A federal appeals court has removed blocks that another judge placed on Congress’s attempt to defund Planned Parenthood and other abortion providers.

In a 3-0 decision, the U.S. Court of Appeals for the First Circuit disagreed on Dec. 12 that Planned Parenthood was likely to succeed in its legal arguments against the defunding measure. More specifically, they pushed back on the idea that the One Big Beautiful Bill Act, which was signed by President Donald Trump earlier this year, violated the Constitution’s guarantee of equal protection under the law.

“Preventing these entities from receiving funds if they continue providing abortion services furthers Congress’s interest in reducing abortions,” U.S. Circuit Judge Gustavo Gelpí said in an opinion.

Section 71113 of the One Big Beautiful Bill Act blocked funding for organizations and affiliates of organizations that provided abortions and received more than $800,000 in Medicaid reimbursements during Fiscal Year 2023.

U.S. District Judge Indira Talwani issued multiple orders this summer blocking that section, citing multiple constitutional provisions. In particular, she said that Planned Parenthood was likely to succeed in arguing that the law was a “bill of attainder” prohibited under Article I, Section 9 of the Constitution.

Bills of attainder are legislative determinations of guilt and inflict punishments. Although the law didn’t specifically name Planned Parenthood, Talwani said it was apparent that the organization was the target and that legislators’ actions pointed to an intent to punish the organization.

The First Circuit acknowledged that the law had “deleterious effects” on Planned Parenthood but rejected the idea that it was a legislative punishment. Section 71113 “imposes no fine or penalty for past conduct,” the court said. “Instead, it establishes new conditions on the receipt of appropriated funds in service of a new policy goal favored by Congress.”

Gelpí added that Congress had used its taxing and spending power to force a difficult choice between federal funding and providing abortions.

“That the law imposes a difficult choice on the recipient of federal funds does not demonstrate that Congress is punishing the recipient for past action—an intrinsic element of a bill of attainder.”

The block on Talwani’s orders follows a more tentative block by the appeals court in September. At the time, Planned Parenthood said the decision would block “more than 1.1 million patients from using their Medicaid insurance at Planned Parenthood health centers.”

Talwani had also used the apparent targeting of Planned Parenthood to argue Congress was denying the organization equal protection under the law, and therefore violating the Fifth Amendment.

Part of the legal controversy involved how Section 71113’s wording targeted affiliates rather than merely organizations that meet certain criteria. In doing so, Talwani said, Congress forced Planned Parenthood’s affiliates to distance themselves from the organization rather than merely stop providing abortions.

Talwani said that by impinging on Planned Parenthood affiliates’ rights to association, the law was impacting a fundamental right and therefore should be scrutinized more heavily. By contrast, the appeals court thought judges should be more lenient in analyzing the law. All that was needed for Congress’s targeting to pass constitutional muster was a rational basis for the law, Gelpí said.

“There are plausible reasons for treating [the targeted entities] differently from other abortion providers, particularly where Congress viewed these entities as the most significant recipients of Medicaid funds,” he said.

His reasoning was partly based on the idea that Congress hadn’t actually violated Planned Parenthood affiliates’ First Amendment right to association. Gelpí interpreted the law’s use of the term “affiliate” as being less about expressive activity and more about whether they were under common control.