A federal appeals court has paused enforcement of a federal government regulation that allows abortion providers to receive federal family planning money — but only in Ohio, where state health officials said the policy took money away from them.

Since 1981, federal policy has changed several times regarding whether programs receiving family planning funds can provide abortions or refer patients to such services. Soon after President Joe Biden took office in 2021, the administration made rules to allow groups with abortion services to receive the funding again.

A dozen states with Republican attorneys general challenged the rule.

A U.S. District Court judge ruled last year that the Biden administration’s version of the rules could remain in effect while the challenge moves through the court system.

A majority of the three-judge panel from the Cincinnati-based 6th U.S. Circuit Court of Appeals overruled that in a decision Thursday — but only as it applies to how the federal government distributes the grants in Ohio.

The majority judges — Joan Larsen and Amul Thapar, both nominated by Republican former President Donald Trump — said that Ohio was the only state that demonstrated it had suffered irreparable harm from the policy. The state health department said it was receiving 20% less in federal family planning funding under the current policy that it did under the regulation that was in place previously.

The judges said that’s because when referrals were banned, Planned Parenthood of Greater Ohio did not apply for funding. When the referrals were again allowed, the group, which also provides abortions, returned. And when that happened, the award to the state’s health department decreased by $1.8 million.

Ohio Attorney General Dave Yost said the result could be that the state’s Planned Parenthood affiliate might need to make changes or risk losing funding.

A third judge, Karen Nelson Moore, who was nominated by former Democratic President Bill Clinton, dissented, saying her colleagues misunderstand the regulations.

The bigger case remains in the court system.

The abortion landscape has changed drastically since the lawsuit was initially filed. Last year, the U.S. Supreme Court overturned its landmark 1973 Roe v. Wade decision that established a nationwide right to abortion.

Since then, most Republican-controlled states, including most of those challenging the Biden administration policy, have enacted bans or strict limits.

Ohio adopted a ban on abortion after cardiac activity can be detected, about six weeks into pregnancy, which is often before women know they’re pregnant. But a court blocked enforcement, and voters last month adopted an amendment to the state constitution enshrining the right to abortion.