Democratic-led states sued in two separate courts on Monday, as the Trump administration officially released its Title X family planning regulation that pulls all funding from abortion clinics.
On Tuesday, the American Medical Association and Oregon Medical Association teamed up with Planned Parenthood Federation of America for an additional lawsuit in the U.S. District Court in Eugene, Ore.
The same court will be hearing the Oregon-led challenge from Monday that included 21 Democratic state attorneys general as plaintiffs. The states want a preliminary injunction to block the regulation, which would significantly reshape the program, from taking effect 60 days from now.
Meanwhile on Monday, California Attorney General Xavier Becerra lodged another suit in a U.S. District Court in San Francisco. And last week, Washington state Attorney General Bob Ferguson announced he would also challenge the rule.
The AMA highlighted the regulation's provision that bars a clinician from directly referring a pregnant patient for an abortion, which AMA President Barbara McAneny called a "blatant violation of patients' rights" under the code of medical ethics.
"Because of the administration's overreach and interference in health care decision making, physicians will be prohibited from having open, frank conversations with their patients about all their healthcare options," McAneny said.
Most significantly, the rule if it takes effect would block Planned Parenthood affiliates from the funding. Planned Parenthood clinics see more than 40% of women who get care through Title X.
HHS said in the final rule that the change addresses "concerns over the fungibility of Title X resources and the potential use of Title X resources to support programs where, among other things, abortion is a method of family planning."
In the early 1980s, President Ronald Reagan's administration implemented a similar rule, ultimately upheld by the U.S. Supreme Court in 1988.
Yet the so-called medical "gag" provision decried by the AMA and others in the medical community could bring the regulation down this time around, according to critics.
Last week Washington Assistant Attorney General Jeffrey Sprung argued that this provision runs counter to current law, thanks to a measure passed with the Affordable Care Act that forbids limits on clinicians' communications.
Until a court weighs in, it's unclear whether, and how soon, the regulation will affect current Title X networks. Clinics, including those run by Planned Parenthood, that received funding in September will run out at the end of next month and the new cycle is set to start May 1.
Correction: An earlier version of this story misstated when the new cycle for Title X funding begins. It begins May 1.
