Planned Parenthood, the country's largest provider of abortion services, has announced that it will withdraw from the federal Title X family planning program, ending its access to millions of dollars in government funding.

The decision is set to take effect Aug. 19, the date by which funding recipients are required to make a "good faith" undertaking to comply with a new rule barring the referral of clients for abortion services.

After it was announced in final form in February, the Protect Life Rule was subject to court challenges from abortion providers and several states. In June, the U.S. 9th Circuit Court of Appeals determined that the rule could come into force. In July, judges refused to issue a stay against that decision.

Planned Parenthood informed the court on Wednesday that, unless the reversed its refusal to grant a stay, it would leave the Title X program on Monday.

Planned Parenthood's acting president Alexis McGill Johnson said 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 addition to barring Title X fund recipients from referring women for abortions it also prevents participating groups from co-locating with abortion clinics and requires financial separation of government-funded programs from those that carry out abortions.

Planned Parenthood had previously intended to remain in the Title X program but refuse funding, an arrangement that HHS Deputy Assistant Secretary Diane Foley called "inconsistent" in a letter to the organization.

In guidance issued by HHS on Friday, the department responded directly to Planned Parenthood's objections to the rule, noting that the organization operated less than 10% of participating sites nationwide.

"To the extent that Planned Parenthood claims that it must make burdensome changes to comply with the Final Rule, it is actually choosing to place a higher priority on the ability to refer for abortion instead of continuing to receive federal funds to provide a broad range of acceptable and effective family planning methods and services to clients in need of these services."

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 administration previously said in June that it would delay enforcement of the rule, provided that fund recipients submitted a compliance plan and made a "good faith" undertaking to comply with most of the rule's requirements as soon as possible. Facilities are required to end co-location with abortion sites by March 2020.

Last month, Marjorie Dannenfelser, president of the pro-life organization Susan B. Anthony List, welcomed the 9th Circuit's decision to deny a stay, calling the Protect Life Rule "greatly encouraging."

"Without reducing Title X funding by a dime, the Protect Life Rule simply draws a bright line between abortion and family planning, stopping abortion businesses like Planned Parenthood from treating Title X as their private slush fund." 

Before announcing its withdrawal from the Title X program, Planned Parenthood and its affiliates had received some $60 million annually, about one-fifth of total Title X funds, making up approximately 15% of its annual federal funding.