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NEW ORLEANS (AP) — A federal appeals court ruled Monday that Texas and Louisiana can cut off Medicaid funding to Planned Parenthood clinics — a move supported by opponents of legal abortion, but opposed by advocates who said it affects a variety of non-abortion health services for low-income women.

The ruling was handed down by the 5th U.S. Circuit Court of Appeals in New Orleans. While it expressly reversed decisions in Texas and Louisiana, it also affects Mississippi, which is under 5th Circuit jurisdiction. The issue is likely to go next to the U.S. Supreme Court.

Opponents of legal abortion have long sought to deny federal Medicaid funding for Planned Parenthood clinics.

Abortion rights supporters and advocates for women’s health have argued that the move would reduce access and choice for low-income women seeking cancer screenings, birth control and other non-abortion-related health services — even in states where Planned Parenthood clinics don’t perform abortions.

The decision by the full 5th U.S. Circuit Court of Appeals in New Orleans reverses an earlier ruling by a three-judge appellate panel that blocked Texas from enforcing its ban on Medicaid funding of Planned Parenthood. It also expressly reversed a ruling in a separate case blocking Louisiana from banning Planned Parenthood funding. A three-judge panel in 2015 had ruled against the ban and that decision stood when the full court deadlocked 7-7 in 2017, when there were only 14 active judges on the court.

The court’s personnel has changed since then. Six nominees of Republican President Donald Trump now sit on the court. Four of them participated in Monday’s case (one was recused and another joined the court too late to take part) and all four joined Judge Priscilla Owen’s opinion for an 11-member majority.

Owen wrote that the seven women who sued Texas officials to challenge the ban had no legal right to question the state’s determination that Planned Parenthood was not qualified to provide the services. She noted that a federal statute “unambiguously provides that a Medicaid beneficiary has the right to obtain services from the qualified provider of her choice,” but added that it “does not unambiguously say that a beneficiary may contest or otherwise challenge a determination that the provider of her choice is unqualified.”

In dissent, Judge James Dennis wrote that the ruling conflicts with other circuits’ decisions and will leave millions of people in Texas, Louisiana, and Mississippi, which falls under 5th Circuit jurisdiction, “vulnerable to unlawful state interference with their choice of health care providers.”

The Texas and Louisiana defunding efforts followed the release by anti-abortion activists of secretly recorded videos in 2015. A state inspector general said the video appeared to show Planned Parenthood had improperly changed how abortions were performed so that better specimens could be preserved for medical research. Investigations by 13 states into those videos have concluded without criminal charges, and Planned Parenthood officials have denied any wrongdoing.

Texas Attorney General Ken Paxton applauded Monday’s ruling, saying the videos showed Planned Parenthood was guilty of “morally bankrupt and unlawful conduct.”

“Today’s decision from the 5th Circuit is yet another devastating blow in Texas’ long history of preventing people from accessing life-saving and essential health care at Planned Parenthood,” said Melaney A. Linton, president and CEO of Planned Parenthood Gulf Coast, in a joint statement with other Planned Parenthood presidents from across the state. Linton said that the decision was not the end of their fight and that “we must do everything we can to expand people’s access to essential health care, not restrict it.”