LOS ANGELES — Once again taking aim at President Donald Trump, California on Monday filed its 47th lawsuit against the administration, this time to block a move that would effectively strip millions of federal dollars from reproductive health providers that perform abortions and abortion referrals.

Attorney General Xavier Becerra, who has become one of Trump’s most aggressive critics, said Monday that the administration’s changes to Title X, the federal family planning program, would punish doctors and clinics for giving women a comprehensive portrait of their reproductive options. The administration announced those changes last month.

“This is 2019, not 1920,” Becerra said. “Jeopardizing the health of women is not what we should be doing in the year 2019.”

On Monday, 20 other states, plus Washington, D.C., said they would file a separate lawsuit challenging the same restrictions.

Millions of low-income patients receive reproductive health services each year through Title X, a $286 million federal family planning initiative. Programs that receive Title X funding provide a range of services, including family counseling, preventive health screenings for breast and cervical cancers, contraceptives and treatment for sexually transmitted infections.

About 40 percent of the 4,000 clinics nationwide that receive Title X funding are operated by Planned Parenthood.

The lawsuit by California was filed Monday just hours after the restrictions devised by the Trump administration were published in the Federal Register.

It was already against the law for health care providers to use federal funds for abortions. The new rule would prohibit organizations that provide referrals for abortions from accepting any federal funds for family planning.

“These rules were put in specifically to target Planned Parenthood,” said Crystal Strait, the head of the organization’s operations in California.

On a practical level, the administration’s order would bar doctors from mentioning the option of an abortion in nearly all cases, Strait said.

“This builds a wall between a doctor and her patients,” Strait said. “We’ve never in the United States accepted that. When you go into your physician, you expect to get medically accurate options.”

Clinics that receive federal funds can provide patients with a list of primary health care providers, including those that provide prenatal care, but cannot identify which ones on the list, if any, perform abortions.

The final rule also requires a complete separation of family planning and abortion services at clinics that offer both. Federal health officials estimate that 10 to 20 percent of Title X sites do not comply and would have to spend an average of $20,000 each to meet the requirement.

The new requirements would effectively redirect Planned Parenthood’s $60 million in yearly funding to faith-based and alternative providers unless its clinics dramatically changed the way they operate.

Anti-abortion organizations applauded the administration’s rule change.

Patrina Mosley, the director of Life, Culture and Women’s Advocacy at the conservative Family Research Council, said clinics like Planned Parenthood had been operating “against the very statute for which the money is intended” by providing referrals for abortions.

She said Monday’s lawsuits were frustrating but not surprising. “When the administration does something that the left doesn’t like, they go to court. This is the habitual pattern,” she said.

The change, critics argue, threatens to leave women without a full understanding of their reproductive options.

Gov. Kate Brown, D-Ore., criticized the new rule as “another attack from the Trump administration on women and families.” Oregon is leading the coalition of states that plan to challenge the rule in a separate lawsuit Tuesday.

California would be particularly hard hit by the administration’s order, Becerra said. Of the 4 million women affected by the rule nationwide, more than 1 million are in California, he said.

“Playing politics with that care is dangerous and grossly irresponsible,” Gov. Gavin Newsom said in a statement. “Our mothers, wives, sisters and daughters deserve better.”

This article originally appeared in The New York Times.