In anticipation of regaining access to more than $800 million in annual federal funding, some Planned Parenthood chapters have been putting the word out to Medicaid patients that they can once again come in for services, and at least one new clinic is set to open later this year in Louisiana — which had lost all of its remaining Planned Parenthood centers over the past year.

But due to ongoing uncertainty over both federal and state funding as well as the difficulty of finding facilities to lease and staff to hire, the vast majority of the dozens of clinics that shut their doors over the past year will not reopen.

Nora Walsh-DeVries, the vice president of political and legislative affairs for Planned Parenthood, said the past year of defunding caused “irreparable damage” to many communities where access to health services is already scarce.

The group reported this week that two-thirds of the health center closures occurred in rural areas, medically underserved areas, or areas with shortages of health workers. Across the national network, there were 250,000 fewer visits compared to the year before. And while nearly a dozen progressive-leaning states where abortion is legal, including California, Illinois, New York, and Massachusetts, dug into state coffers to backfill some of the lost funding, red states that prohibit the procedure did not, resulting in the shuttering of many facilities that only provided non-abortion services like contraception and pelvic exams.

“The impact of this defund did not result in less abortion care. It just resulted in less people being healthy, less people being able to get care and access in a place that they want to get care and access,” Walsh-DeVries said. “And there’s not a way to put a number on how many people were not able to come in and get a cancer screening, and what that did to them.”

At the same time, many threats to the organization’s other sources of taxpayer funding remain. A Supreme Court ruling last year cleared the way for states to kick Planned Parenthood out of their Medicaid networks, and several GOP-led states are expected to join South Carolina in doing so.

Some clinics also recently lost millions in federal grants under the Teen Pregnancy Prevention Program, while others are bracing for President Donald Trump’s health department to enact a version of the Title X rule from his first administration that cuts off tens of millions in family planning funds that Planned Parenthood currently receives.

And of course, Congress could defy the odds and pass a party-line bill that revives the Medicaid funding ban later this year or — if Democrats fail to flip one or both chambers — in 2027.

Anxious to prevent that outcome, Planned Parenthood’s electoral advocacy arm just invested another $2 million in an ongoing campaign targeting a handful of vulnerable House Republicans who voted last year to defund the group: Reps. David Schweikert and Juan Ciscomani of Arizona, Gabe Evans of Colorado, Mariannette Miller-Meeks of Iowa, Bill Huizenga and Tom Barrett of Michigan, Mike Lawler of New York, and Pennsylvanians Brian Fitzpatrick and Ryan Mackenzie. The group also flew hundreds of activists into DC for a Capitol Hill lobby day in June, and held demonstrations at GOP members’ district offices during the Memorial Day recess.

“We have to really continue to do the work that we’re doing to make this as politically toxic as possible,” Walsh-DeVries said.