The Trump administration exceeded its authority and violated constitutional protections in attempting to defund Planned Parenthood, according to a lawsuit filed today by California Attorney General Rob Bonta along with Oregon, 21 other states and the District of Columbia.
The suit, filed in the U.S. District Court in Massachusetts against the U.S. Department of Health and Human Services, is Bonta’s 36th lawsuit against the Trump administration.
It contends that Trump’s signature tax law — the “One Big Beautiful Bill Act” — passed earlier this month is unconstitutionally vague and requires states to violate Planned Parenthood’s First Amendment rights.
The law, which went into effect July 4, prohibits Medicaid reimbursements for any health services conducted at large nonprofit health clinics that “primarily” provide abortions.
“We won’t sit back while Congress and this federal administration tries to roll back our progress, silence their opposition and ignore the rule of law,” Bonta said.
The complaint also argues the law violates federal rules requiring the government to give states “clear notice” of major Medicaid funding restrictions. It also argues the law requires states to enforce provisions that violate Planned Parenthood’s constitutionally protected freedoms of speech and assembly.
HHS did not immediately respond to a request for comment, nor had it filed a legal response at the time of publication.
Five California clinics have closed
Critics of the law have characterized it as a “backdoor abortion ban” designed to target Planned Parenthood in states where abortion is legal. Already five Planned Parenthood clinics in California have closed, citing the loss of $100 million in Medicaid payments.
Federal law already prohibits the use of federal funds to pay for abortions except in extremely limited circumstances, but nearly 80% of Planned Parenthood patients in California use Medicaid, also known as Medi-Cal, the federal health insurance program for low-income people and those with disabilities.
“To be clear, this isn’t even federal funding that goes toward abortions,” Bonta said.
According to the complaint, Congress has never before restricted Medicaid spending based on health care provided outside of the Medicaid program.
Planned Parenthood Federation of America earlier filed a separate lawsuit challenging the law. U.S. District Judge Indira Talwani in Boston on Monday reversed a ruling from last week that had effectively cut Medicaid reimbursements for all but a few Planned Parenthood operations around the nation.
Despite the new ruling, five Planned Parenthood centers in California will remain closed, according to Andrew Adams, chief of staff for Planned Parenthood Mar Monte, which oversees 30 health centers in Northern and Central California and Nevada. Adams said the court order was a “key victory” in the fight to preserve reproductive health access, but the network needs to preserve its financial stability.
Monday’s order reestablishes funding for California clinics while legal action is pending. Bonta is also asking the court to prevent implementation of the law. Bonta said because the state’s Medicaid program is harmed by the law, it was appropriate for the state to pursue separate legal action and that the complaints challenge different constitutional protections.
‘We strongly disagree’
In a statement, a spokesperson for the U.S. Department of Health and Human Services said “we strongly disagree with the court’s decision” and reiterated an argument from last week that states should not have to reimburse organizations that have “chosen political advocacy over patient care.”
Medicaid is jointly administered by states and the federal government with each generally paying for 50% of the cost of health services.
In its lawsuit, Planned Parenthood Federation of America argues, in part, that by withholding funding, the law violates its First Amendment rights. It also asserts that the tax law violates the Due Process Clause of the Fifth Amendment.
HHS had not filed an appeal as of Tuesday morning.
Adams said in an email to CalMatters that Planned Parenthood Mar Monte will continue to fight any attempt to restrict abortion and reproductive health care access.
“We will not back down, but we must have the resources to continue this fight while keeping as many doors open to patient care as possible,” Adams said.
In her order, Talwani reasoned that disruptions to patient care are likely to result in “adverse health consequences,” including an increase in unintended pregnancies, pregnancy complications and undiagnosed cancers and sexually transmitted infections.
“Restricting access to [Planned Parenthood] healthcare clinics will negatively affect more than just reproductive health; [Planned Parenthood clinics] often serve as a source of primary care for patients,” Talwani wrote.
Talwani also wrote that the order does not require the federal government to pay for abortions, and that Planned Parenthood shows a “substantial likelihood” of winning the lawsuit.
Abortions account for less than 10% of services provided through California Planned Parenthood, according to the organization. The majority of patient visits are for primary care, birth control, sexually transmitted infection testing and treatment, and cancer screenings.
The clinics that closed last week are located in South San Francisco, San Mateo, Gilroy, Santa Cruz and Madera. Together they served 22,000 patients, according to Planned Parenthood Mar Monte. The organization also ended primary care, behavioral health and prenatal care services as a result of the federal budget cuts. Those cuts total roughly $100 million for the Mar Monte clinics, according to a news release.
Leaders for Planned Parenthood Affiliates of California, which represents more than 100 clinics throughout the state, including the Mar Monte clinics, said Trump’s tax law will cost the system about $300 million in Medicaid reimbursements.
Jodi Hicks, president and chief executive of Planned Parenthood Affiliates of California, said the “economic sanctions” imposed by the Trump administration has “jeopardized access for countless Californians” to critical health care services. Still, the organization remains committed to continuing to provide patient care, Hicks said.
“Planned Parenthood will not go away quietly. We are fighting back with every tool that we have,” Hicks said.
Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.