Planned Parenthood just forfeited $60 million in federal funding over their withdrawal from Title X funding.

President Donald Trump's "gag rule" policy to prohibit family planning clinics that provide abortion services or referrals from receiving $286 million in federal funding under Title X went into effect in February.

Planned Parenthood's withdrawal from Title X funding could affect over 1.5 million people nationwide, many of whom are uninsured and rely on Title X and Planned Parenthood for reproductive healthcare.

By removing funding for contraception, the gag rule could have the effect of increasing unplanned pregnancies and sexually transmitted infections.

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Planned Parenthood just forfeited $60 million in federal funding for refusing to comply with a regulation issued by the Department of Health and Human Services that will prohibit family planning clinics that receive funding under Title X from providing privately funded abortions or referring patients to abortion services.

President Donald Trump first announced the gag rule while speaking at a gala for the anti-abortion organization Susan B. Anthony's List in May 2018.

The rule reflects Trump's campaign promise to defund clinics that provide abortions, such as Planned Parenthood, and more broadly decrease access to abortion nationwide.

While pro-life groups celebrated the rule's enactment, family planning clinics slammed the new regulations for causing "irreparable harm" to clinics' ability to provide healthcare.

According to the Los Angeles Times, a federal appeals court did not grant Planned Parenthood's request to temporarily block the rule from going into effect last week but could issue another ruling next month.

Here's everything you need to know about Title X, what this so-called "gag rule" means for patients, and what effects it could have for patients' health on a national scale.

What Title X is

Established in 1970, Title X is the only federal statute that issues grants to clinics that provide family planning and health services to low-income and uninsured people who wouldn't otherwise be able to afford such services.

Approximately $286 million in Title X grants are administered to health centers and family planning clinics, such as Planned Parenthood, through the Office of Population Affairs (OPA) within the Department of Health and Human Services (HHS) each year.

According to an April 2018 report from the Congressional Research Service, 4 million people received services funded by Title X in 2016. There are 4,000 Title X-funded health centers throughout the country, with Planned Parenthood serving approximately 41% of Title X patients.

Read more: After just 8 months, the head of Planned Parenthood is out

Planned Parenthood officially announced on August 19 they will not comply with the rule and now stand to lose $60 million in Title X funding as a result. As The New York Times noted, however, they still receive about $500 million from Medicaid, the federal program that helps provide healthcare for low-income individuals.

"Trump's gag rule is destroying the nation's decades-old program for affordable birth control and reproductive health care. While the Trump administration may have given up on you, we NEVER will — we're doing everything we can to make sure patients don't lose care," Planned Parenthood Action tweeted, calling the rule "absolutely devastating."

Services Title X subsidizes

The main services funded by Title X grants are wellness exams, cervical and breast cancer screenings, birth control, contraception education, STI testing and treatment, and family planning counseling. A 2016 OPA report estimates that Title X funding allowed clinics to provide 700,000 pap smears, four million STD tests, and a million breast cancer screenings.

While Title X funding can pay for counseling in which patients are educated and informed about abortion, it cannot directly pay for abortion procedures. The Hyde Amendment of 1976 expressly prohibits any federal programs, including Title X and Medicaid, from funding an abortion procedure except in rare cases where pregnancy would endanger the life of a pregnant person.

Cheered on by Carol McDonald from Planned Parenthood Federation of America, women rally on Capitol Hill in Washington, Thursday, July 11, 2013. J. Scott Applewhite (Associated Press)

What the gag rule entails

According to a memo released by HHS in May 2018, the new policy will bar clinics that provide abortions along with other family planning services from receiving any Title X funding at all, even though none of that funding directly goes toward abortions services.

Additionally, doctors at clinics that receive Title X funds but do not provide abortions would be largely prohibited from referring patients to clinics that do provide abortions.

The new rule removes the requirement that providers counsel pregnant people on abortion as an option, and only permits doctors to make referrals to abortion services if the patient has already made up their mind to terminate the pregnancy.

Read more: Rep. Steve King questioned whether there would be 'any population left' without pregnancies from rape and incest

HHS is making more Title X grants available for faith-based and other clinics like Obria, that offer counseling for "natural" forms of family planning like the rhythm method but do not prescribe hormonal birth control.

—Planned Parenthood Action (@PPact) August 15, 2019

Many anti-abortion groups celebrated the news that Planned Parenthood would be withdrawing from the program.

"Abortion is neither healthcare nor family planning and taxpayer dollars should not support abortion," March for Life president Jeanne Mancini said in a Monday statement to INSIDER, adding, "Planned Parenthood's decision today doubles down on their ultimate goal, which is political abortion advocacy, not healthcare."

In January of 2017, Trump also reinstated a global gag rule known as the Mexico City Policy that prohibits global non-profits and NGOs that receive US government aid from providing information or referrals on abortion to patients in foreign countries.

Originally enacted by President Ronald Reagan in 1984, the Mexico City Policy has since been consistently implemented by Republican presidents and revoked by Democratic ones to signal their positions on abortion.

Who is most affected

Health clinics and opponents of the policy argue this new gag rule will disproportionately affect the most disadvantaged populations and leave them with nowhere else to turn for referrals to abortion providers.

The 2016 OPA report found that 89% of patients who received care through Title X funding identified as female, 64% had family incomes at or below the poverty line, and 43% lacked health insurance coverage.

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This rule means that clinics that refuse to comply with the restrictions on abortion services and referrals would lose all funds that provide birth control and contraception education. The rule could also increase the prevalence of unplanned pregnancies and STIs.

A 2011 study on the impact of the global gag rule during the George W. Bush administration found that this decreased availability of contraception services had the impact of nearly doubling unplanned pregnancies and abortions in sub-Saharan Africa.