SAN FRANCISCO (AP) — A U.S. appeals court has declined once again to immediately halt new Trump administration rules that bar taxpayer-funded clinics from referring patients for abortions.

The 9th U.S. Circuit Court of Appeals late Friday rejected a request from more than 20 states, Planned Parenthood and the American Medical Association to block the rules from taking effect while the case proceeds.

A three-judge panel and an 11-judge panel have already said the rules can take effect while the administration appeals lower court rulings that blocked them. Oral arguments are next month.

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Planned Parenthood has said it will leave the federal Title X program by Monday if the rules aren’t blocked.

About 4 million women are served nationwide under the program, which is designed to improve access to family planning for low-income women.