The federal abortion battle testing the pro-life movement

For 50 years, the pro-life movement fought to return abortion law to the states by ending Roe v. Wade. That goal was achieved. Yet this week, a ruling from a federal courtroom in Boston revealed a harder truth: while abortion policy may now rest with the states, the systems that fund and normalize abortion remain firmly under federal control.

At the center of that struggle sits Planned Parenthood and the question that has defined this movement for decades: Should American taxpayers be forced to subsidize an industry built on the destruction of unborn human lives?

The Power of One Judge

Earlier this year, the federal government attempted to enforce new Medicaid restrictions that would have cut taxpayer funding from many Planned Parenthood affiliates across more than 20 states.

This week, a federal judge intervened.

United States District Judge Indira Talwani issued a preliminary injunction blocking the funding restriction for 22 states and the District of Columbia. In her ruling, she described the law as impermissibly ambiguous and warned that enforcing it could limit access to contraception and preventive care while increasing costs to state health programs.

Because of that order, Medicaid reimbursements to many Planned Parenthood clinics continue for now. The injunction is temporary. The federal government may still appeal. But the immediate result is unmistakable: taxpayer dollars continue flowing to the nation’s largest abortion provider.

For pro-life Americans, this moment is painfully familiar. Again and again, efforts to separate public money from abortion are stalled not by voters, but by courts. What makes this moment different is that this is not the first time Judge Talwani has intervened to stop federal defunding efforts aimed at abortion providers.

Earlier attempts to enforce similar restrictions were also blocked by her court and later reviewed by higher courts. To many Americans, this pattern raises serious concerns about the role of a single district judge in determining national health policy.

A Moral and Structural Fight

Today, Medicaid alone covers tens of millions of Americans. It represents one of the largest streams of taxpayer funding in the federal budget. When abortion providers remain embedded within that system, defunding becomes not only a moral fight but a structural one.

Courts are no longer simply interpreting abortion law. They are protecting the financial backbone that allows abortion providers to expand, advertise, and stabilize their operations nationwide.

At the same time, another decisive federal battle is unfolding more quietly, but with consequences that may last even longer than any budget fight: the future of conscience protections in American medicine.

Senator James Lankford has introduced legislation to strengthen protections for medical residents who object to participating in abortion. Under the current system, residents may technically opt out, but many report professional pressure tied to evaluations and career advancement. The proposed reform would reverse that structure by requiring opt in participation so that no resident is forced into abortion training by default.

When introducing the bill, Senator Lankford stated that medical professionals should never be forced to choose between deeply held beliefs and the future of their career. For the pro-life movement, this legislation is not a side issue. It is central to whether the next generation of American doctors will include men and women willing to stand for the sanctity of life without fear of professional punishment.

States do not have full control over the abortion landscape

Together, these two federal fights show the new terrain of the abortion debate. Even in a post-Roe era where abortion regulation largely resides with the states, Washington still controls the money, the training pipelines, the agencies, and the courts. That control determines what kind of medicine exists in practice.

The public is often told that abortion has been returned to the states. What is less often said is that the financial and institutional architecture surrounding abortion remains federal. Courts still decide how taxpayer dollars flow. Congress still writes the rules that govern national health programs. Federal agencies still shape the medical workforce.

For organizations like Live Action, this week shows a central truth. The battle for life is no longer confined to state legislatures passing abortion statutes. It now stretches across federal budgets, judicial power, administrative law, and the culture of American medicine itself.

Abortion may be debated in statehouses. But the systems that sustain it remain national.

And in Washington, money still shapes everything.

A Constitutional Question Now Beneath the Battle

Judge Talwani’s repeated use of broad injunctions to block federal abortion funding restrictions has intensified a deeper constitutional debate. Some legal scholars argue that when a single district judge issues relief that applies not only to the parties before the court but across dozens of states and entire national programs, the court may be extending its power beyond what Article Three of the Constitution allows.

Under this view, federal courts exist to resolve concrete disputes between actual parties, not to function as national policy makers. Critics argue that when one judge effectively halts the enforcement of a duly enacted federal law for much of the country, that judge is stepping into a role reserved for Congress.

Other legal scholars respond that courts have long exercised equitable powers that can affect non parties when necessary to prevent widespread harm. They argue that broad injunctions are sometimes the only practical way to restrain unlawful government action from causing irreversible damage.

This debate remains unresolved at the highest level of the judiciary, but it is no longer theoretical. It is now shaping the national abortion funding landscape in real time.

Bio: Mark Wiltz is the Director of Government Affairs for Live Action.