Several abortion-rights and LGBT advocacy groups announced Tuesday that they filed the fourth major lawsuit challenging a Trump administration rule that could affect access to abortion and contraception.

The challenge comes a week after state attorneys general filed different lawsuits also attempting to block the final rule from going into effect this year.

The Center for Reproductive Rights, Lambda Legal, Americans United for Separation of Church and State, and Santa Clara County filed a joint lawsuit on Tuesday in the U.S. District Court for the Northern District of California.

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The Department of Health and Human Services rule would greatly expand when a person assisting in a health care service could object due to religious or moral reasons. Many advocates worry that it will restrict access to abortion, LGBT care, and end-of-life care.

“The rule is extremely broad and contains no limits on who can be denied treatment,” said Genevieve Scott, senior staff attorney for the Center for Reproductive Rights. “The rule is intentionally confusing and unworkable for health care facilities to implement.”

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“Under our current policies, we require advanced notice about refusing to participate in certain care,” he said, adding that patient care must come first. If a health professional objects to helping during a medical emergency, he or she must provide care until a replacement can step in.

The rule, he said, would make this impossible.

Last week, New York Attorney General Letitia James announced a lawsuit from a coalition of almost two dozen states and cities. That same day, California Attorney General Xavier Becerra filed a separate lawsuit challenging the rule.

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Both lawsuits allege that if implemented, the rule could result in denial of care.

Earlier this month, a city attorney for San Francisco also challenged the rule in the U.S. District Court for the Northern District of California.

The groups filing their lawsuit Tuesday say this lawsuit differs from the other challenges because the plaintiffs include providers.

“Private clinics can make some sorts of legal claims including the constitutional claims that government agencies are not suited for,” said Richard B. Katskee, legal director for Americans United for Separation of Church and State.

“Because we are bringing these claims on behalf of health care providers, we have unique constitutional claims,” said Jamie Gliksberg, senior attorney with Lambda Legal. She added that the rule would infringe on First Amendment rights because patients are less likely to express their sexual orientation or be open about their reproductive health care needs in case it may affect access to care.

Without an injunction, the rule will take effect July 20.