In 1977, the Hyde Amendment barred the use of federal funds to pay for most abortions. While states are free to use their own funds to cover abortion, Maine does not. As a result, MaineCare covers pregnancy-related care for women who choose to carry a pregnancy to term, but withholds coverage from eligible women who decide to have an abortion. The result is a significant coverage gap for those insured by MaineCare.
Maine Family Planning believes that every person–regardless of income –should be able to make the decisions that are best for their health and their family. That’s why today we joined with the American Civil Liberties Union, Mabel Wadsworth Women’s Health Center, and Planned Parenthood of Northern New England in filing a lawsuit challenging Maine’s prohibition of MaineCare coverage for abortion care. We are proud to take this step toward ensuring fair and equal health care access for all Mainers.
The Legal Landscape in Maine
Although Maine public policy expressly prohibits restricting a woman’s “exercise of her private decision to terminate a pregnancy,” and Maine’s Constitution guarantees that all people have the right to pursue liberty, safety, and equality, the Maine Department of Health and Human Services has been withholding insurance coverage for abortion for decades.
At its core, the prohibition on abortion coverage is discriminatory. Sure, every woman has the constitutional right to abortion, but for decades, Maine has effectively limited abortion access for many low-income and disabled women. “A woman cannot make a real decision about something as important as abortion if she can’t even afford to have one,” said one of our attorneys, Alexa Kolbi-Molinas of the ACLU Reproductive Freedom Project. “A qualified woman should be able to use her Medicaid coverage for the medical care she needs, including abortion.”
We should be concerned about the coercive nature of coverage bans. A woman who qualifies for MaineCare would benefit from insurance coverage for pre-natal care, delivery, and post-partum care for both her and her baby. Should she choose to terminate the pregnancy, however, she would receive no coverage for the health care she needs. When we withhold coverage from someone likely living paycheck to paycheck, we tip the scales and push her towards a particular choice—and not necessarily the one she knows is best for her and her family.
This is about Economic Justice
Right now, Maine enforces a two-tiered system where those who can afford private insurance have a level of access that those who depend on the government for healthcare coverage do not. When legislators restrict insurance coverage for abortion, women are either forced to carry the pregnancy to term (as 1 in 4 poor women end up doing) or come up with a significant amount of money in a short period of time. Many women are forced to into unjust situations, having to sacrifice rent, heat, transportation, or groceries in order to get care.
Denying health care coverage for a woman who is already struggling financially can push her and her family deeper into poverty. Research tells us that women who seek abortion but are denied are more likely to fall into poverty than those who are able to get the care they need. And despite anti-choice rhetoric to the contrary, we are talking about entire families: the majority of those who seek abortion are already parenting.
This is about health and safety
When a person needs to end a pregnancy, it is important that safe, professional medical care is readily accessible. Providing insurance coverage ensures she will be able to see a licensed provider without unnecessary delay. We already know that too many women are forced to defer their abortions—sometimes to the point of being denied access altogether—purely because of the cost. Abortion is one of the safest, most common medical procedures performed in this country, but both costs and medical risks increase with gestational age. No one’s health and safety should have to suffer because of their income.
Mainers with low incomes, disabilities, and people of color are disproportionately affected by coverage bans, as they are already the least likely to be able to afford out-of-pocket medical expenses (including travel, lodging, and childcare costs necessary to access care) and the most likely to experience chronic health conditions. Bans on health care coverage only serve to intensify existing health and economic disparities.
Trust Maine Women and Families
The decision about how to handle a pregnancy is a deeply personal one that will have implications for the rest of a person’s life. Politicians should not have jurisdiction over anyone’s reproductive decisions—no matter how much they make or how they’re insured. By continuing to bar state funds from covering abortion care, however, we are complicit in attempting to make these very decisions for women and their families.
Maine Family Planning is proud to be a part of the lawsuit that seeks to end this unjust policy. We hope that the result will be fairer access to reproductive health care for all Maine women.