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Once again taking aim at President Trump, California on Monday filed its 47th lawsuit against the administration, this time to block a move that would effectively strip millions of federal dollars from reproductive health providers that perform abortions and abortion referrals. Attorney General Xavier Becerra, who has become one of Mr. Trump’s most aggressive critics, said Monday that the administration’s changes to Title X, the federal family planning program, would punish doctors and clinics for giving women a comprehensive portrait of their reproductive options. The administration announced those changes last month. (Del Real and Pear, 3/4)

Twenty states and Washington, D.C., said they would sue separately Tuesday. The states are: Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin. Washington's Democratic attorney general also previously said the state would challenge the rule. Trump administration officials have told abortion opponents that they expected a number of legal challenges to the new family planning rule, which also prohibits federally funded family planning clinics from being housed in the same place as abortion providers. (Elias, 3/4)

Federal funding can't be used for abortions, but the administration argues any money that goes to abortion providers could indirectly support the procedure. Opponents call it a "gag rule" because it would ban clinics from referring women for abortions or counseling them on abortion as an option to end pregnancy. Rosenblum said the rule would force providers who receive funding to decide whether they will refuse it or "cave" to the new requirements. (Hellmann, 3/4)

The rule is designed primarily to target Planned Parenthood, the largest provider under the Title X family-planning program. The network of women’s health clinics receives about 10% of its funds from the program. The funding would instead largely shift to faith-based groups. The Title X program has become a battlefront in the U.S. fight over reproductive rights, with Democrats rallying to protect abortion rights against President Trump and Republicans who have made gains curtailing access to the procedure in this administration and in state legislatures in recent years. (Armour, 3/4)

Becerra, in the California filing, called the rule an “extraordinary overreach.” “HHS has exceeded the scope its statutory authority and acted in a manner that is arbitrary, capricious, and not in accordance with law,” he wrote. In a statement, Becerra said the rule would deny “patients access to critical health care services and prevents doctors from providing comprehensive and accurate information about medical care.” (Cha, 3/4)

“The Trump-Pence Administration has doubled down on its attacks on women’s health," Becerra said in a statement. “The Trump-Pence Administration’s sabotage of Title X services that millions of women across our nation rely on is not only irresponsible, it is dangerous to women’s health. President Trump treats women and their care as if this were 1920, not 2019.” (Leitsinger, 3/4)

More than 360 clinics in California receive federal family planning funding to provide birth control, cancer screenings, testing for sexually transmitted diseases and other health care services for primarily low-income patients. Their programs serve about 1 million people a year, more than a quarter of the Title X patients in the country. (Koseff, 3/4)

The referral restrictions are set to go into effect 60 days after the date of publication of the new regulations, while there’s a yearlong wait on enforcement of the requirement that clinics have separate entrances and exits, treatment facilities and patient records. (Mehrotra, 3/4)

Last week, Washington State Attorney General Bob Ferguson filed a separate lawsuit challenging the rule. The National Family Planning & Reproductive Health Association and the American Civil Liberties Union filed a similar lawsuit, and Ferguson said the two cases could be consolidated at some point. (Raman, 3/4)

On Monday, 21 states announced they would be filing a federal lawsuit Tuesday in Oregon, arguing the rule imposes “an unlawful and unethical restriction on health care professionals.” But facilities in New Hampshire are still bracing for sweeping reductions. Planned Parenthood’s New Hampshire clinics expect to see a quarter of their collective budget vanish if the rule moves ahead: $1.6 million over two years, according to Sabrina Dunlap, vice president of public policy at Planned Parenthood of Northern New England. And independent clinics say the funding cuts will draw away from nonabortion related care such as contraceptives and STD treatment. (DeWitt, 3/4)