If you’re a woman of limited means in need of reproductive health care, prepare to wait a long time or drive a long way for it. As of Monday, all Planned Parenthood affiliates will have officially withdrawn from the federal Title X program, which has provided funding for family planning and reproductive health care for low-income individuals for nearly half a century. Other health care providers are also leaving the program, including Maine Family Planning, which has been the sole recipient of Title X funding in the entire state of Maine.

All are leaving because the Trump administration has foisted upon Title X grant recipients a ludicrous rule that would, among other things, forbid health care providers to refer patients to an abortion service when they request one. At most, providers can offer a list of comprehensive health care centers that may or may not include abortion services — and the provider can’t tell the patient which is which.

That’s a gag rule. Providers of Title X services must also refer patients to prenatal care whether they ask for it or not. That’s forced speech.

This is not the government prohibiting funding for abortions. Congress has been doing that for decades. This is the government restricting health care professionals from offering comprehensive care to their patients.

Many providers of family planning services, who had until Monday to inform the Department of Health and Human Services whether they would follow the new rule, say complying with it would be unethical.

This is devastating news for the patients who rely on the clinics that have chosen to withdraw from the program, which serves roughly 4 million people (40% of them through Planned Parenthood facilities). Planned Parenthood says it does not plan to close any clinics just yet, but it’s likely to cut back its hours of service. That means contraception and other reproductive health care will be harder to come by, particularly in rural areas where the Title X withdrawal will have the most impact.

Nor do industry experts believe other community health clinics will pick up the slack, as the Trump administration has predicted. Even if those clinics were willing to try, it would take years for the ones already serving broad populations to be able to take on hundreds of new reproductive care patients. And that’s if those clinics are willing. Many of them could make the same decision as Planned Parenthood to forgo the Title X funding out of ethical and legal concerns.

Congressional Democrats reacted by passing an annual spending bill for HHS that would block the rule. The GOP-controlled Senate should concur; after all, Title X is a bipartisan creation, and it has a long history of helping low-income women get the contraception and health care they need. It’s deeply troubling to see that being upended by Trump’s new, medically unnecessary gag rule.