The Trump administration continues to think it knows best on how to provide women’s health care, this time with its “gag rule” on Title X funding for federally approved services at organizations that also provide birth control access, sexually transmitted disease testing, and treatment and cancer screenings for uninsured women or those on low incomes.

Planned Parenthood, which serves about 40 percent of 4 million Title X patients in this country, has decided not to comply with new rules and is refusing the funding. Had the organization decided to accept the changes, it would be in violation if it continued to provide non-federally funded abortions or made referrals for such, other than in cases of rape, incest or medical emergency. The rule has resulted in a choice between two miserable outcomes.

Keene Health Center, a chapter of Planned Parenthood, served 2,000 patients in 2018 with these and other forms of care. Those who need Title X money to cover the services have no other local source; Keene Health is the only provider in Cheshire County. It does not provide surgical abortion, but does provide medication abortions.

To be clear, money from Title X, which was signed into law by President Nixon, isn’t used for abortions. No matter; under the gag rule, if the topic is generally discussed between a clinician and a patient, that’s enough to void family planning funds used to prevent the need for an abortion in the first place.

Logic? Well, that’s not a strong suit for this administration, which argues abortions aren’t health care.

Alexis McGill Johnson, acting president and CEO of Planned Parenthood Federation of America, reacted sharply to the rule change, which went into effect in June and survived a court challenge in August.

“For too many people struggling to make ends meet, this gag rule may mean they delay or go without care,” she said. “I want our patients to know that Trump may have given up on you, but we never will.”

Among other examples of the administration’s bullying attitude toward women, this rule change is particularly shameful. Because to this point, Trump has been unable to directly outlaw abortions, his minions continually connive ways to indirectly block access for women who have a constitutional right to make such a choice. And, in this case, he’s making it impossible for some women to get affordable cancer screenings and other necessary health-care services — or forcing those in Cheshire County to look outside the region for Title X-funded care.

The matter hasn’t totally played out. The U.S. House passed a bill that blocks the gag rule; the Senate has not been asked to do so. Also, there is, in the state budget, $2.3 million in supplemental family planning money for the next two years as a contingency. But that budget was vetoed by Gov. Chris Sununu, and those funds are not in the previous budget, under which the state will operate until a deal is made to move forward. We’ll see if Sununu bucks the bully in the White House and approves a budget that provides that safety net.