The Trump administration moved Friday to place new restrictions on access to abortion, as the Health and Human Services Department prepared new regulations that would effectively bar organizations that receive federal family planning money from providing abortions or counseling women about how to get the procedure.
The much-anticipated proposal — which has not yet been officially issued as a rule — would greatly expand limits on what activities organizations such as Planned Parenthood can provide.
And it almost certainly will set off a new legal battle over abortion services.
According to the White House, the proposal would require recipients of Title X family planning funds to establish a "bright line of physical as well as financial separation" between federally-funded family planning services and any programs where abortion services are performed or discussed.
The administration argues that this is not a "gag rule" that would prohibit discussions of abortion services.
But the proposal would greatly expand long-standing restrictions on the use of federal funds. Currently abortion providers must ensure that no federal money is used to pay for the procedure.
And many family planning advocates believe that the new rule, if implemented, would make it effectively impossible for many clinicians to talk freely with pregnant women about their options.
"This 'gag rule' is not only unconscionable, but it undermines medical ethics by forcing healthcare professionals to withhold accurate and timely medical information from patients," said Dr. Jenn Conti, a fellow with Physicians for Reproductive Health.
"As a provider of comprehensive reproductive health care, it is my number one priority to keep my patients safe and honor the trust they give me. If I can't mention the word 'abortion,' then I am not providing my pregnant patients who want to know all of their options with complete, accurate, unbiased medical information."
Abortion opponents have been lobbying hard for new restrictions, pushing the Trump administration to extend the new limits on federal funding.
And a host of anti-abortion rights groups cheered the White House moves Friday.
"We thank President Trump for taking action to disentangle taxpayers from the abortion business," said Susan B. Anthony List President Marjorie Dannenfelser. "This is a major victory which will energize the grassroots as we head into the critical midterm elections."
Trump, whose past pronouncements in support of abortion rights once made social conservatives nervous, is scheduled to speak at the Susan B. Anthony List's annual gala on Tuesday.
The White House on Friday cast the new proposal as the latest in the administration's moves to fulfill Trump's campaign promise to restrict access to abortion services.
The Trump administration has strongly supported provisions in GOP bills to roll back the Affordable Care Act that would have cut off funding to Planned Parenthood, the nation's largest provider of abortion services.
Those bills failed, as the GOP campaign to repeal the 2010 healthcare law collapsed.
But anti-abortion rights groups have kept up their campaign to squeeze off government funding for Planned Parenthood and other organizations that provide abortion services.
In the crosshairs has been Title X, the nation's first federal program dedicated to supporting family planning services, such as contraception and counseling.
Since its inception in 1970, the Title X program has funded thousands of clinics and other medical providers.
The money has never been used to pay for abortions. But because some recipients of Title X funding have also provided abortion services, Title X has been a longtime target of social conservatives.
In the 1980s, President Ronald Reagan's administration proposed regulations to bar clinicians at any organization receiving Title X funding from providing abortion counseling or referral, even when requested by a pregnant woman.
This so-called "domestic gag rule" was challenged in court and upheld by the Supreme Court, but by then President Clinton was in office and he stopped implementation of the rule. It was never reinstated.
The new proposal from the Trump administration would not explicitly prohibit organizations that receive Title X money from counseling women about abortion services, according to the White House.
But it would change the longstanding requirement that family planning counseling include a discussion about the full range of options available to women, including abortion.
And it would prevent Title X recipients from referring women who want abortions to providers that offer these services.
That would mark a major step backward, said Kinsey Hasstedt, senior policy manager at the Guttmacher Institute, a nonprofit that studies family planning and abortion.
"Title X is based around the concept of patient-centered care," she said. "It requires that all pregnant patients receive counseling on and referral for the full range of pregnancy options."
Equally troubling, Hasstedt and others say, is that the new rule could make it impossible for organizations such as Planned Parenthood that provide abortion services to get Title X funding.
For decades, Planned Parenthood and other abortion providers have rigidly segregated their funding to assure that Title X money is not used to pay for abortions, which have been funded through other streams of money.
The Trump administration now appears to be saying that this segregation is inadequate.
Times staff writer Noah Bierman contributed to this report.
9:25 a.m.: This story was updated with additional reaction and background.