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ACLU Challenges Maine Medicaid Program's Restrictions on Abortion Coverage

The American Civil Liberties Union of Maine on Tuesday sued Maine over state rules that bar MaineCare, the state's Medicaid program, from covering abortion care except in limited circumstances, the Bangor Daily News reports.

Background

Under Maine rules, state Medicaid funding can cover abortion care only in cases of rape, incest and life endangerment. The federal Hyde Amendment applies such restrictions to federal funding for abortion care, but states can opt to use their own funds to cover the procedure in additional circumstances.

According to the Guttmacher Institute, Maine is among 32 states that fund only abortions permitted under the Hyde Amendment. Seventeen states cover the procedure for additional circumstances, including four states that opted to do so voluntarily and 13 that were ordered to provide additional coverage by the courts (Shepherd, Bangor Daily News, 11/24). According to the Portland Press Herald, MaineCare covers pregnancy-related care.

Lawsuit Details

ACLU of Maine filed the legal challenge in Cumberland County Superior Court against the Maine Department of Health and Human Services.

The lawsuit was filed on behalf of three reproductive health care not-for-profits -- Mabel Wadsworth Women's Health Center, Maine Family Planning and Planned Parenthood of Northern New England -- that together provide care for about 21,500 Maine residents annually. Of those residents, more than 50% are eligible for low-income health coverage (Dolan, Portland Press Herald, 11/24).

The lawsuit contends that Maine's policy violates an equal protection clause in the state constitution by restricting abortion care access for low-income women. The restriction does not affect women with private insurance coverage, the plaintiffs noted (Bangor Daily News, 11/24). The plaintiffs also stated that Maine's policy discriminates against low-income women who seek abortion care services by excluding coverage for such services while insuring pregnancy-related care.

Comments

Zachary Heiden, legal director of the ACLU of Maine, expects the lawsuit to be successful, noting that courts in other states have required the state Medicaid programs to expand their abortion coverage. "Abortion is a protected right for all women, regardless of what type of insurance they have," Heiden said, adding, "This lawsuit aims to right the ship and to bring [Maine Department of Health and Human Services] policy back in line with the Maine Constitution." Similarly, Andrea Irwin, executive director of Mabel Wadsworth Women's Health Center, said, "As more Maine women and families experience poverty, with fewer safety net programs to support them, the need to act has become increasingly urgent. We can no longer accept a policy that treats the rights of women in Maine according to two different standards -- whether you can afford to pay for your rights or not."

Kate Brogan, vice president of public affairs at Maine Family Planning, said, "When a person needs to end a pregnancy, it is essential that professional medical care is accessible without barriers."

Donna Burkett, medical director at PPNNE, added, "When [a woman] decides it's better to end her pregnancy, which could be due to health concerns, she needs to be able to use her Medicaid benefits to get the care she needs." She said, "All too often, we see a woman delay her decision, potentially jeopardizing her health, because she couldn't afford to care for herself" (Portland Press Herald, 11/24).