President Donald Trump signed a bill Thursday that will allow states to withhold federal funds from organizations and facilities that provide abortion services, such as Planned Parenthood.

And for a president fond of spectacle, the signing was unusually private, with no media present.

The bill reverses a rule enacted by Barack Obama, days before the end of his presidency, that barred states from withholding state-managed Title X family planning funds — state grants aimed at helping low-income individuals receive family planning services at reduced or no cost — from health providers that offer abortions. The reasoning was that those providers also often offer services like contraception and screenings for sexually transmitted infections, and under the Obama-era rule, states could only deny providers the grants if they could not actually provide family planning services.

Crucially, the new measure also does not keep abortion providers from receiving federal Medicaid reimbursements, a policy option often referred to as “defunding” Planned Parenthood. (It is already illegal to use taxpayer dollars to pay for abortions, except in cases of rape, incest, or medical emergency.) But its impact could still be immense, abortion rights groups say.

“Four million people depend on the Title X family planning program, and by signing this bill, President Trump disregards their health and well-being,” Planned Parenthood Executive Vice President Dawn Laguens said in a statement condemning the signing. In the last six years, at least 13 states that use Title X grants have approved limitations that would keep abortion providers from participating in them, according to a Department of Health and Human Services report.

The bill passed only narrowly in Congress — Vice President Mike Pence, the highest-ranking government official to ever attend the anti-abortion March for Life, had to step in and cast a tie-breaking vote in favor of the measure. Groups who oppose abortion have pointed to Pence’s action as a sign that Trump is keeping his campaign promises to restrict abortion access.

“That allowed choice for the [states] on how they want to spend healthcare dollars,” Kristi Hamrick, a spokesperson for Americans United for Life, told VICE News before the signing. “That was a huge change, a huge victory.”