In a sweeping move that undermines Republican efforts to halt public funding for abortion providers, a federal judge has ordered Medicaid to resume payments to all Planned Parenthood clinics—regardless of whether they currently provide abortions or are located in states where abortion is illegal.

U.S. District Judge Indira Talwani, appointed by Barack Obama, expanded her original injunction against a GOP-led defunding measure within the so-called “Big, Beautiful Bill,” a landmark legislative package passed earlier this year aimed at slashing taxpayer support for abortion organizations. The bill’s one-year defunding clause was carefully written to avoid naming Planned Parenthood explicitly, but it targeted entities that matched its profile—effectively slashing Medicaid funds for the abortion giant.

Talwani’s decision? Block the entire defunding provision. Her justification? According to the judge, stripping Planned Parenthood clinics of taxpayer funding—even those not currently performing abortions—would “likely” lead to unintended pregnancies, untreated STIs, and clinic closures, harming public health.

In her own words: “Restricting Members’ ability to provide healthcare services threatens an increase in unintended pregnancies and attendant complications,” Talwani wrote. Yet she insisted her ruling doesn’t force the government to pay for abortions. It simply forbids them from cutting off reimbursements—despite Congress explicitly doing just that.

The lawsuit, brought by Planned Parenthood, claims the defunding language unfairly singled out the organization while sparing other providers. The group warned nearly 200 of its clinics were “at risk of closure” if the funding didn’t continue. The judge agreed—at least for now.

The Trump administration’s Department of Health and Human Services pushed back hard. In a strongly worded filing, HHS argued that Planned Parenthood has “no right to taxpayer money” and that the court should respect Congress’s authority to decide where federal dollars go. “The court should not invent such a right,” the department warned.

But the ruling isn’t just about Medicaid funds. It’s also about the growing tension between elected lawmakers and unelected judges. Pro-life leaders say this is another case of activist courts ignoring the will of the people—and helping the abortion industry cling to public subsidies it has no right to.

In fact, Planned Parenthood’s most recent annual report shows the group isn’t exactly scraping by. The group committed over 400,000 abortions last year—its highest total ever—and raked in more than $792 million in taxpayer dollars, a record high. That’s nearly $100 million more than the previous year.

Planned Parenthood CEO Alexis McGill Johnson praised the ruling and vowed to keep fighting to protect “critical health care,” while HHS communications director Andrew Nixon shot back: “States should not be forced to fund organizations that have chosen political advocacy over patient care.”

Meanwhile, pro-life legal experts are fuming. They say Talwani’s ruling contradicts a recent Supreme Court decision that allowed South Carolina to block Medicaid funds from going to Planned Parenthood. In that case, the high court held that Planned Parenthood couldn’t sue the state under federal civil rights law—casting doubt on whether the Massachusetts ruling will hold up on appeal.

For now, however, taxpayers are still on the hook. Whether the litigation continues or escalates to the Supreme Court again remains to be seen—but the stakes are clear: one judge just forced every state in the country to keep funding the nation’s largest abortion provider.