On April 24, Maine Family Planning was in federal court in Bangor, arguing for a preliminary injunction against a sweeping set of rule changes to the national Title X family planning program, under which more than 23,800 Mainers get affordable reproductive and sexual health services each year. The rule changes, known collectively as the domestic gag rule, because they include unethical restrictions on what providers can say to their patients about abortion, represent the Trump-Pence administration’s latest attack on low-income people’s access to essential health care.
At the hearing in April, our lawyers from the global Center for Reproductive Rights and Covington & Burling, made several critical points before Judge Lance Walker. While the government had based the domestic gag rule on an outdated U.S. Supreme Court decision from nearly 30 years ago, our lawyers explained that the facts and law have changed significantly over those decades. Notably, Congress has since passed several laws making explicit that Title X health providers must be able to freely communicate with patients about all their options — including abortion. And the Affordable Care Act has since outlawed government restrictions that erect barriers to and obstruct access to health care.
Most importantly, our case emphasized how the gag rule would undoubtedly harm Mainers in very real ways by making it harder to access basic health care services, including abortion care, while undermining trust between patients and providers. The gag rule could force between 50 percent and 85 percent of abortion sites in Maine to shutter. It could lead providers such as Maine Family Planning to leave the family planning network, with no options to replace those services. And it would sabotage the sacred relationship between patients and their health care providers, forcing expert clinicians to obscure facts and let down the people who depend on them most, such as our patients in rural communities such as Fort Kent or Calais.
Our lawyers criticized the U.S. Department of Health and Human Services for its wholesale indifference to these harms, noting that the government spectacularly failed to address how the gag rule would affect people on the ground (a consideration that is arguably central to this agency’s very existence).
The very next day, a federal judge in Washington state — who had heard a separate case against the gag rule brought by the National Family Planning and Reproductive Health Association (of which Maine Family Planning is a member) and the ACLU — issued a nationwide preliminary injunction against the rule, blocking it from going into effect while legal challenges continue. Within the next few days, judges in Oregon and California also issued national and statewide injunctions, respectively, against the gag rule.
“At best, the Final Rule is a solution in search of a problem,” Oregon Judge Michael McShane wrote. “At worst, it is a ham-fisted approach to health policy that recklessly disregards the health outcomes of women, families, and communities.”
With Mainers protected from the rule’s imminent implementation by the national injunction, our team determined there was no need for additional emergency relief in our case at this time. So, we withdrew our motion for a preliminary injunction and breathed a big sigh of relief, knowing that our ability to provide care and referrals as we always have is not in jeopardy.
These developments don’t mean the end of the road for our lawsuit. Our case continues. As the sole statewide Title X grantee, we are committed to saving this tremendously successful federal program from those who would sabotage it for ideological gain.
The U.S. government has initiated steps to appeal all the preliminary injunction in the Ninth Circuit. We will watch those appeals closely as our case in Maine proceeds and as we continue to fight to protect Maine patients and providers.
Meanwhile, we continue to offer high quality, affordable, and comprehensive care throughout Maine’s robust Title X network — at Maine Family Planning’s 18 clinics statewide and our 29 additional partners in reproductive health. Although we dreaded the gag rule’s inevitable release, at least now we know what we are fighting. And fight we will, on behalf of patients and providers in Maine and nationwide.
George A. Hill is president and CEO of Maine Family Planning.