The Trump administration is expected to announce a policy on Friday that would bring the so-called “global gag rule” — also known as the Mexico City policy — to American shores, the New York Times reported.

Under this rule, clinics in the US that provide abortion services or referrals will be ineligible for federal funding. Federal family planning funding laws already prohibit clinics from directly applying funds to abortion services, but the policy change would force health centers that receive these funds to stop providing abortion services, even if they are funded through other means, or to provide them at a separate location with separate staff.

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The measure is seen as a step toward fulfilling Trump’s presidential campaign promise to tighten abortion laws.

Though Republicans have campaigned to stop public funding from reaching Planned Parenthood, a nonprofit reproductive health care organization, for many years, Trump administration officials have said the move is not intended to explicitly target the organization.

"This proposal does not necessarily defund Planned Parenthood, as long as they're willing to disentangle taxpayer funds from abortion as a method of family planning, which is required by the Title X law," a Trump administration official said.

Read more: Why Women Need Health Funding Now More Than Ever

Every year, Planned Parenthood serves 1.5 million people through Title X — a federal grant program established in 1970 to make birth control and reproductive health care affordable to people with low incomes. The services Planned Parenthood and its affiliated clinics provide through Title X include testing and treatment for HIV and other sexually transmitted diseases, as well as breast cancer screenings. And Planned Parenthood’s patients account for about 38% of all patients served by Title X nationwide.

If Planned Parenthood health centers lost their Title X funding, these patients' access to affordable health services could be jeopardized.

However, the majority of Planned Parenthood's funding comes from reimbursements from Medicaid for preventative care. Nearly half of the services its health centers delivered in 2016 were related to testing for and treating sexually transmitted infections, according to a factsheet on the organization’s website, and abortions made up 3% of the services it provided. This means that many of Planned Parenthood’s services can remain intact as long as abortion services are clearly separated from other services and the organization continues not to use federal funding to support those services.

But the policy change could still have a major impact on women living on low incomes and in underserved areas.

Nearly three-quarters of its patients live on low incomes, and more than half of its health centers are in rural or medically underserved areas, meaning that hundreds of thousands of women would lose access to affordable health care services under Trump’s policy.

Read more: The World’s Poorest Women Also Lack Reproductive Care, and It Could Be Driving Global Inequality

The proposed rule is not a new one.

A similar domestic policy was first implemented by President Ronald Reagan in 1988, requiring clinics that received family planning funds to have physically separate facilities and personnel for abortion-related services. Trump’s proposal would retain this requirement, CNN reported. The Reagan rule also barred health care workers at federally funded clinics from providing information about abortions or where to receive them to patients. 

Though Trump’s rule is still likely to prohibit clinics that receive federal funding from referring women to abortion service providers, the policy does not appear to prohibit all abortion counseling, NPR’s Sarah McCammon reported on Twitter.

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The policy is similar to another Reagan-era policy, the “global gag rule,” which President Trump revived in January 2017. It was heavily criticized as making health care less accessible to women and girls around the world, particularly in developing countries.

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