It may be New Year's Eve, but you'd be forgiven for thinking it might be Groundhog Day when I tell you that the 1st Circuit Court of Appeals has — once again — had to place Massachusetts District Court Judge Indira Talwani in check over the One Big Beautiful Bill provision that withholds Medicaid funding from certain abortion providers, namely Planned Parenthood (Section 71113).
It seems like just yesterday we were reviewing a 1st Circuit decision correcting Talwani's rulings in the case styled Planned Parenthood Federation of America, Inc. v. Kennedy, vacating preliminary injunctions she had issued in July, which enjoined the Trump administration from enforcing the provision in question. And, in truth, it was less than three weeks ago — but this ruling has to do with a different set of plaintiffs, namely 21 states and the District of Columbia, who challenged the provision, and a different/later preliminary injunction Talwani issued (on December 2nd).
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Similar to the case brought by Planned Parenthood affiliates, in this case, the states sued to block the enforcement of § 71113, alleging that the provision violates the Spending Clause of the United States Constitution. (U.S. Const., art. I, § 8, cl. 1.) The provision prohibits (for one year) the expenditure of Medicaid reimbursement dollars to "prohibited entities," which, pursuant to the statutory definition, primarily affects Planned Parenthood Federation of America (PPFA) and its affiliates (hence the other/previous lawsuit referenced).
The 1st Circuit's ruling (which is blessedly brief at five pages) essentially boils down to this: They believe the administration has made a sufficient showing that it is likely to succeed on the merits to warrant staying the district court's injunction.
While the plaintiffs contend that the language of § 71113, setting forth which entities are covered by it, is ambiguous, the 1st Circuit disagrees, noting that courts are often called upon to interpret Medicaid regulations.
The 1st Circuit also asserts that Judge Talwani got it wrong in holding that § 71113 imposes an impermissible retroactive condition because the states' Medicaid plans had already been approved by CMS. The court points to prior case law and relevant statutory provisions that lead to the opposite conclusion, noting:
[b]ecause Congress has reserved in the Medicaid Act the power to 'alter' or 'amend' the Medicaid program, states have had fair notice that Congress may make incremental changes to Medicaid...and the Medicaid program contemplates that participating states may have to amend their plan to conform to federal law, even after they have been approved.
So, once again, Judge Talwani is being schooled — albeit gently — by the appellate court.
🚨 The First Circuit has STAYED a federal judge's order that blocked the Trump Administration from defunding Planned Parenthood under the OBBB.
— SCOTUS Wire (@scotus_wire) December 31, 2025
This is the THIRD time that the 1st Circuit has stayed or vacated an injunction by Judge Talwani in this case alone. pic.twitter.com/ZYIW0bdZba
Keep in mind, this panel consists of Chief Judge David Barron (an Obama appointee), Judge Gustavo Gelpi (a Bush 43/Biden appointee), and Judge Lara Montecalvo (also a Biden appointee). They're not exactly right-wing ideologues.
Think she'll finally get the message?
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