A federal appeals court ruled Monday that the Trump administration's policy adjustments to the Title X program can stay, meaning that Planned Parenthood will continue to lose out on about $60 million in federal funding. 

On Feb. 24, the 9th Circuit Court of Appeals ruled 7-4 to uphold the "Protect Life Rule," which changed eligibility requirements for the Title X program. The policy change, first announced in May, 2018, bars clinics that provide abortion services or referrals for abortions from receiving funds from the program.

Title X is a federal program created in 1965 that subsidizes family-planning and preventative health services, including contraception, for low-income families. It has been frequently updated and subject to new regulations.

The Protect Life Rule also requires that clinics receiving federal funds be located in a different physical location than an abortion facility by March 2020. 

The rule had been blocked by courts in Washington, Oregon, and California, and judges in Washington and Oregon had issued nationwide injunctions stopping the rule entirely. The Department of Health and Human Services announced in July that they would be delaying enforcement of the rule due to the numerous legal challenges. Planned Parenthood pulled out of the Title X program entirely in August. 

Planned Parenthood's acting president Alexis McGill Johnson said at the time that the group refused "to let the Trump administration bully us into withholding abortion information from our patients."

Calling the Protect Life Rule a "gag on health care providers," Johnson said in a statement that the rule is "a blatant assault on our health and rights, and we will not stand for it."

In the majority opinion, Judge Sandra Ikuta wrote that the Supreme Court had approved of similar regulations in the 1991 case Rust v. Sullivan, and that the Protect Life Rule was actually "less restrictive in at least one important respect."

Under the terms of the Protect Life Rule, "a counselor providing nondirective pregnancy counseling 'may discuss abortion' so long as 'the counselor neither refers for, nor encourages, abortion,'" wrote Ikuta. 

Planned Parenthood was critical of the 9th Circuit's ruling, calling the Protect Life Rule an "unethical, dangerous Title X gag rule" that will result in people losing access to medical care.

"Congress must reverse the gag rule," said Planned Parenthood on Twitter.

The American Medical Association wrote that they "strongly disagree" with the court's decision, and that it is "unacceptable for the government to tell physicians what they can and cannot say to patients."