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% 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.
The Trump administration said that while clinics accepting Title X funds could continue to talk to patients about abortion, they could not refer women to an abortion provider or suggest where to obtain an abortion.
That distinction may seem like a subtle one, but Planned Parenthood and many other organizations, including the American Medical Association, say the restriction would force them to withhold medical information from patients, interferes with the doctor-patient relationship, and could deny pregnant women the range of options available to them.
“Trump’s administration is trying to force us to keep information from our patients,” Alexis McGill Johnson, acting president of Planned Parenthood, said in a statement Friday. “The gag rule is unethical, dangerous, and we will not subject our patients to it.”
The decision by Planned Parenthood is the latest step in the faceoff between those who oppose restricting women’s reproductive health choices and the Trump administration, which has been steadily shifting federal health programs in the direction of conservative preferences like promoting abstinence and allowing exemptions to insurance coverage of birth control.
Planned Parenthood receives about $60 million of the $286 million given annually by Title X to health centers providing reproductive health care, as well as screenings for breast cancer and cervical cancer, to about 4 million patients.
The Trump administration rule, announced in February, is being challenged in court by Planned Parenthood, several states and other organizations, but a federal court in July said the policy change could take effect while the legal cases were pending.
Planned Parenthood and some other organizations that receive Title X funds had decided to stop using the money until the legal challenges were resolved, although they have not officially withdrawn from the program.
The Department of Health and Human Services said that a type of intermediate status would not be acceptable. It said organizations had until Aug. 19 to submit an “assurance and action plan” showing they intend to make “good faith efforts” to comply with the new rule.
Last week, Planned Parenthood sent a letter to the U.S. Court of Appeals for the 9th Circuit, asking a panel of judges to stay the deadline until the legal cases could be decided. On Friday, the court declined to do so.
The immediate effect of a Planned Parenthood withdrawal is unclear and likely to vary by state. Planned Parenthood has said many clinics would feel pressure from the cuts.
The organization said that at least one program — a mobile health center in Cleveland that provides HIV testing, pregnancy tests and other services — would have to close. In states like Utah, where Planned Parenthood is the only Title X grantee, and Minnesota, where Planned Parenthood serves 90% of the Title X patients, those seeking care may face long waits for appointments. Some patients may delay care or go without.
Some state governments have promised to make up the lost federal funding. Governors in Hawaii, Illinois, New York, Oregon and Washington have said their states would not participate in Title X under the new rule. Legislatures in Massachusetts and Maryland have passed laws that essentially have the same effect.
Earlier this month, the Department of Health and Human Services posted an explanation of the timeline and details of the new policy, saying it is “not a gag rule.”
This article originally appeared in The New York Times.