On Feb. 22, 2019, the Department of Health and Human Services (HHS) released a final rule to alter Title X: the only federal grant program whose funds are directed towards providing family planning and preventative health services to low-income Americans. A prominent focus of the final rule is abortion, as HHS states that Title X funds cannot be used to, “perform, promote, refer for, or support abortion as a method of family planning.”

Federal funds may still be given to clinics who provide abortions, but there must be a barrier between authorized and unauthorized health services under Title X. In part, this is a financial barrier that separates federal funding from any provided abortion services. Clinics are also required to maintain a physical barrier that secludes the spaces in which abortions are provided from the rest of a clinic.

The Trump administration first proposed this rule in May 2018 and received backlash from abortion-rights activists who criticized the proposal as a “gag rule”: an attempt to stop doctors from having open conversations with women about all of their options, including abortion. In a statement from the Press Secretary, Sarah Sanders, on May 18, 2018— it was stated that, “HHS’s proposal does not include the so-called ‘gag rule,’” and that it was meant to, “ensure that taxpayers do not indirectly fund abortions.”

Alongside continued backlash, the rule also has a base of support comprised of religious groups who are hoping to see some of the federal funding directed towards programs that support methods for prevention outside of abortion. In an interview with NPR, Mario Dickerson, the executive director of the Catholic Medical Association said, “we could provide abstinence programs; we could provide natural family planning… but not have to provide these other services.”

Amid those voicing their concerns about the proposed changes is Planned Parenthood— an organization whose clinics serve about 41 percent of the 4 million people who receive care through Title X. Dr. Leana Wen, the president of Planned Parenthood told NPR that “it’s unconscionable and unethical for politicians to restrict doctors like me from speaking honestly to our patients.”

Those 4 million people who receive care through Title X are mainly young women— 67 percent of whom had family incomes below the poverty line in 2017. HHS’s 2017 report also states that 54 percent of the clients “identified themselves as white, 33 percent as Hispanic or Latino, 22 percent as African American or black, 4 percent as Asian, 1 percent as either Native American or other Pacific Islander, and 1 percent as American Indian or Alaska Native.”

The rule was published in the Federal Register on March 4, 2019 and will take effect 60 days after its publication.