On Monday (March 4), the Trump administration published a rule in the Federal Register that reproductive rights advocates call a domestic gag rule.” Now, the federal government is facing a wave of legal opposition.

Yesterday, Planned Parenthood Federation of America and the American Medical Association (AMA) filed a lawsuit to block the rule from being instituted. “The groups argued in a filing in U.S. District Court in Oregon on Tuesday that the requirement would violate patients’ rights, force doctors to withhold information and harm the 4 million patients who rely on the Title X program for their health care,” reports The Washington Post.

They join a coalition of 21 state attorneys general and California that separately announced lawsuits on Monday (March 4). Among the states involved in the suit are Oregon, Colorado, Connecticut, Hawai‘i and New York, plus the District of Columbia. Reports The Washington Post:

The multi-state lawsuit also describes the requirement of physical and financial separation as onerous. In a statement, Oregon officials explain that “it would require health clinics to open another location, or create a separate entrance for patients, have separate examination rooms, hire separate personnel to work at separate workstations, maintain a separate phone number and website, and have separate electronic medical systems in order to continue to accept Title X funds.”

That lawsuit also takes issue with the rule’s mandate that every pregnant patient get a referral for prenatal care “regardless of the needs or the wishes of the patient.”

The new regulation changes the requirements under which health care providers can receive federal money under Title X, the federal family planning program established in 1970. It provides $286 million in funding for programs that provide services like birth control and mammograms, and screenings for breast cancer and cervical cancer.

If the rule is implemented, health care providers will be able to discuss abortion with patients, but will be barred from saying where one can be obtained. Clinics will also be able to omit abortion from conversations with pregnant women who are weighing their options, whereas previously a clinic could not receive federal funding unless all options were discussed.

In addition, clinics that are licensed to perform abortions will have to do so in a separate facility from where they provide their other services. They will not be able to tell patients that they can get an abortion there, as that is considered a referral. And they will also have to keep separate financial records for abortion-related expenses.

Religious groups have declared the rule a victory. Catherine Glenn Foster, president of Americans United for Life, said in a statement that the rule reflects “the commitment of the majority of Americans not to have their hard-earned tax dollars subsidize Planned Parenthood and other members of the abortion industry.”

Planned Parenthood serves 41 percent of all patients receiving care under Title X. The organization’s lawsuit states that the rule “blesses biased and incomplete pregnancy counseling where the interests of the patient are no longer paramount.”

Planned Parenthood President Leana Wen called the rule “unethical, illegal and harmful to public health” in a statement. She also said:

Title X serves women and families with low incomes, the majority of whom are people of color, Hispanic, or Latino, and the gag rule will worsen existing racial, socioeconomic and geographical health disparities. Families that are struggling to make ends meet and people who live in rural areas must have the same access to full, unbiased information from their doctor as everyone else. Planned Parenthood will never force our doctors and nurses to withhold medical information from our patients, and we will fight the Trump administration in the courts to protect everyone’s fundamental right to health care.

Dr. Barbara L. McAneny, president of AMA, said in a statement, “Because of the administration’s overreach and interference in health care decision making, physicians will be prohibited from having open, frank conversations with their patients about all their healthcare options. This blatant violation of patients’ rights under the Code of Medical Ethics is untenable.”

The rule is scheduled to go into effect 60 days after being published in the Federal Register on Monday. However, clinics will have 120 days to comply with the financial requirement to keep separate books and a year to implement the provision for separate facilities.