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The Department of Health and Human Services (HHS) recently issued a proposed rule that would revise implementing regulations for Title X of the Public Health Service Act (Title X), the country’s only publicly funded family planning, serving millions of women annually. Though the grant program is already bound by the legal limits on directly using federal grants to fund abortion services, the proposed rule now seeks to encumber entities that provide both Title X-eligible programs and abortion-related services with additional restrictions. Our comments focus on serious errors and oversights in the Department’s analysis of the Proposed Rule’s costs and benefits. First, HHS misstates and misapplies the standard for conducting a regulatory impact analysis under Executive Order 12,866. Second, HHS ignores the Proposed Rule’s potentially substantial indirect costs—most notably, the health consequences stemming from patients’ reduced access to healthcare services. Third, HHS fails to assess the distributional impacts of the Proposed Rule.