Seattle — Trump administration rules that impose additional hurdles for low-income women seeking abortions are on hold once again.

The 9th U.S. Circuit Court of Appeals in San Francisco on Wednesday vacated a unanimous ruling from a three-judge panel and said a slate of 11 judges will reconsider lawsuits brought by more than 20 states and several civil rights and health organizations challenging the rules.

The rules ban taxpayer-funded clinics from making abortion referrals and prohibit clinics that receive federal money from sharing office space with abortion providers.

Critics say the rules would force many clinics to find new locations, undergo expensive remodels or shut down.

The Justice Department did not immediately respond to an email seeking comment. The agency previously said its position “is supported by long-standing Supreme Court precedent, and we are confident we will ultimately prevail on appeal.”

Federal judges in Washington, Oregon and California blocked the rules from taking effect. U.S. District Judge Michael McShane in Oregon 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.”

A three-judge panel of the 9th Circuit overruled them two weeks ago. The judges called the rules “reasonable” and said they align with a federal law that prohibits taxpayer funds from going to “programs where abortion is a method of family planning.”

With that decision vacated, the injunctions issued by the lower court judges are once again in effect. It’s not clear when new court arguments will be held.

“We are profoundly grateful the preliminary injunction is back in place,” said Clare Coleman, president of the National Family Planning and Reproductive Health Association, which is involved in the cases.

She said the U.S. Department of Health and Human Services had not yet been enforcing the new rules, even though the three-judge panel’s ruling had given it the green light to do so.

The rules affect organizations that provide, and women who receive, health care through Title X, a 1970 law designed to improve access to family planning services.

Among them is Planned Parenthood, which had called the now-vacated panel decision “devastating.” It serves about 1.6 million of the 4 million low-income patients who receive health care through Title X.

Abortion is a legal medical procedure, but federal laws prohibit the use of Title X or other taxpayer funds to pay for abortions except in cases of rape, incest or to save the woman’s life. Abortion opponents and religious conservatives say Title X has long been used to indirectly subsidize abortion providers.

If allowed to take effect, the administration’s new policy would mark a return to rules that were adopted in 1988 and subsequently upheld by the Supreme Court. Under the Clinton administration, those rules were abandoned in favor of a requirement that the clinics provide neutral abortion counseling and referrals upon request.

Those challenging the Trump administration’s approach have pointed to the Affordable Care Act, which bars the government from creating unreasonable barriers to medical care or interfering with communications between the patient and provider.

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