November 08, 2019
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Maine laws expanding abortion access unlikely to fill federal funding gap, providers say

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Kate Brogan, then the vice president of public affairs at Maine Family Planning, speaks at a 2015 rally held by Planned Parenthood in Portland. A Maine Family Planning official called new state laws expanding abortion access a "game changer" for clients, but they're not expected to fill a funding gap for providers.

AUGUSTA, Maine — Maine’s biggest family planning providers say two new state laws that expanded abortion access are unlikely to fill the funding gap left after a move from President Donald Trump’s administration led them to opt out of federal funding under Title X.

The state has been reimbursing MaineCare providers for abortions not provided for under the Hyde Amendment — a federal law only allowing Medicaid to cover abortions when they are needed to protect the life of a mother or when the pregnancy results from rape or incest — since Sept. 19, under emergency rules and using state funds included in the budget for the purpose.

That was one of the landmark laws passed by the new Democratic-led Legislature earlier this year under Gov. Janet Mills over heavy opposition from anti-abortion groups. Another law that allows physician assistants and advanced nurse practitioners to perform abortions went into effect at the same time.

Leah Coplon, the program director for Maine Family Planning, which operates 18 clinics around the state, said the new laws have been an immediate “game changer,” especially for the state’s rural populations, because the changes have made abortion more accessible.

But Coplon said it was unlikely the additional coverage provided by MaineCare, the state’s Medicaid program, would cover the roughly $2 million hole in Maine Family Planning’s budget after Maine Family Planning and Planned Parenthood opted out of Title X funding after the Trump administration banned participants from referring women to abortion providers, commonly referred to as a “gag rule.”

That funding never covered abortion, but it provided for other family planning services for low-income individuals, such as STI testing. Enforcement of another part of the rule requiring facilities offering abortion to be physically separate from those offering other federally funded reproductive health care services will begin next year.

Maine Family Planning has been Maine’s grantee for Title X funds for nearly 50 years. Rejecting them meant giving up about $1.8 million — or 30 percent of its revenue. Planned Parenthood of Northern New England lost about $400,000 in Maine, a spokesperson said.

Maine Family Planning sued the Trump administration in federal court in March over the gag rule, seeking an injunction to stop it from going into effect. A judge denied the injunction request, and the group had appealed the decision to a federal court in Boston. But Emily Nestler, an attorney with the Center for Reproductive Rights, said the group dropped their appeal of the decision last week, because Maine Family Planning was able to raise enough funds to cover the $1.8 million loss. The case will continue in federal court.

In the two-year budget passed earlier this year, the Maine Legislature included $227,546 and $375,843, respectively, for the current fiscal year and the next one beginning in July 2020 to provide abortions for MaineCare recipients who aren’t provided for under the Hyde Amendment.

According the Kaiser Family Foundation, only 15 states funded all or most medically necessary abortions as of June — not including Maine — for Medicaid recipients. And the non-doctor law stood in contrast to a number of anti-abortion measure passed around the country, Planned Parenthood of Northern New England spokesperson Nicole Clegg said. She pointed specifically to a law in Alabama that could criminalize abortion, which was blocked by a federal judge on Tuesday.

Providers are required to distinguish between which abortions are covered by federal funds while submitting for reimbursement. MaineCare reimbursement rates have not been set yet, and the rulemaking process for the process is ongoing. While funding futures may be uncertain, both Clegg and Coplon said the laws have made impacts on their clients by making abortions more accessible.

Prior to the change, Planned Parenthood only provided surgical abortions on Fridays, Clegg said. Maine Family Planning now offers the services on Thursdays, although the nonprofit has also offered chemical abortions through telemedicine since 2016.

“It used to be we would have to strategize for 10 minutes with patients for ways to come up with that money,” Coplon said. “Now, you can feel some of them bracing themselves, and when you tell them they’ll be covered by MaineCare, you can feel the relief coming off of them.”

Correction: An earlier version of this report misstated who MaineCare, the state’s Medicaid program, reimburses for abortion services.


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