Read more about the Trump administration’s new rule here.

UPDATE, March 29, 3:12 p.m.: The Trump administration on Friday unveiled its Title X grant awards. The administration didn’t include funding for Planned Parenthood in Wisconsin, Hawaii, North Carolina, Virginia, and southwest Ohio, while giving $1.7 million to Obria Group, an anti-choice network that opposes contraception and “is marketing itself as the anti-abortion alternative to Planned Parenthood,” according to the Campaign for Accountability.

The U.S. Department of Health and Human Services (HHS) released the final version of its new regulations for Title X programs, which will ban federal family planning funds from going to health providers who perform or refer patients for abortion services. This amounts to a domestic “gag rule,” reproductive rights advocates say.

The updated rule, posted online by HHS on Friday, still needs to be officially published in the Federal Register.

The gag rule, first proposed in May, limits patients’ access to medically accurate family planning information by banning abortion referrals and forces abortion providers to physically and financially separate abortion services from family planning services in order to receive Title X funding. The move is an apparent attempt to make good on President Donald Trump’s campaign promise to “defund Planned Parenthood,” which serves 41 percent of Title X patients.

Reproductive health and rights advocates warn that the domestic gag rule could serve as a critical roadblock in access to care for Title X patients. “This rule will block doctors across the country from referring Title X patients for safe, legal abortion,” Dr. Leana Wen, president of Planned Parenthood, told Rewire.News in a statement. “It will block patients from getting birth control at places like Planned Parenthood, and it will prohibit doctors from being able to provide full and accurate information to their patients. There are 4 million people across the country who rely on Title X to access critical health care like birth control, cancer screenings, and STI testing and treatment—and more than 1.6 million seek that care at Planned Parenthood.”

“We will fight this rule in every way possible, and we will continue to provide care to our patients —no matter what,” Wen said.

The unofficial final rule comes after a group of anti-choice groups convened in November at the White House with administration officials, expressing disappointment over its slow progress. Vice President Mike Pence, a vocal opponent of abortion rights, was also present at that meeting, according to a Washington Post report. “It wasn’t a hostile audience today, obviously,” Students for Life of America President Kristan Hawkins told Rewire.News, specifically pointing to the Title X rule. “We did express some disappointment that things haven’t moved faster and that there were things that they’ve promised that they haven’t done yet.”

Anti-choice officials installed by the Trump administration at HHS have long held the goal of defunding Planned Parenthood, a primary recipient of Title X funding, as well as undermining access to comprehensive reproductive health care. In May 2018, anti-choice activist Diane Foley was appointed to oversee distribution of Title X funding as head of the Office of Population Affairs (OPA). Foley previously served as the president and CEO of Life Network, which, according to its website, promotes “life-affirming alternatives to abortion” and operates two anti-choice clinics in the Colorado Springs area. The organization is an affiliate of CareNet, which operates one of the largest networks of anti-choice “crisis pregnancy centers” in the United States. It gets support from Focus on the Family, an anti-choice organization that opposes some forms of contraception such as intrauterine devices (IUDs).

A long series of anti-choice actions from the administration paved the way for the domestic gag rule. In an announcement in August, HHS shortened the period of time covered by Title X grants issued last year, forcing each provider to reapply for funds for a second year in a row rather than the customary biennial grant application process. Advocates worried the move was connected to the gag rule and expressed concern that forcing providers to reapply for funding again may interrupt critical services for patients.

According to an email from an HHS spokesperson to Rewire.News in November, when the 2019 Title X funding opportunity announcement was released, the rule will apply to new and existing Title X grants. “If a new Title X regulation is finalized, grantees will need to come into compliance with the new regulation according to the timetable within the rule. However, scoring criteria for this competition will not change from that stated in the FOA,” the spokesperson said. The rule will go into effect 60 days after it is posted to the Federal Register, applying to 2019 grantees.

In a letter last week to Mick Mulvaney, director of the Office of Management and Budget (OMB), and Neomi Rao, administrator of the Office of Information and Regulatory Affairs (OIRA), Democrats expressed concern that HHS may not have followed the proper administrative procedure in finalizing the rule.

The letter, which was sent by Rep. Elijah E. Cummings (D-MD) and Sens. Patty Murray (D-WA), Kamala Harris (D-CA), and Maggie Hassan (D-NH) prior to the release of the domestic gag rule’s final text, expressed concern that it would be finalized before HHS “conducted a comprehensive cost-benefit analysis of the rule’s potential economic and health impacts.”

“Of particular concern, HHS declined to deem the Title X rule economically significant—completely disregarding the considerable health-related costs the rule would impose—and failed to conduct a comprehensive regulatory impact analysis,” the letter states. It went on to call for the rule to be returned to HHS “so that it can perform a comprehensive regulatory impact analysis and provide stakeholders additional opportunity for public comment.”

Mulvaney currently serves as acting chief of staff for the president in addition to his role at OMB, and Rao was recently nominated to be a judge on the D.C. Court of Appeals.

This is a developing story. Rewire.News will continue to report as more information emerges.