How the ‘Huge Lovely Invoice’ May Hit Maine’s Reproductive Care


Sweeping cuts in President Donald Trump’s “One Huge Lovely Invoice” concentrating on abortion suppliers threaten to drastically cut back entry to all kinds of sexual and reproductive well being care companies in Maine—regardless that the state has protected reproductive rights.

Two organizations—Deliberate Parenthood and Maine Household Planning—that serve roughly half of the sufferers in Maine’s complete sexual and reproductive well being care community are liable to being excluded from receiving Medicaid funds due to a provision within the tax and spending bundle, which narrowly handed the Senate on Tuesday and now faces a vote within the Home. The availability would prohibit Medicaid funding for any well being care companies supplied by Deliberate Parenthood and Maine Household Planning for one yr.

Medicaid is a state-federal program that gives medical insurance protection for greater than 70 million individuals from low-income households throughout the nation, together with a whole lot of 1000’s of individuals in Maine alone. If the invoice passes with that provision included, reproductive well being specialists concern that a number of the most weak sufferers received’t be capable of entry the care they want.

The availability applies to well being care nonprofit organizations that present abortions and acquired greater than $800,000 from Medicaid in 2023. Each Deliberate Parenthood and Maine Household Planning supply abortion companies, and abortion is authorized in Maine till round fetal viability. However Medicaid {dollars} don’t fund abortions—with very restricted exceptions—and as an alternative cowl different, non-abortion well being care companies that the organizations’ clinics present, resembling contraception, STI testing and therapy, and most cancers screenings.

Learn Extra: Trump’s ‘Huge Lovely Invoice’ and the Supreme Courtroom Put Deliberate Parenthood Funding in Jeopardy

Maine Household Planning runs 18 clinics in medically underserved areas within the state, based on the group’s president and CEO George Hill. The group additionally operates a cell medical unit, which is designed to serve individuals who could face further challenges accessing a brick-and-mortar website, resembling people who find themselves unhoused or who’re combating opioid use dysfunction. Almost half of the sufferers who go to Maine Household Planning’s clinics every year are Medicaid eligible, Hill says.

And for about 70% of the sufferers who go to the group’s clinics, that’s the solely well being care go to they’ll make in the midst of a yr, making it their solely touchpoint with the well being care system, based on Hill. He provides that three of the 18 clinics that Maine Household Planning manages supply major care companies.

Excluding Maine Household Planning from Medicaid could be a “blow to people who reside in communities that basically don’t have a substantial amount of entry to well being care,” Hill says. Whereas Hill says it’s not but clear how the group will adapt if the invoice passes with the availability, he worries that Medicaid recipients wouldn’t have the identical stage of entry to care. About 20% of Maine Household Planning’s annual funds—roughly $1.9 million {dollars}—comes from Medicaid funding, based on Hill.

“I don’t wish to alarm employees, I don’t wish to alarm sufferers,” Hill says. “We’re going to maintain offering care to individuals even [if] we’re excluded from the Medicaid program for so long as we are able to.”

However the group already runs “very shut margins and [has] to fundraise to make up the gaps in order that we’re ready to offer care to individuals who can’t afford to pay for it,” Hill says. If the invoice passes with the availability, Hill says Maine Household Planning will think about litigation.

Deliberate Parenthood has mentioned that whether it is “defunded” by the invoice, practically 200 of its well being facilities in 24 states might be liable to closing. Greater than 90% of these clinics are in states the place abortion is authorized, based on the group. About 60% are in medically underserved areas, areas with major care supplier shortages, or rural areas, Deliberate Parenthood mentioned. If the invoice passes, Deliberate Parenthood warned that greater than 1.1 million sufferers throughout the nation might lose entry to well being care.

Three Republican Senators broke celebration ranks to hitch Democrats in voting in opposition to the invoice on Tuesday, together with Sen. Susan Collins of Maine. In an announcement, Collins mentioned that her objections to the invoice stem “primarily from the dangerous impression it can have on Medicaid, affecting low-income households and rural well being care suppliers like our hospitals and nursing houses.” She added that just about a 3rd of Maine’s inhabitants relies on the Medicaid program. A consultant for Collins didn’t instantly reply to a request for remark concerning the senator’s ideas on the availability concentrating on Maine Household Planning and Deliberate Parenthood.

The risk to Maine Household Planning’s Medicaid funding comes after the Trump Administration froze the group’s Title X funds—in addition to funds for 15 different organizations, together with some Deliberate Parenthood associates—at first of April. Maine Household Planning, the only real Title X recipient within the state, receives about 20% of its working funds from the federally funded household planning program. As with Medicaid, the Title X program doesn’t fund abortion care, however does cowl different well being care companies for individuals from low-income households. Whereas the Maine state legislature lately handed a funding invoice that Hill says would assist mitigate the lack of Title X funding, these funds will solely final for a yr. After that, he’s undecided what’s going to occur if the Trump Administration doesn’t restore the group’s Title X funding.

Hill says that, as an abortion supplier receiving federal funds, Maine Household Planning is “within the crosshairs of the Trump Administration.”

“We’re not being debarred or excluded from Medicaid on the idea of any fraud or prison habits; we’re being excluded as a result of we’re abortion suppliers, plain and easy,” Hill says. He calls the invoice “a backdoor assault to restrict entry to abortion care in blue states the place abortion is authorized and accessible by stopping suppliers like us, like Maine Household Planning and Deliberate Parenthood, from collaborating within the Medicaid program.”

“We’re going to combat this,” Hill provides. “This can be a public well being situation.”

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