Groups that provide or refer patients for abortions would reportedly be barred from receiving federal funding under a soon to be released Trump administration proposal.

It would apply to the federal Title X program, which helps low-income patients get reproductive health services including birth control, cancer screenings and STD testing. In Iowa, it would be the second reproductive health program recently targeted by abortion opponents.

More than 36,000 low-income Iowa patients used the Title X program last year, according to the Family Planning Council of Iowa.

If the rule goes into effect, it could block those patients from getting services at Planned Parenthood, Iowa’s biggest Title X provider.

“It would have a devastating impact on access to reproductive health care in Iowa, even more so than we saw last year,” said Erin Davison-Rippey, Director of Public Affairs at Planned Parenthood of the Heartland.

Davison-Rippey said Planned Parenthood clinics in Iowa are projected to serve about 14,500 Title X patients this year.

In 2017, the Iowa Legislature blocked funding from a different federal program from going to abortion providers. The exclusion of abortion providers from Iowa’s Family Planning Program led to the closure of four Planned Parenthood clinics. The Associated Press reports participation in the program has declined significantly.

Anti-abortion rights groups and lawmakers have long been attempting to “defund Planned Parenthood.” Planned Parenthood maintains it doesn’t use federal funding for abortions.

Republican U.S. Senator Joni Ernst of Iowa recently led an effort to ask the U.S. Department of Health and Human Services to put restrictions on Title X funding.

“Title X programs which are co-located with abortion clinics or refer for abortion send a message that abortion is considered a method of family planning in federally-funded family planning programs, contrary to the law,” reads a letter signed by her and Sen. Chuck Grassley.

The Trump administration proposal would go through a federal rules process that would take months and include a public comment period.