Ohio lawmakers have long tried to make it impossible for women to get an abortion there. The state has restricted abortion in a number of ways, including with a ban on a common abortion method and a law that requires women seeking abortions receive ultrasounds first; currently, legislators are considering a bill that would effectively prohibit abortions as early as six weeks from conception—one of the most restrictive abortion laws in the nation.

And this year, Ohio lawmakers have found a new strategy to chip away at abortion access: blocking state funding for Planned Parenthood. In late March, the Cleveland Plain Dealer reported, the Ohio Department of Health began notifying Planned Parenthood clinics that funding they receive from the state would run out on April 20.

Last year, the state Department of Health gave out $600,000 worth of grants to Planned Parenthood clinics across Ohio. The use of public funds to pay for abortions directly is already banned, except in cases of life endangerment, rape, and incest, so that money went to things including sex education efforts, services for sexual assault survivors, sexually transmitted infection testing, and breast and cervical cancer prevention.

Anti-abortion politicians have for decades tried to limit public funding for Planned Parenthood and other abortion providers, with varying degrees of success. In 1976, Congress blocked the use of federal Medicaid dollars for abortions except in rare circumstances, and many states followed suit, passing laws blocking their state Medicaid money from going toward abortions directly. After the Affordable Care Act passed in 2010, states targeted the private insurance marketplace with laws banning abortion coverage. Eighteen states have laws on the books limiting public funding for abortions.

Not all of these efforts have been successful. Amid the release of a series of undercover videos by the Center for Medical Progress, an anti-abortion group, some states tried to take their bans on Medicaid funding for abortion a step further and cut all Medicaid funding to Planned Parenthood. In 2015, the Obama administration notified two of those states that cutting Medicaid funding to the organization might violate federal law. And in December, the Supreme Court declined to hear a case brought by Kansas and Louisiana seeking to block Medicaid funding for non-abortion-related services.

Now, Ohio may have hit on the next tactic for weakening access to abortion. The effort started in early 2016, when Ohio lawmakers passed a bill allowing the state to block funding for Planned Parenthood. So far, it’s gotten some positive response from the courts: In March, a federal appeals court upheld the law after it was struck down by a three-judge appeals court panel in August. The Department of Health notices to the reproductive health organization were issued shortly after.

Meanwhile, new rules from the Trump administration, which go into effect next month, will strip tens of millions of Title X federal family planning dollars from Planned Parenthood and impose stringent regulations upon clinics that offer abortion services, like requiring abortions to be performed at different facilities than where Title X programs are administered. The rule will also effectively “gag” Title X health care providers by barring them from telling patients how they can obtain abortions. The move is likely to be challenged in court, but Planned Parenthood is already bracing itself for the effects of the so-called gag rule, calling it “one of the most dangerous and unconscionable attacks on our health and rights we’ve seen yet.”

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