In a setback in the fight for accessible, comprehensive reproductive health care for all, Planned Parenthood Federation of America on Monday (August 19) withdrew from the federal Title X program, which provides millions of dollars of the organization’s annual funding.

On Friday (August 16), the United States Court of Appeals for the Ninth Circuit denied Planned Parenthood’s request to reverse an order that permitted the Trump administration’s Title X abortion clinic-referral restriction to go into effect pending the outcome of a lawsuit to block the rule that was filed by Planned Parenthood, the American Medical Association and 22 states.

The regulation—which reproductive rights advocates call a domestic “gag rule”—changes the requirements that health care providers must meet to receive federal money via Title X, the federal family planning program that was established in 1970. Title X provides $286 million in funding for programs that provide services like birth control, mammograms and screenings for breast cancer and cervical cancer. 

Under the rule, 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 people who are weighing their options, whereas previously, a clinic could not receive federal funding unless all options were discussed.

Reports CNN: “Critics say the regulations would mostly affect communities of color, low-income people, the uninsured and rural residents.”

According to The New York Times, Planned Parenthood’s withdrawal from the program will have major consequences:

Such a move could affect more than 1.5 million low-income women who rely on Planned Parenthood for services like birth control, pregnancy tests and screening for sexually transmitted diseases. Planned Parenthood operates about 40 percent of the more than 4,000 clinics that receive money under Title X. In some rural communities, Planned Parenthood is the only provider of such services.

After announcing the withdrawal, the organization held a press conference to announce next steps. Acting President Alexis McGill Johnson said in her opening remarks:

Planned Parenthood is still open. Our doors are open today, and our doors will be open tomorrow.

[…]

For too many people struggling to make ends meet—including those people in rural areas and communities of color—this gag rule may mean they delay or go without care. We believe that the Trump administration is doing this as an attack on reproductive health care and to keep providers like Planned Parenthood from serving our patients. 

Johnson stressed that even after using emergency funding to address budget gaps, there will be an impact on the care patients receive. “Wait times for appointments will skyrocket, and people will delay or go without care. We already see women having to drive impossible distances to access abortion. This gag rule could mean that we now will see women driving hundreds of miles just to find a provider who can help them access birth control such as an IUD,” she said.

Several states—Hawaii, Illinois, New York, Oregon and Washington—have said they would not comply with the new rule. They join Massachusetts and Maryland, which had already passed laws that allow the states to opt out of participating in the gag rule.

All health care organizations receiving funding via Title X must decide by Monday if they will be in compliance with the new rule.

The week of September 23, the Ninth Circuit court will hear oral arguments in the lawsuit filed against the federal government.