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DATE: |
November 18, 2025 |
19 |
SUBJECT
Title
SUPPORTING LAWSUITS TO PROTECT PLANNED PARENTHOOD AND REPRODUCTIVE HEALTH ACCESS (DISTRICTS: ALL)
Body
OVERVIEW
Across the country, a little-known section of the new federal budget law, H.R. 1, has thrown the nation’s reproductive health care system into crisis. The law imposes a one-year ban on Medicaid reimbursements to nonprofit providers that also offer abortion services, cutting off all Planned Parenthood services from their critical source of funding.
The law, which went into effect July 4, prohibits Medicaid reimbursements for any large nonprofit health clinic who provide abortions, even though federal funding is never used for abortions. Medicaid has long excluded abortion coverage under the Hyde Amendment, but this new restriction goes much further, blocking reimbursement for non-abortion services such as cancer screenings, contraception, and STI screenings and treatments that millions of families rely on to stay healthy.
The impacts are severe and immediate. In California, nearly 80 percent of Planned Parenthood patients rely on Medicaid to afford care. Without federal reimbursements, many health centers face the prospect of closing or reducing services, leaving tens of thousands without affordable options for basic health care. At least 20 Planned Parenthood clinics across seven states have already closed. In October, seven primary care clinics run by Planned Parenthood in Orange and San Bernardino counties announced their closure, citing the loss of roughly $100 million in Medicaid reimbursements. Planned Parenthood officials warn that up to 200 clinics nationwide could ultimately be at risk if the federal ban remains in place.
These clinics are about basic health care. Abortions account for less than ten percent of services provided by California affiliates. The vast majority of visits are for preventive care, birth control, cancer screenings, and testing and treatment for sexually transmitted infections. For many low-income families, Planned Parenthood is their only consistent medical provider, offering comprehensive and affordable care in communities where access is already limited.
Planned Parenthood Federation of America filed a court lawsuit in Massachusetts on July 7 to block the federal provision banning Medicaid reimbursements. A federal judge granted a preliminary injunction recognizing that losing access to care would cause serious health consequences for patients. However, an appellate court stayed the injunction on September 10, so Planned Parenthood is now unable to submit for reimbursement of Medicaid patients. This underscores the urgent need to take action.
On August 29, a coalition of 23 state attorney generals, including Attorney General Rob Bonta, filed a lawsuit in Massachusetts to also block the same Medicaid reimbursement provision, making the argument that this illegally targets specific healthcare providers, specifically Planned Parenthood. The lawsuit has requested another preliminary injunction, which the courts are currently considering. This is the opportunity for the County to weigh in with the requested amicus brief.
The County has a direct stake in this fight. Planned Parenthood operates 11 clinics across San Diego County and served over 122,000 patient visits in the last year alone. As the local health jurisdiction responsible for public health and Medicaid administration, the County relies on a stable network of community clinics to keep residents healthy and reduce pressure on emergency health systems. As federal Medicaid reimbursements are withdrawn, our communities will face the burden of higher costs and deeper inequities.
To help stabilize the system, Governor Gavin Newsom announced a $140 million emergency allocation on October 23, 2025, to support Planned Parenthood clinics. While this funding provides short-term relief, the long-term stability of California’s reproductive health system depends on restoring Medicaid reimbursements.
Today’s action authorizes County Counsel to seek court permission to file or join an amicus brief, as appropriate, supporting the lawsuits filed by Planned Parenthood or Attorney General Bonta, asserting the County’s duty to protect the health and safety of its residents. This filing ensures the court fully understands how federal funding cuts threaten the local health infrastructure that millions of families depend on. By taking this action, the County is defending a health care system under unprecedented attack, standing up for healthcare providers who form the foundation of community health across our region.
RECOMMENDATION(S)
CHAIR TERRA LAWSON-REMER
Authorize County Counsel, in consultation with the Chief Administrative Officer, to seek court permission to file or join an amicus curiae brief in either the trial or appellate court, as appropriate, on behalf of the County in support of Planned Parenthood’s appellate court, as appropriate, or the multistate lawsuit led by California Attorney General Rob Bonta to block new federal restrictions on Medicaid funding for reproductive health providers.
EQUITY IMPACT STATEMENT
This action advances health equity by protecting access to essential reproductive and preventive health services for low-income residents, women, and families who rely on Medicaid. Planned Parenthood health centers serve a disproportionate share of patients from historically marginalized communities, including women of color, young people, and residents in medically underserved areas. The federal ban on Medicaid reimbursements deepens inequities in access to care, forcing vulnerable populations to travel farther or go without services such as cancer screenings, contraception, and STI screenings and treatments. Supporting the lawsuit by Planned Parenthood or the Attorney General helps safeguard equitable access to comprehensive health care for all San Diegans, regardless of income, geography, or insurance status.
SUSTAINABILITY IMPACT STATEMENT
Protecting access to reproductive and preventive health care supports the County’s long-term public health and sustainability goals by preventing avoidable medical crises and reducing pressure on emergency and hospital systems. When residents lose access to reproductive healthcare, health outcomes worsen and costs shift to publicly funded acute and crisis services.
FISCAL IMPACT
There is no fiscal impact associated with these recommendations. Funds for the actions requested are included in the Fiscal Year 2025-26 Operational Plan based on existing staff time. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
This action is not expected to have any direct immediate impact on local businesses. However, maintaining access to preventive and reproductive health services contributes to a healthier, more stable workforce and reduces downstream economic costs associated with untreated illness, emergency care, and lost productivity. For example, in October 2025, Planned Parenthood of Orange & San Bernardino Counties announced the closure of its Melody Health primary-care practice and laid off 81 staff as a result of federal funding cuts. By supporting continued Medi-Cal reimbursement for providers such as Planned Parenthood, the County helps sustain critical healthcare infrastructure, and the jobs, small businesses, and families across the region that depend on it.
Details
ADVISORY BOARD STATEMENT
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BACKGROUND
Across the country, a little-known section of the new federal budget law, H.R. 1, has thrown the reproductive health-care system into turmoil. The provision imposes a one-year ban on Medicaid reimbursements to nonprofit providers that also offer abortion services, effectively cutting off Planned Parenthood from the key source of operational funding.
The law, which went into effect July 4, prohibits Medicaid reimbursements for any large nonprofit health clinic who provide abortions, even though federal funding is never used for abortions. Medicaid has long excluded abortion coverage under the Hyde Amendment, but this law goes much further, blocking reimbursement for non-abortion services such as cancer screenings, contraception, and STI screening and treatments that millions of families depend on to stay healthy.
The consequences are immediate and severe. In California, nearly 80 percent of Planned Parenthood’s patients rely on Medicaid to afford care. Without federal reimbursements, many health centers could be forced to close or cut services, leaving tens of thousands of San Diegans without affordable options for basic health care. At least 20 Planned Parenthood clinics across seven states have closed, including seven affordable primary care clinics run by Planned Parenthood across Orange and San Bernardino counties that announced their closure in October 2025, citing the loss of $100 million in Medicaid reimbursements. Planned Parenthood officials warn that as many as 200 clinics nationwide could ultimately be at risk if the federal ban remains in place.
These clinics are about basic health care. Abortions account for less than 7% of services provided through California Planned Parenthood, according to the organization. Most patient visits are for birth control, sexually transmitted infection testing and treatment, and cancer screenings. For many low-income families, Planned Parenthood is their only consistent medical provider, offering comprehensive, regulated, and affordable care in communities where access is already limited.
Legal battles are now underway. Planned Parenthood Federation of America filed a court lawsuit in Massachusetts on July 7 to block the federal provision banning Medicaid reimbursements. A federal judge granted a preliminary injunction recognizing that losing access to care would cause serious health consequences for patients. However, an appellate court stayed the injunction on September 10, so Planned Parenthood is now unable to submit for reimbursement of Medicaid patients. This underscores the urgent need to take action.
On August 29, a coalition of 23 state attorney generals, including Attorney General Rob Bonta, filed suit to also try to block the same Medicaid reimbursement provision, making the argument that this illegally targets specific healthcare providers, specifically Planned Parenthood. The lawsuit has requested another preliminary injunction, which the courts are currently considering. This is the opportunity for the County to weigh in with the requested amicus brief.
To help stabilize the system, Governor Gavin Newsom announced a $140 million emergency allocation on October 23, 2025, to keep Planned Parenthood clinics open statewide and prevent further closures following the federal cuts. While this funding provides critical short-term relief, the organization still faces an uncertain future as litigation continues.
The County of San Diego has a direct stake in this fight. As the local health jurisdiction responsible for public health and Medicaid administration, the County depends on a stable network of community clinics to keep residents healthy and reduce pressure on emergency and behavioral-health systems. If federal reimbursements are withdrawn, those systems will face higher costs and deeper inequities.
Today’s action authorizes County Counsel to seek court permission to file or join an amicus brief supporting the lawsuits underway. This filing ensures the court hears directly from local government about the real-world impact of federal funding cuts on community health and access to care. By taking this action, the County is standing up to protect a health care system under assault, defending the clinics, providers, and patients who form the foundation of community health across our region.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions advance the County of San Diego’s 2025-2030 Strategic Initiatives of Health, Equity, Safety by safeguarding access to essential reproductive and preventive health services, protecting vulnerable residents from care disruptions, and strengthening the County’s health system.
Respectfully submitted,
TERRA LAWSON-REMER
Supervisor, Third District
ATTACHMENT(S)
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