In an unusual ruling for the hyper-liberal court, the 9th U.S. Circuit Court of Appeals on Monday upheld rules set in place by President Trump’s administration that ban the use of taxpayer money for family planning clinics that refer women for abortions.

The 7-4 ruling by the 9th U.S. Circuit Court of Appeals overturned previous decisions issued by judges in three other courts in Washington, Oregon and California. The administration’s changes to to the rules were allowed to take effect while the federal government appealed the earlier rulings.

“Congress has long prohibited the use of Title X funds in programs where abortion is a method of family planning and (the Department of Health and Human Service’s) recent rule makes that longstanding prohibition a reality,” U.S. Justice Department spokeswoman Mollie Timmons said in a written statement applauding the 9th Circuit’s ruling. “We look forward to continuing to defend this vital rule against all challenges.”

Under the rules, taxpayer-funded clinics in the Title X program for low-income women are barred from making abortion referrals. And starting March 4, the rules will also prohibit clinics that have federal funding from from using the same office space as abortion providers.

But Title X patients will still be able to access affordable birth control and other care through the existing program, including cancer screenings and HIV testing.

“More than 20 states and several civil rights and health organizations challenged the rules in cases filed in Oregon, Washington and California. Judges in all three states blocked them from taking effect, with Oregon and Washington courts issuing nationwide injunctions. One judge called the new policy ‘madness’ and said it was motivated by ‘an arrogant assumption that the government is better suited to direct women’s health care than their providers,'” The Washington Times reported.

Planned Parenthood, which served 1.6 million of the 4 million patients who received care through Title X, has already left the program in protest, giving up about $60 million a year in federal funding.

Overall, nearly 1,000 clinics have left Title X, according to the National Family Planning and Reproductive Health Association. Washington and Oregon have abandoned the program entirely. In Vermont, all of the Title X clinics were Planned Parenthood, leaving none there.

In California, the number of patients served by the program has fallen 40 percent under Trump’s rules – and it will fall further once the physical separation requirement takes effect March 4, said Essential Access Health, which administers Title X in California.

The administration’s new rules are a return to the spirit of rules that were adopted in 1988 and subsequently upheld by the Supreme Court in the 1991 case Rust v. Sullivan. Under the Clinton administration, those rules were abandoned in favor of a requirement that the clinics provide neutral abortion counseling and referrals upon request.

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