After Five Clinic Closures, Planned Parenthood Starts Selling $9 Botox

The largest Planned Parenthood affiliate in the United States is now offering Botox injections at $9 a unit — 25 to 50 percent below what most Northern California medical spas charge — after federal Medicaid cuts eliminated more than $100 million in annual funding and forced it to permanently close five health centers.

Planned Parenthood Mar Monte, which covers 46 counties across Northern and Central California and Northern Nevada, launched the cosmetic services at its Sacramento clinic in response to financial pressure from the “One Big Beautiful Bill,” the 2025 budget reconciliation law signed by President Trump on July 4 that barred Planned Parenthood affiliates from receiving federal Medicaid reimbursements. The same law’s broader Medicaid restructuring is also driving Nebraska’s first-in-the-nation work-requirements rollout, which puts up to 41,000 Medicaid expansion enrollees at risk of losing coverage starting May 1.

The damage came fast. Three weeks after the law took effect, on July 24, 2025, Mar Monte shut clinics in Gilroy, Santa Cruz, Madera, San Mateo, and South San Francisco, laying off 62 employees that day and more than 120 total in the months that followed.

A $100 Million Hole

About 75 to 80 percent of Mar Monte’s patients are enrolled in Medi-Cal, California’s Medicaid program. When the federal reimbursement ban hit, it cut away more than half of the affiliate’s roughly $129 million annual operating budget. The organization serves more than 220,000 patients a year across its 30-plus remaining health centers.

“We know we have to face reality to keep our doors open,” said Stacy Cross, Mar Monte’s president and CEO.

The affiliate is now offering Botox at its Sacramento B Street Health Center at $9 per unit. Beyond Botox, it has rolled out IV hydration packages — branded “immunity,” “wellness,” “ultimate recovery,” and “hangover helper” — for $100 to $150, available Saturdays at Sacramento and San Jose locations. All are cash-pay services.

More Services Coming

Dr. Laura Dalton, Mar Monte’s chief medical operating officer, said the staff response was immediate when the pivot was announced.

“After our announcement, we had 30 providers immediately sign up, asking to be trained” in aesthetic services, she said.

Dermal fillers and laser hair removal are in the pipeline. The affiliate is also adding GLP-1 weight-loss medications — the drug class that includes Ozempic and Wegovy — at its clinics and through a new telehealth program called Poppy, which offers perimenopausal care visits at $250 each, with GLP-1 prescriptions available as part of those appointments.

Dalton said the expansion aligns with the organization’s core philosophy on patient autonomy, even as the financial pressure driving it is acute.

“Our kind of future financial stability remains uncertain. We are resilient and innovative, and I like to say that when faced with a crisis, our doors did not close. They opened wider.”

Political Fallout

The pivot has drawn scrutiny in Washington. Sen. Marsha Blackburn (R-TN) called on the IRS to investigate whether Mar Monte’s nonprofit tax-exempt status should remain intact given that it is now generating revenue from elective cosmetic procedures.

The Medicaid reimbursement ban was written as a one-year provision, set to expire July 4, 2026. Sen. Josh Hawley (R-MO) has filed an amendment to extend it, and Sen. John Cornyn (R-TX) has pushed for a permanent defunding measure in the next reconciliation bill. House Speaker Mike Johnson has not indicated plans to include one in his current legislative agenda.

Courts have partially blocked the ban’s implementation in several states, and litigation continues. The Kaiser Family Foundation is tracking active cases.

For now, Mar Monte is betting that cash-pay demand for elective services can partially fill the gap left by Medicaid — offering Botox injections in the same buildings where patients come for STI testing, contraception, and cancer screenings.