A federal judge on Tuesday blocked U.S. President Donald Trump’s administration from enforcing in 22 states a provision of the Republican’s signature tax and domestic policy bill that would deprive Planned Parenthood and local affiliates that perform abortions of Medicaid funding.

U.S. District Judge Indira Talwani in Boston said a group of Democratic state attorneys general who had challenged the provision were likely to succeed in establishing that the law constitutes an unconstitutional retroactive condition on their participation in the Medicaid healthcare program.

Talwani called the law “impermissibly ambiguous,” and said that allowing it to remain in effect would “increase the percentage of patients unable to receive birth control and preventive screenings, thereby prompting an increase in states’ healthcare costs.”

The judge, who was appointed by Democratic President Barack Obama, issued a preliminary injunction that covers the 22 states that sued to challenge the provision led by California, Connecticut and New York, as well as the District of Columbia. But she put her ruling on hold for seven days to allow the Trump administration to appeal.

Talwani had previously blocked the law from being implemented on other grounds in a separate case by Planned Parenthood. A federal appeals court put that decision on hold in September while it weighed the administration’s appeal.

A Planned Parenthood spokesperson in a statement hailed the ruling, saying Talwani “again recognized the ‘defund’ law for what it is: unconstitutional and dangerous.”

The White House and the U.S. Department of Health and Human Services did not immediately respond to requests for comment.

A provision in the One Big Beautiful Bill Act, passed by the Republican-led Congress, bars Medicaid funding for tax-exempt organizations that provide family planning and reproductive health services if they perform abortions and received more than $800,000 in Medicaid funds during the 2023 fiscal year.

Planned Parenthood says the law is already having devastating effects, noting that at least 20 health centers have closed since September, when the appeals court allowed the law to take effect.

The states had sued in July, arguing they were unprepared and ill-equipped to implement the law, which they said violated the U.S. Constitution’s Spending Clause by failing to provide states clear notice of which healthcare providers the defunding provision covered.

They said the provision constituted a change the states could not have anticipated when they joined the joint federal-state Medicaid program, which provides healthcare coverage to low-income Americans. States, not the federal government, have long been left to determine which providers qualify for the Medicaid program, the states said.

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(Reporting by Nate Raymond in Boston; Editing by Franklin Paul, Rod Nickel, Alexia Garamfalvi, David Gregorio and Leslie Adler)