A federal judge in Portland has ruled against temporarily restoring Medicaid funding for a network of Maine reproductive health clinics whose funding was cut by the Trump administration as part of an effort to stop taxpayer dollars from flowing to abortion providers.

The 19-page decision Monday by Chief U.S. District Judge Lance Walker means Maine Family Planning will have to turn away all primary care patients by the end of October. It also threatens the network’s ability to continue providing other services, the organization said.

The decision stands in contrast to a Massachusetts court’s order late last month allowing Planned Parenthood clinics to continue billing Medicaid while a similar lawsuit against the Trump administration plays out there.

Walker wrote that Maine Family Planning’s attorneys failed to make the case that funds should be restored under the Equal Protection Clause, “due to several severe jurisprudential headwinds that I am bound to observe.”

“Undoubtedly, most of the public that is outraged by Congress’s defunding of ‘prohibited entities’ will feel as they do because they find the provision unwise, unfair and illogical,” he wrote. “However unwise is the prohibition of Medicaid funding to providers best positioned to deliver Medicaid services to underserved rural populations, the Judicial Branch, despite much generated confusion on this basic point, does not serve as an omnibus super-legislature to sit in final judgment as to which policy outcomes it prefers. That judgment rests with the people.”

Both the Maine Family Planning suit, filed in U.S. District Court in Portland, and the Massachusetts suit from Planned Parenthood came in response to cuts approved last month as part of President Donald Trump’s policy and tax bill, known as the “big beautiful bill.”

The bill eliminated Medicaid funding for one year for nonprofit entities “primarily engaged in family planning services, reproductive health and related medical care” that provide abortions and that had Medicaid revenues in excess of $800,000 in fiscal year 2023.

Walker’s decision comes a little more than a week after representatives for Maine Family Planning and a U.S. Department of Justice attorney representing the administration appeared in court in Portland to argue whether the funding should be temporarily restored while the Maine lawsuit is pending.

Maine Family Planning operates 18 clinics across the state primarily focused on reproductive and sexual health care services, including testing for sexually transmitted infections, cervical cancer screenings, gynecological exams and access to contraception, as well as primary care at three locations. The network also offers procedural abortions at one of its locations and medication abortions at all 18 locations.

In 2024, Maine Family Planning clinics served over 8,000 patients, including 645 abortion patients, 633 primary care patients and 7,215 family planning patients, according to court records. About half of all patients are Medicaid recipients.

“This ruling is a devastating setback for Mainers who depend on us for basic primary care,” George Hill, president and CEO of Maine Family Planning, said in a written statement. “The loss of Medicaid funds — which nearly half our patients rely on — threatens our ability to provide life-saving services to communities across the state. Mainers’ health should never be jeopardized by political decisions, and we will continue to fight for them.”

In court earlier this month, Meetra Mehdizadeh, an attorney with the New York-based Center for Reproductive Rights who is representing Maine Family Planning, accused the federal government of discriminating against Maine Family Planning by cutting off funding for non-abortion services that other clinics around the country who provide the same services are still receiving.

“We are arguing that the defunding provision, which takes Medicaid away from a tiny subset of Medicaid providers who also provide abortions, violates the Constitution’s equal protection guarantee because it treats some providers differently from others who are still able to continue to bill Medicaid,” Mehdizadeh said at the time.

Emily Hall, a U.S. Department of Justice attorney representing the administration, refuted that idea, saying that Congress and the president have the right to decide how taxpayer funds are spent and that the law containing the cuts clearly laid out criteria for how they would be determined.

Hall did not immediately respond Monday to an email seeking comment on the order.

Maine Family Planning has already stopped enrolling new primary care patients who rely on Medicaid and said Monday it may have no choice but to close clinics, cut services, or severely limit the number of patients it serves.

The network has said its work is critical because it serves people in primarily low-income and rural areas where access to health care is already challenging.

“Without federal Medicaid reimbursements, MFP’s ability to provide comprehensive health care to Medicaid-eligible patients is at grave risk,” attorneys for Maine Family Planning wrote in court records. “The result is significant and irreparable harm to MFP and its patients, many of whom have nowhere else to turn for time-sensitive health care such as cancer screenings and STI testing.”