Texas and Louisiana can remove Planned Parenthood from their Medicaid programs, a federal appeals court ruled Monday night, a victory for abortion opponents who have long sought to cut federal and state funding for the organization.

The 5th U.S. Court of Appeals sided with state officials in Texas and Louisiana on Monday in an 11-5 decision overturning lower court rulings blocking the changes from coming into effect.

State officials argued that they should be able to remove “unqualified” providers from Medicaid, the federal and state health insurance program for the poor.

The majority of the judges wrote that the women who sued Texas officials to challenge the ban, who were represented by Planned Parenthood, had no right to challenge the state’s determination that the organization did not. is “unqualified” and therefore cannot participate in Medicaid.

“While the law unambiguously provides that a Medicaid beneficiary has the right to obtain services from the qualified provider of their choice, [the law] does not say unambiguously that a recipient can challenge or otherwise challenge a decision that the supplier of their choice is not qualified, ”wrote Chief Justice Priscilla Owen in the majority opinion.

It’s a blow to Planned Parenthood, which recently scrapped a separate federal family planning grant program after new restrictions were imposed by the Trump administration.

“Let’s be clear, patients should be able to turn to the provider they know and trust, regardless of their zip code and income level,” said Alexis McGill Johnson, President and CEO of the Planned Parenthood Federation of America.

“Accountability is coming and we will fight against any politician who does not prioritize expanding quality, accessible and affordable health care,” she added.

Planned Parenthood’s involvement in Medicaid has long been the target of abortion opponents, as about half of its patients benefit from the program.

Planned Parenthood argued that federal law allows Medicaid patients to see any qualified and willing provider, and efforts to remove it from the program are politically motivated and will have a disproportionate effect on people of color.

While federal law already prohibits federal funding for abortion, politicians and abortion advocates have long argued that any money that goes to organizations like Planned Parenthood indirectly supports the process.

Through Medicaid, Planned Parenthood offers patients birth control, family planning, STD screening and treatment, cancer screenings and other services, but not abortions except in limited cases, such as to save mother’s life.

Planned Parenthood will likely ask the Supreme Court to hear the case, despite recent confirmation from Trump’s candidate Amy Coney BarrettAmy Coney BarrettOvernight Health Care: Takeaways from the Supreme Court’s Obamacare decision | COVID-19 has claimed 5.5 million years of American life | Biden administration invests billions in antiviral pills for COVID-19 Five takeaways from Supreme Court Obamacare decision The Supreme Court unanimously sides with the Catholic adoption agency that denied couples to same sex PLUS, which they say opposes abortion.

However, the Supreme Court recently declined to hear an appeal of a similar case with a different outcome in which a lower court ruled that the South Carolina Department of Health could not cut Medicaid funding to Planned Parenthood. .

The discrepancy between lower court rulings could make it more likely that the Supreme Court will hear cases from Texas or Louisiana so the matter can be settled.

The state’s efforts to remove Planned Parenthood from Medicaid have been supported by the Trump administration, which recently approved a request from Texas to implement a federally funded Medicaid family planning program that excludes Planned Parenthood.

States can obtain waivers from the federal government to extend Medicaid coverage of sexual and reproductive health services to people who do not qualify for the traditional Medicaid program.

Tennessee, South Carolina and Idaho have similar demands pending before the Trump administration, but it’s unclear when or if they will be approved. The new Biden administration would likely refuse these waivers.