Maine Expands Access to Abortion

While abortion bans in Republican-led states dominated headlines in recent weeks, a handful of other states have expanded abortion access. Maine joined those ranks in June with two new laws ― one requires all insurance and Medicaid to cover the procedure and the other allows physician assistants and nurses with advanced training to perform it.

With these laws, Maine joins New York, Illinois, Rhode Island and Vermont as states that are trying to shore up the right to abortion in advance of an expected U.S. Supreme Court challenge. What sets Maine apart is how recently Democrats have taken power in the state.

“Elections matter,” said Nicole Clegg of Planned Parenthood of Northern New England. Since the 2018 elections, Maine has its largest contingent of female lawmakers, with 71 women serving in both chambers. “We saw an overwhelming majority of elected officials who support reproductive rights and access to reproductive health care.”

The dramatic political change also saw Maine elect its first female governor, Janet Mills, a Democrat who took over from Paul LePage, a Tea Party stalwart who served two terms. LePage had blocked Medicaid expansion in the state even after voters approved it in a referendum.

Clegg and other supporters of abortion rights hailed the new abortion legislation: “It will be the single most important event since Roe versus Wadein the state of Maine.”

Taken together, the intent of the two laws is to make it easier for women to afford and to find abortion care in the largely rural state.

Nurse practitioners like Julie Jenkins, who works in a small coastal town, said that increasing the number of abortion providers will make it easier for patients who now have to travel long distances in Maine to have a doctor perform the procedure.

“Five hours to get to a provider and back ― that’s not unheard of,” Jenkins said.

Physician assistants and nurses with advanced training will be able to perform a surgical form of the procedure known as an aspiration abortion. These clinicians already are allowed to use the same technique in other circumstances, such as when a woman has a miscarriage.

Maine’s other new law, set to be implemented early next year, requires all insurance plans ― including Medicaid ― to cover abortions. Kate Brogan of Maine Family Planning said it’s a workaround for a U.S. law known as the Hyde Amendment that prohibits federal funding for abortions except to save the life of the woman, or if the pregnancy arises from incest or rape.

“[Hyde] is a policy decision that we think coerces women into continuing pregnancies that they don’t want to continue,” Brogan said. “Because if you continue your pregnancy, Medicaid will cover it. But if you want to end your pregnancy, you have to come up with the money [to pay for an abortion].”

State dollars will now fund abortions under Maine’s Medicaid, which is funded by both state and federal tax dollars.

Though the bill passed in the Democratic-controlled legislature, it faced staunch opposition from Republicans during floor debates including Sen. Lisa Keim.

“Maine people should not be forced to have their hard-earned tax dollars [used] to take the life of a living pre-born child,” said Keim.

Instead, Keim argued, abortions for low-income women should be funded by supporters who wish to donate money; otherwise, the religious convictions of abortion opponents are at risk. “Our decision today cannot be to strip the religious liberty of Maine people through taxation,” Keim said during the debate.

Rep. Beth O’Connor, a Republican who says she personally opposes abortion but believes women should have a choice, said she had safety concerns about letting clinicians who are not doctors provide abortions.

“I think this is very risky, and I think it puts the woman’s health at risk,” O’Connor said.

In contrast, advanced practice clinicians say the legislation, which will take effect in September, said this law merely allows them to operate to the full scope of their expertise and expands access to important health care. The measure has the backing of physician groups like the Maine Medical Association.

Just as red-state laws restricting abortion are being challenged, so are Maine’s new laws. Days after Maine’s law on Medicaid abortion passed, organizations that oppose abortion rights announced they’re mounting an effort to put the issue on the ballot for a people’s veto.

This story is part of a partnership that includes Maine Public Radio, NPR and Kaiser Health News.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.