Under the new spending bill, the nation’s largest abortion provider would have to stop offering abortion in some states or lose millions in Medicaid funding for basic health care.

The federal government and many states already block using Medicaid funds to cover abortion. But the state-federal health insurance program for lower-income people does pay for other services from Planned Parenthood, including birth control, cancer screenings and testing and treatment for sexually transmitted infections.

Ruling says Medicaid patients cannot sue to get non-abortion health care from Planned Parenthood if states have cut off government funding for those clinics.