-pocket costs, physician visits or travel to replace the loss of Planned Parenthood clinics.
Colleen’s Story: ‘I Might Not Even Be Here Today’
When Colleen was 27, she was in between jobs and without insurance when she noticed a concerning lump in her breast.
“I didn’t have enough savings to go to a private doctor, so I figured I would just ignore the lump. I had no family history of breast cancer, and I hoped it was nothing important to worry about. I was really close to just ignoring it,” she wrote.
“But then I remembered about Planned Parenthood. I called my local health center and went in for an appointment. I was diagnosed with invasive stage 2 breast cancer … If I hadn’t gone to Planned Parenthood, I would not have gotten my diagnosis. I might not even be here today. … I’m grateful that I had access to affordable healthcare during a time in my life when I was struggling to pay the bills. All Americans must have affordable healthcare because it gives them security.”
Between 2023 and 2024, Planned Parenthood provided 426,268 cancer screenings and cancer-related prevention services.
Consider now, the thousands of Colleens who will no longer have access to care. Between 2023 and 2024, Planned Parenthood provided 426,268 cancer screenings and cancer-related prevention services. With clinics closing and low-income patients asked to pay out-of-pocket, 2026 could look dismally different.
There are millions of uninsured women today and many who will lose Medicaid coverage under the Republican spending package. For these women, Planned Parenthood’s sliding-scale payment structure and wide range of locations would usually make it the most accessible option.
But with current funding restrictions, more people will be left without a provider to detect their cancer or treat their illness. This will kill people.
The “Defund Planned Parenthood” Movement
One-third of Planned Parenthood’s revenue comes from federal funding, primarily Title X grants and Medicaid subsidies. Without federal support, 200 Planned Parenthood clinics across 24 states are likely to close, and it will become more difficult for the organization to provide low-cost care on a sliding scale.
As clinics close, even privately insured people will be impacted by the loss of healthcare facilities.
Highlighted as a priority in Project 2025, antiabortion groups and legislators have long fought for the end of Medicaid coverage at Planned Parenthood, intending to decimate abortion providers indirectly through revenue loss.
According to Planned Parenthood, more than 90 percent of likely clinic closures will occur in states where abortion is currently legal. Sixty percent of those clinics are located in medically underserved areas, such as rural areas with a shortage of primary healthcare physicians.
More than 90 percent of likely clinic closures will occur in states where abortion is currently legal.
In addition to the spending package provision, the Medina v. Planned Parenthood South Atlantic ruling at the Supreme Court this June furthered this antiabortion agenda. Distinct from the federal budget provision, the Medina ruling created a precedent empowering states to refuse Medicaid reimbursements for healthcare at clinics like Planned Parenthood.
Long before this ruling, many states have tried to restrict funding for local, comprehensive family planning clinics. A 2017 change to Iowa’s family planning program, which ousted Planned Parenthood and other clinics, caused an 86 percent decline in the number of people served under the program. This coincided with a significant increase in sexually transmitted infections across the state.
In tandem, the Republican budget bill and Medina will dramatically shift the landscape of sexual and reproductive healthcare access in the United States, impacting low-income women most of all.
Even if federal Medicaid funding is restored through litigation, conservative states are likely to redouble their antiabortion efforts, using the Medina decision to block Medicaid coverage and other funding for patients within their borders.
“Their Goal Has Always Been a National Abortion Ban”
Elected officials anticipated this assault on reproductive healthcare months ago, before the Medina decision or budget bill came to fruition.
On the third anniversary of the Dobbs decision in June, Democratic senators held a hearing, “Under Attack: Republicans’ Escalating War on Reproductive Freedom,” hosted by Sen. Patty Murray (D-Wash.), to highlight Republicans’ “backdoor plan” to ban abortion nationally, which they said included Medicaid restrictions in the (at that point, yet-to-be-passed) “Big Beautiful Bill.”
As Murray and others highlighted at the event, Republicans have a plan to achieve what reproductive rights experts say is effectively a national abortion ban by:
- “defunding” Planned Parenthood through Medicaid and Title X restrictions—which this spending package and the Medina ruling together accomplish;
- ordering the FDA to reassess approval of abortion pills, which would make abortion without an in-person clinic visit extremely difficult. This review has already begun;
- pardoning violent antiabortion activists and repealing the Freedom of Access to Clinic Entrances (FACE) Act, which made it a federal crime to injure or threaten reproductive healthcare providers at clinics. This makes clinics functionally inaccessible;
- including “fetal personhood” in executive orders, which has begun; and
- weakening enforcement of EMTALA (the law requiring access to abortion when the life of a pregnant person is in immediate danger), which occurred when the Trump administration rescinded the Biden-era EMTALA guidelines.
An excerpt from Murray’s powerful remarks at the hearing is below:
Their goal has always been a national abortion ban . . .
[S]ince Republicans know they do not have the votes right now to pass a national abortion ban outright, they are slowly, but surely, advancing a backdoor nationwide abortion ban, and chipping away at access to reproductive health piece-by-piece—even in states where abortion is protected . . .
We will keep fighting tooth and nail against every new strategy Republicans cook up to ban abortion and shutter the doors of healthcare providers in our country.
Great Job Ava Blando & the Team @ Ms. Magazine Source link for sharing this story.
