The action is part of a series of efforts to remake government policy on reproductive health to please conservatives who are a key part of President Donald Trump's political base. Religious conservatives see the family planning program as providing an indirect subsidy to Planned Parenthood, which runs family planning clinics and is also a major abortion provider.
The administration's move came as Planned Parenthood is threatening to leave the Title X family planning program over the restrictions, and a federal court in San Francisco plans to hear arguments in a lawsuit to block the regulation.
The Department of Health and Human Services sent notices to program participants saying they must certify by Sep. 18 that they're complying with most major provisions of the rule. Plans on how the clinics intend to comply are due earlier, by Aug. 19.
In addition to the ban on abortion referrals, the rule's short-term requirements include financial separation from facilities that provide abortion, designating abortion counseling as optional instead of standard practice, and limiting which staff members can discuss abortion with patients. Clinics have until next March to separate their office space and examination rooms from the physical facilities of providers that offer abortions.
Known as Title X, the federal family planning program serves about 4 million women a year. The government distributes about $260 million a year in state grants to keep the program running. Many low-income women also get basic health care from the clinics. Organizations representing the clinics say the administration's rule violates basic ethical requirements that medical providers fully inform patients of their options.
HHS said Friday it will work individually with clinics making a "good-faith" effort to comply. The agency also said it has received no official notice from providers who may be planning to drop out. Officials expect the reaction to the rule to vary considerably from state to state. Politically conservative states are likely to accept the restrictions, while in some more liberal parts of the country, state officials have signaled they'd be willing to step in so clinics can continue to make abortion referrals.
The controversy may come to a head next month. The federal appeals court in San Francisco has scheduled oral arguments the week of Sept. 23, right around the same time HHS expects the clinics to comply.
Abortion is a legal medical procedure, but federal laws prohibit the use of taxpayer funds to pay for abortions except in cases of rape or incest or to save the life of the woman.