Opponents have called it a "gag" rule that compromises medical ethics and endangers the lives of patients because it explicitly bars doctors, nurses or other care personnel from referring a woman for an abortion.
More than 37,000 patients passed through Title X clinics in OR in 2017, a lot of them below the federal poverty level.
"As a doctor, I can not imagine withholding information from my patients".
The lawsuit also takes issue with the rule's mandate that every pregnant patient get a referral for prenatal care "regardless of the needs or the wishes of the patient".
Marjorie Dannenfelser, who heads the national pro-life group Susan B. Anthony List, defended the rule Monday after the lawsuits were announced. "This rule is shameful, and it's unsafe".
Jonathan Keller, president of the California Family Council, said he supports the rule change because there needs to be a firewall between federal funds and abortion services. Low-income people, rural residents, communities of color and the uninsured, opponents argue, are the ones who will suffer most.
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The 21 states are just some of the parties - including the American Civil Liberties Union and the Center for Reproductive Rights - that have vowed to sue over the rule, which was published Monday in the Federal Register.
The ACLJ said the rule "ensures that program recipients are in full compliance with the law, particularly the statutory prohibition on funding to programs where abortion services are performed or recommended as a form of family planning". "The final regulation is the latest of numerous recent decisions - from rolling back insurance coverage for contraceptives to attempting to eliminate funding for evidence-based teen pregnancy prevention programs - that unravel the threads of this safety net".
The plan, announced by the Department of Health and Human Services in February, would require "clear financial and physical separation" between Title X-compliant facilities and those that provide abortions or abortion referrals, the administration said.
The new rule will cause high-quality family planning providers to flee the Title X program, according to the California suit.
Health and Human Services Department declined to comment, citing the litigation.
Other lawsuits are expected to follow soon. The Title X program has become a battlefront in the US fight over reproductive rights, with Democrats rallying to protect abortion rights against President Trump and Republicans who have made gains curtailing access to the procedure in this administration and in state legislatures in recent years.
"Abortion is not family planning", Sills said in a statement. The multistate lawsuit, brought mostly by Democratic-controlled states, is expected to be filed Tuesday in U.S. District Court in Eugene, Ore. After the rule was released, Planned Parenthood said it "would be impossible" for it to continue participating in Title X adding that it put providers like Planned Parenthood in an "impossible position". And while Planned Parenthood certainly stands to lose millions, independent clinics and health centers that don't have national name recognition - like those in ME - see this as a fight for their survival, too.