A federal judge on Monday ruled Planned Parenthood clinics nationwide must continue to be reimbursed for Medicaid funding as the nation’s largest abortion provider fights President Donald Trump’s administration over efforts to defund the organization in his signature tax legislation.

The new order replaces a previous edict handed down by U.S. District Judge Indira Talwani in Boston last week. Talwani initially granted a preliminary injunction specifically blocking the government from cutting Medicaid payments to Planned Parenthood members that didn’t provide abortion care or didn’t meet a threshold of at least $800,000 in Medicaid reimbursements in a given year.

“Patients are likely to suffer adverse health consequences where care is disrupted or unavailable,” Talwani wrote in her Monday order. “In particular, restricting Members’ ability to provide healthcare services threatens an increase in unintended pregnancies and attendant complications because of reduced access to effective contraceptives, and an increase in undiagnosed and untreated 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.

Although Planned Parenthood is not specifically named in the statute, which went into effect July 4, the organization’s leaders say it was meant to affect their nearly 600 centers in 48 states. However, a major medical provider in Maine and likely others have also been hit.

In her Monday order, Talwani said that the court was “not enjoining the federal government from regulating abortion and is not directing the federal government to fund elective abortions or any healthcare service not otherwise eligible for Medicaid coverage.” Instead, Talwani said that her decision would block the federal government from excluding groups like Planned Parenthood from Medicaid reimbursements when they have demonstrated a substantial likelihood of success in their legal challenge.

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 in a statement on Monday. “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 lawsuit was filed earlier this month against Health and Human Services Secretary Robert F. Kennedy Jr. by Planned Parenthood Federation of America and its member organizations in Massachusetts and Utah.

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.”

Medicaid is a government health care program that serves millions of low-income and disabled Americans. Nearly half of Planned Parenthood’s patients rely on Medicaid.

WHAT DOES THIS MEAN FOR MAINE?

Planned Parenthood of Northern New England operates health centers in Maine, New Hampshire and Vermont. The organization was set to lose roughly $3.3 million because of the Medicaid cuts across the three states, including about $900,000 in Maine, said Nicole Clegg, CEO of Planned Parenthood of Northern New England.

The preliminary injunction means that Planned Parenthood of Northern New England can now submit claims for reimbursement for the care it has provided since the reconciliation law passed, Clegg said.

“It provides some stability for our patients, especially those insured by Medicaid who weren’t sure what the defunding measure would mean for them,” Clegg said. “And I think for us, it’s reassuring. We fundamentally believe that the effort to deprive us of getting paid for services applying to Medicaid patients is wrong, and it’s cruel, and we’re glad that the courts agreed with us today.”

The Medicaid cuts would have curtailed non-abortion services such as cancer screenings, access to birth control, wellness exams and treatment for sexually transmitted infections. Those services make up more than 90% of the organization’s work, Clegg said.

Maine Family Planning, which operates health centers and family planning clinics in Maine, is also suing the Trump administration over the Medicaid cuts.

Despite the victory for Planned Parenthood Monday, Clegg said the fight is not over.

“I think we know that this is not going to be the end, that the Trump administration is going to try to appeal this decision,” she said. “So the fight will continue. But I think for today, we’re just going to be really focused on celebrating the fact that our patients can continue without worry about accessing our care.”

Morning Sentinel Staff Writer Hannah Kaufman contributed to this report.