Dirigo: Maine Leads on Reproductive Rights

Six new laws protect access & remove barriers to care

Against the backdrop of 12 states enacting more than two-dozen abortion bans, with six states having imposed such onerous restrictions that there is now only a single abortion provider, Maine has moved in the opposite direction. At the close of this legislative session, Maine will have six new laws protecting and expanding access to reproductive and sexual health care including removing barriers to abortion care, as well as expand access to health care more broadly by funding Medicaid Expansion, ensuring insurance protections for transcare, and dozens of other measures to make health care more affordable and accessible.

“Maine has a long tradition of respecting people’s decisions about pregnancy and abortion. It’s why our laws protect the right to an abortion, but a right isn’t a right if you can’t access or afford it. This year, the Maine legislature took a giant step forward to ensure that a woman, regardless of income or where she lives, can make a decision about abortion that’s best for her and her family,” said Nicole Clegg, Vice President of Public Policy for the Planned Parenthood Maine Action Fund and Planned Parenthood of Northern New England. “Legislators made their opinions clear. Maine is a state where access to reproductive and sexual health care is essential to living a healthy, successful life and politicians shouldn’t be putting up barriers to care.”

The six new laws are as follows:

LD 820 - Insurance Coverage for Abortion Care

• Sponsored by Representative Jay McCreight, LD 820 requires public and private insurance coverage of abortion care. It is a state solution to the 1976 federal Hyde Amendment denying federal Medicaid coverage of abortion except in extreme circumstances of rape, incest, and life endangerment.

• With 3 in 4 people seeking abortion care earning less than 200% of the Federal Poverty Level, abortion is increasingly concentrated among poor women. For people facing structural barriers to health care, like people with low incomes, people of color, people living in rural areas, and people with disabilities, the legal right to an abortion means little when you can’t access or afford the care you need. One in four Medicaid-qualified women who seek an abortion is forced to carry her pregnancy to term because of cost and women forced to carry an unwanted pregnancy to term are more likely to fall into poverty within a year.

• Maine is now the 16th state to guarantee Medicaid (MaineCare) coverage of abortion.

• “Ensuring abortion is accessible and affordable no matter where you live, how much money you make or what kind of insurance you have is critical to allowing people to make a real decision and will dramatically improve the lives of women and their families in Maine,” added Clegg.

LD 1261 - Advanced Practice Clinicians Can Provide Abortion Care

• Speaker Sara Gideon sponsored LD 1261 to end an outdated, medically unnecessary law preventing advanced practice clinicians like nurse practitioners from providing abortion care. APCs provide abortion care in more than a dozen other states, including New Hampshire and Vermont and data, including from the CDC, shows abortion has a 99 percent safety record, meaning fewer than one percent of abortions have complications. Peer-reviewed medical literature, including a recent four-year study of more than 11,000 abortion patients published in the American Journal of Public Health, uniformly confirms that nurse practitioners and other APCs can safely and effectively provide abortion care.

• There are currently only three public providers of in-office abortion care in Maine: Mabel Wadsworth in Bangor, Maine Family Planning in Augusta, and Planned Parenthood of Northern New England in Portland.

• With the passage of LD 1261, providers will be able to offer comprehensive abortion care; Planned Parenthood of Northern New England will expand access to abortion care from York to Sagadahoc County.

• “Reproductive and sexual health care providers form deep trusting relationships with their patients that can span decades. From delivering babies to counseling infertility to any myriad of health care needs, women trust and count on their providers and they should be able to turn to them for care when considering an abortion,” said Donna Burkett, Medical Director of Planned Parenthood of Northern New England. “Allowing women to seek care in their community from a provider they know and trust is what the kind of care women should be able to count on in Maine.”

LD 37 - Nonprescription Medicine Including Emergency Contraception in Vending Machines

• Sponsored by Rep. Mo Terry, LD 37 aligns Maine with multiple other states that allow the sale of nonprescription medicine through vending machines. Brought to Rep. Terry’s attention by student activists at the University of Southern Maine who wanted to bring a wellness vending machine able to dispense over the counter methods of emergency contraception on the campus. Emergency contraception is a form of birth control taken to prevent pregnancy after sexual assault or unprotected sex. An outdated Maine law prevented nonprescription drugs from being sold in vending machines.

• Emergency contraception has been available for people of all ages over the counter (i.e. without a prescription or pharmacist approval) since 2013 and with the college sexual assault crisis, the increased access to emergency contraception is particularly important on college campuses where nearly 1 in 4 undergraduate women experience rape or sexual violence.

• “Maine is a large, rural state with multiple challenges delivering health care to people in their communities. This is particularly problematic with time-sensitive medication like emergency contraception,” explained Nicole Clegg. “Wellness vending machines dispensing nonprescription medicines like emergency contraception and painkillers will increase the availability of care for Mainers, especially people with low-incomes, young people, and people in rural areas.”

• The legislature enacted LD 37 and the governor is expected to sign the bill on Friday.

LD 1580 - Protecting Clinicians’ Privacy

• Right now, Maine law allows the release of the personal information of licensed medical professionals through a public records requests. People and organizations hostile to reproductive rights have taken advantage of this situation to exploit and harass reproductive healthcare providers by publishing personal, private information about them, including their home addresses and telephone numbers, photos, and Social Security Numbers, on websites designed to threaten and intimidate abortion providers.

• These websites implicitly encourage the harassment of reproductive health providers. Anti-abortion activists have posted photographs of providers’ cars and homes, leaving providers vulnerable to threats in their homes and neighborhoods, causing providers to fear for their safety and the safety of their families.

• Sponsored by House Majority Leader Matt Moonen, LD 1580 will reduce the likelihood that medical practitioners are exposed to this type of harassment or violence by allowing clinicians to review information before it is released and petition to have information withheld if there is a safety risk to the provider or their family.

• “This is a reasonable, common-sense solution to mitigate the threats posed daily to medical providers who offer abortion care to their patients,” said Clegg.

LD 494 - Updating Maine’s Family Planning Statutes

• Sponsored by Senator Linda Sanborn of Gorham, LD 494 provides much-needed updates to Maine’s outdated family planning laws, like acknowledging that testing and treatment for STIs are part of sexual and reproductive health care and that advanced practice clinicians provide sexual and reproductive health care.

• Family planning is an important part of a woman’s life. Nearly 99 percent of all women will use a method of birth control at some point in the lifetime and most women will depend upon family planning services for more than three decades of their lives. For women, family planning is essential health care. As Maine looks to identify ways to expand access to essential health care like family planning, it’s important that we have laws on the books that reflect best medical practices and real lived experiences of Maine women.

• LD 494 also addresses gaps in minor’s consent law. Prior to its passage, a young woman in Maine could not consent to receive prenatal care. In other states with similar issues, teenagers have been denied critical care during a pregnancy and labor and delivery.

 

LD 78 - Increasing Access to Reproductive Health Care Coverage

• In 2015, Maine implemented the Limited Family Planning Benefit program, an expansion of MaineCare coverage for sexual and reproductive health care. Hostile to any form of Medicaid Expansion, the LePage Administration’s Department of Health and Human Services made it difficult for Mainers to enroll in the program.

• Sponsored by Rep. McCreight, LD 78 removes enrollment barriers in order to maximize the number of Mainers who can receive free and reduced-cost sexual and reproductive health care through the program.

• Delays in access to reproductive health care increases the risk of unintended pregnancy and other poor health outcomes including risks of certain types of cancer. Removing barriers to care like LD 78 allows people with low-incomes to receive care when needed.

A recent poll confirms that Mainers are overwhelmingly supportive of abortion rights. A majority of voters say that if a woman has decided to have an abortion the experience should be supportive (83%), affordable (79%), available in her community (79%), without added burdens (76%), and covered by her insurance (70%). More than three in four Mainers (76%) believe women should be able to make their own medical decisions about abortion without politicians and insurance companies denying care.

These new laws will all take effect 90 days after the legislature adjourns.

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