President Donald Trump spent part of his first Monday in office following in the footsteps of other Republican presidents by reinstating the Global Gag Rule, officially known as the Mexico City Policy.

The Reagan-era rule bars U.S. aid from going to international NGOs that offer abortion services or even provide information about it as an option—even when they use non-U.S. funds to do so. It’s been criticized for devastating not only reproductive healthcare services but primary healthcare services as well, as clinics, faced with budget shortfalls, are forced to cut back or shut down completely.

And it was made clear, from that January memorandum, that Trump’s order would mark an expansion of the rule, as it directed the Secretary of State “to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.” As Human Rights Watch explained in March:

Under previous Republican administrations, the restrictions in the Mexico City Policy applied specifically to U.S. family planning funds, approximately U.S.$575 million.

Trump’s policy extends restrictions to all U.S. global health assistance…

On Monday, CBN reported that “Trump is taking the pro-life policy to a whole different level,” as the rule, rebranded as the “Protecting Life in Global Health Assistance” program, will affect $8.8 billion in funding.

CBN adds that the “nearly $9 billion in global health assistance funds will be appropriated to the Department of State, the U.S. Agency for International Development (USAID), and the Department of Defense.”

The State Department also announced Monday its plan to implement the policy, stating:

Under this expanded policy, “global health assistance” includes funding for international health programs, such as those for HIV/AIDS, maternal and child health, malaria, global health security, and family planning and reproductive health.

It adds:

All foreign NGOs will have the opportunity to receive global health assistance awards if they indicate their agreement to abide by the terms of Protecting Life in Global Health Assistance by accepting the provisions in their award.

NARAL said the announcement showed the president was “yet again throwing women under the bus.”

“President Trump is treating women’s lives like political bargaining chips, trading them away to shore up his flagging support,” said Sasha Bruce, senior vice president of campaigns and strategy for the pro-choice organization.

“Barely more than 100 days into his presidency, this pattern of behavior is an ominous portent of things to come for women and families. A man who was best known during the campaign for disrespecting and objectifying women clearly hasn’t changed his behavior despite wielding even more power,” Bruce added.

According to Brian Dixon, senior vice president of Population Connection Action Fund, Trump’s “dramatic expansion of the policy needlessly threatens the lives and well-being of millions,” and the re-branded rule is “just more brazen gaslighting by the Trump administration.”

“The Global Gag Rule doesn’t protect lives; it destroys them,” he continued.

“It causes health clinics to close; it causes contraceptive shortages; it significantly reduces access to critical reproductive health care; and it, not surprisingly, causes dramatic increases in unsafe abortion. Rather than recognizing the utter failure of the policy, this administration has expanded its breadth, threatening global efforts to fight malaria and Ebola and Zika and HIV. And it will stifle efforts to address the challenge that unsafe abortion poses throughout the developing world,” Dixon said.