Low-income patients in Texas and Louisiana who utilize Planned Parenthood’s many health services will soon see their options restricted. Meanwhile, cuts in other states have had profound consequences.

A federal appeals court in New Orleans ruled this week that Texas and Louisiana could cut Medicaid funding to Planned Parenthood, a blow against legal abortion that will also affect low-income patients’ access to other medical services. State officials argued they should be able to remove “unqualified” providers such as Planned Parenthood from the list of programs eligible to receive dollars from the tax-funded health insurance program for the poor.

The ruling by the 5th US Circuit Court of Appeals in New Orleans reversed two earlier decisions in Texas and Louisiana that preserved Medicaid funding in those states. In the opinion for the 11-member majority, Judge Priscilla Owen wrote that the federal statute “unambiguously provides that a Medicaid beneficiary has the right to obtain services from the qualified provider of her choice,” but it “does not unambiguously say that a beneficiary may contest or otherwise challenge a determination that the provider of her choice is unqualified.”

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In dissent, Judge James Dennis wrote that the decision left millions of people “vulnerable to unlawful state interference with their choice of health care providers.”

Planned Parenthood CEO Alexis McGill-Johnson tweeted that the Medicaid ban “would have a devastating impact on Texans.”

“@GovAbbott knows exactly who he’s hurting — people of color, women, and people with low incomes,” she wrote. In addition to Texas and Louisiana, the decision also affects Mississippi, which is under 5th Circuit jurisdiction. 

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Defunding Planned Parenthood, one of the biggest healthcare providers in the country, has had profound consequences in other states. Iowa saw a 25% increase in abortions when the state made a similar move in 2019 to withdraw from a federally funded family planning program. Before that, Iowans had shown a steady 56% decrease in abortions from 2008 to 2018. 

In Indiana, under then-Gov. Mike Pence, cutting funding to Planned Parenthood led to one of the state’s worst public health crises in recent history: a massive HIV outbreak. At its peak in 2015, 20 new cases of HIV were being diagnosed each week, reaching a total of nearly 200 cases by the time the outbreak was finally under control.

This week’s ruling is yet another notch in abortion opponents’ crusade to take federal and state dollars away from Planned Parenthood. According to its website, 34% of its funding comes from government health services reimbursements and grants, such as Medicaid and Title X. And in 2019 the health provider withdrew from the federal Title X program over new Trump administration rules that forbade grantees from providing or referring patients for abortions except in cases of rape, incest, or medical emergency.

The issue is likely headed for the US Supreme Court.

READ MORE: Colorado Voted to Protect Reproductive Rights. Louisiana? Not So Much.