Planned Parenthood, state governments and other health groups will be back in court Monday challenging the Trump administration’s changes to a federal family planning program.

They’re asking the 9th Circuit Court of Appeals to block a rule issued by the Department of Health and Human Services (HHS), which bans federally funded family planning providers from referring women for abortions.

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The rule, which took effect this summer, has led Planned Parenthood, several states and other health care organizations to leave the Title X family planning grant program, which funds birth control, STD testing and treatment, and other reproductive health services for low-income women and men.

The court is expected to rule in several weeks on whether the Trump administration can continue implementing the rule while it’s being challenged in several courts.

The ruling could foreshadow the outcome of a case that could eventually make it to the Supreme Court.

“I think how the 9th Circuit rules will foreshadow what is probably going to end up happening with the case,” said Rachel Morrison, litigation counsel at Americans United for Life, which supports the rule.

A three-judge panel on the 9th Circuit has already sided with the Trump administration, throwing out several preliminary injunctions that had been placed on the rule by lower district courts.

In the arguments Monday, the American Civil Liberties Union (ACLU) will ask an 11-judge panel to reinstate those injunctions, which would again block the administration from implementing the rule.

“I think HHS and the government have a very strong argument and position and I would anticipate they would come out successful in the end,” predicted Morrison.

The ACLU and other groups are also fighting in district courts to have the rule thrown out permanently and declared unlawful, with arguments likely starting early next year.

But the rules have already had a significant effect on the program since the administration started implementing them this summer.

“In California, a broad range of agencies have withdrawn from program participation, including federally qualified health centers, city and county health departments, and women's health clinics,” said Julie Rabinovitz, president and CEO of Essential Access Health, one of the groups suing over the rules.

She said the number of California counties with a Title X provider has been almost cut in half.

The rules also block clinics from providing abortions or being financially connected to an abortion clinic, disqualifying Planned Parenthood, which serves more than 41 percent of Title X patients.

Government funds, including Title X grants, are banned under law from paying for abortions. But the Trump administration argues that funding for abortion providers still indirectly supports the procedure.

Planned Parenthood says it will continue serving Title X patients, but it has had to raise prices for some services to make up for the funding loss.

Several states, including California, Washington, Oregon and New York, have pulled out of the program and are also suing the administration over the rules.

Opponents of the rules say they’re detrimental to public health because clinics that remain in the Title X program must withhold information from their patients about where they can get abortions.

Monday's oral arguments are only the latest step in what has been a complicated court fight since HHS finalized the changes in March.

Federal district court judges in California, Oregon and Washington blocked the rules in three separate cases this spring.

But the administration appealed to the 9th Circuit Court of Appeals, where a three-judge panel stayed those injunctions, allowing the rules to go in effect while they were being challenged in court.

The ACLU, representing the National Family Planning and Reproductive Health Association, will argue Monday that the injunctions should be reinstated because the rules have damaged the program.

“It would be hugely important for the 9th Circuit to put back in place our victories from the district court to stop further implementation of this rule,” said Fiona Kaye, senior staff attorney for the ACLU.

“It is a really incredibly important public health program for low-income people,” she added.

Meanwhile, the administration is pushing ahead. Officials plan to award $20 million to grantees that have remained in the program to fill in gaps left by Planned Parenthood and other groups that have left.

“We are in process of fulfilling our commitment to all patients seeking services covered by the Title X program as well as the appropriate next steps and will provide further guidance in due course,” said an HHS spokesperson.