Latest news with #MaineFamilyPlanning
Yahoo
17-05-2025
- Health
- Yahoo
Providers warn major Medicaid cuts would strip thousands of rural Mainers of family planning care
Planned Parenthood's office on Congress Street in Portland, Maine. (Photo by Maine Morning Star) Maine's reproductive health providers are raising alarm about the thousands of patients that would be left without care if a proposal to cut off Medicaid funding from family planning providers comes to pass. The U.S. House of Representatives Committee on Energy and Commerce, which oversees health care, approved a massive tax cut and spending bill this week, which proposes the largest cuts to Medicaid in the history of the program, and would leave more than 8 million Americans without coverage. But a part of the bill also proposes cutting off funding to any nonprofit health care providers that offer abortions and receive more than $1 million in Medicaid funding. That means two of Maine's largest family planning service providers, both of whom serve a large number of patients on MaineCare — the state's Medicaid program — may no longer be reimbursed by the federal government for services. Both Planned Parenthood and Maine Family Planning have policies to serve patients regardless of their ability to pay, meaning they would still commit to providing services for patients, they said. Medicaid reimbursements are already lower than what providers receive from private insurance, which means many Maine centers, particularly those in rural areas, are already facing significant deficits. With the likely loss of a major funding stream, these providers are now confronting a fiscal cliff, according to Olivia Pennington, director of advocacy and community engagement for Maine Family Planning, the largest network providing a wide range of services including abortions across 18 centers in Maine. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'This is a clear attack on rural Mainers, on working class Mainers. Folks who otherwise may not be able to access the health centers if their local family planning clinic has to close its doors,' Pennington said. Already, some rural health centers in Rumford, Damariscotta and Dexter can only stay open once or twice a week because of the persistent deficits these centers have been facing, she said. The targeted exclusion from Medicaid funding, which 47% of all Maine Family Planning patients used last year, further jeopardizes the services they can provide, she said. The bill 'segregates abortion providers, and cuts folks off from making us their provider of choice,' said Lisa Margulies, vice president of public affairs for the Maine Planned Parenthood centers. 'There's an intention to destabilize our funding streams, such that we aren't able to fulfill our core mission, and really put us out of business,' she said. The centers' ability to use Medicaid or Title X, a federal grant that supports family planning services for low-income individuals, is already restricted by the Hyde Amendment, a provision prohibiting the use of federal funds to pay for abortions that President Donald Trump reinstated at the start of his second term. Maine Family Planning has been subject to regular audits to make sure Medicaid funding is not used for abortion, Pennington said. It is not clear how Maine's congressional delegation is going to vote on the proposed health care cuts, but during a press conference Friday Planned Parenthood of Northern New England CEO Nicole Clegg said the organization expects them to reject the proposal. 'Based on their long-standing records of opposing defunding efforts of Planned Parenthood and restrictions to reproductive health providers, our expectation is that they would not support any of these proposals moving forward,' she said. In light of the proposed cuts, the providers are hoping the Maine Legislature can help fill the funding gap. They highlighted LD 143, a bill that would provide $6 million a year for family planning services, including routine gynecological exams, testing and treatment for sexually transmitted diseases, birth control, cancer screenings, and gender-affirming and behavioral health care. 'We really see LD 143 as essential for weathering the national storm, sort of weatherproofing our family planning care network in the midst of these potential federal defunds,' Marguiles said. 'It's really critical that the state partners with us in providing care to anyone who needs it.' Both the Maine House and Senate cast initial votes to pass the legislation, but it was placed on the appropriations table where it will compete with many other funding needs for whatever is available as the state faces a substantial budget deficit. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Miami Herald
08-05-2025
- Health
- Miami Herald
Despite historic indictment, doctors will keep mailing abortion pills across state lines
When the news broke on Jan. 31 that a New York physician had been indicted for shipping abortion medications to a woman in Louisiana, it stoked fear across the network of doctors and medical clinics who engage in similar work. "It's scary. It's frustrating," said Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project, a clinic near Boston that mails mifepristone and misoprostol pills to patients in states with abortion bans. But, Foster added, "it's not entirely surprising." Ever since the Supreme Court overturned Roe v. Wade in 2022, abortion providers like her had been expecting prosecution or another kind of legal challenge from states with abortion bans, she said. "It was unclear when those tests would come, and would it be against an individual provider or a practice or organization?" she said. "Would it be a criminal indictment, or would it be a civil lawsuit," or even an attack on licensure? she wondered. "All of that was kind of unknown, and we're starting to see some of this play out." The indictment also sparked worry among abortion providers like Kohar Der Simonian, medical director for Maine Family Planning. The clinic doesn't mail pills into states with bans, but it does treat patients who travel from those states to Maine for abortion care. "It just hit home that this is real, like this could happen to anybody, at any time now, which is scary," Der Simonian said. Der Simonian and Foster both know the indicted doctor, Margaret Carpenter. "I feel for her. I very much support her," Foster said. "I feel very sad for her that she has to go through all of this." On Jan. 31, Carpenter became the first U.S. doctor criminally charged for providing abortion pills across state lines - a medical practice that grew after the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization decision on June 24, 2022, which overturned Roe. Since Dobbs, 12 states have enacted near-total abortion bans, and an additional 10 have outlawed the procedure after a certain point in pregnancy, but before a fetus is viable. Carpenter was indicted alongside a Louisiana mother who allegedly received the mailed package and gave the pills prescribed by Carpenter to her minor daughter. The teen wanted to keep the pregnancy and called 911 after taking the pills, according to an NPR and KFF Health News interview with Tony Clayton, the Louisiana local district attorney prosecuting the case. When police responded, they learned about the medication, which carried the prescribing doctor's name, Clayton said. On Feb. 11, Louisiana's Republican governor, Jeff Landry, signed an extradition warrant for Carpenter. He later posted a video arguing she "must face extradition to Louisiana, where she can stand trial and justice will be served." New York's Democratic governor, Kathy Hochul, countered by releasing her own video, confirming she was refusing to extradite Carpenter. The charges carry a possible five-year prison sentence. "Louisiana has changed their laws, but that has no bearing on the laws here in the state of New York," Hochul said. Eight states - New York, Maine, California, Colorado, Massachusetts, Rhode Island, Vermont, and Washington - have passed laws since 2022 to protect doctors who mail abortion pills out of state, and thereby block or "shield" them from extradition in such cases. But this is the first criminal test of these relatively new "shield laws." The telemedicine practice of consulting with remote patients and prescribing them medication abortion via the mail has grown in recent years - and is now playing a critical role in keeping abortion somewhat accessible in states with strict abortion laws, according to research from the Society of Family Planning, a group that supports abortion access. Doctors who prescribe abortion pills across state lines describe facing a new reality in which the criminal risk is no longer hypothetical. The doctors say that if they stop, tens of thousands of patients would no longer be able to end early pregnancies safely at home, under the care of a U.S. physician. But the doctors could end up in the crosshairs of a legal clash over the interstate practice of medicine when two states disagree on whether people have a right to end a pregnancy. Doctors on Alert but Remain Defiant Maine Family Planning, a network of clinics across 19 locations, offers abortions, birth control, gender-affirming care, and other services. One patient recently drove over 17 hours from South Carolina, a state with a six-week abortion ban, Der Simonian said. For Der Simonian, that case illustrates how desperate some of the practice's patients are for abortion access. It's why she supported Maine's 2024 shield law, she said. Maine Family Planning has discussed whether to start mailing abortion medication to patients in states with bans, but it has decided against it for now, according to Kat Mavengere, a clinic spokesperson. Reflecting on Carpenter's indictment, Der Simonian said it underscored the stakes for herself - and her clinic - of providing any abortion care to out-of-state patients. Shield laws were written to protect against the possibility that a state with an abortion ban charges and tries to extradite a doctor who performed a legal, in-person procedure on someone who had traveled there from another state, according to a review of shield laws by the Center on Reproductive Health, Law, and Policy at the UCLA School of Law. "It is a fearful time to do this line of work in the United States right now," Der Simonian said. "There will be a next case." And even though Maine's shield law protects abortion providers, she said, "you just don't know what's going to happen." Data shows that in states with total or six-week abortion bans, an average of 7,700 people a month were prescribed and took mifepristone and misoprostol to end their pregnancies by out-of-state doctors practicing in states with shield laws. The data, covering the second quarter of 2024, is part of a #WeCount report estimating the volume and types of abortions in the U.S., conducted by the Society of Family Planning. Among Louisiana residents, nearly 60% of abortions took place via telemedicine in the second half of 2023 (the most recent period for which estimates are available), giving Louisiana the highest rate of telemedicine abortions among states that passed strict bans after Dobbs, according to the #WeCount survey. Organizations like the Massachusetts Medication Abortion Access Project, known as the MAP, are responding to the demand for remote care. The MAP was launched after the Dobbs ruling, with the mission of writing prescriptions for patients in other states. During 2024, the MAP says, it was mailing abortion medications to about 500 patients a month. In the new year, the monthly average has grown to 3,000 prescriptions a month, said Foster, the group's co-founder. The majority of the MAP's patients - 80% - live in Texas or states in the Southeast, a region blanketed with near-total abortion restrictions, Foster said. But the recent indictment from Louisiana will not change the MAP's plans, Foster said. The MAP currently has four staff doctors and is hiring one more. "I think there will be some providers who will step out of the space, and some new providers will step in. But it has not changed our practice," Foster said. "It has not changed our intention to continue to practice." The MAP's organizational structure was designed to spread potential liability, Foster said. "The person who orders the pills is different than the person who prescribes the pills, is different from the person who ships the pills, is different from the person who does the payments," she explained. In 22 states and Washington, D.C., Democratic leaders helped establish shield laws or similarly protective executive orders, according to the UCLA School of Law review of shield laws. The review found that in eight states, the shield law applies to in-person and telemedicine abortions. In the other 14 states plus Washington, D.C., the protections do not explicitly extend to abortion via telemedicine. Most of the shield laws also apply to civil lawsuits against doctors. Over a month before Louisiana indicted Carpenter, Texas Attorney General Ken Paxton filed a civil suit against her. A Texas judge ruled against Carpenter on Feb. 13, imposing penalties of more than $100,000. By definition, state shield laws cannot protect doctors when they leave the state. If they move or even travel elsewhere, they lose the first state's protection and risk arrest in the destination state, and maybe extradition to a third state. Physicians doing this type of work accept there are parts of the U.S. where they should no longer go, said Julie F. Kay, a human rights lawyer who helps doctors set up telemedicine practices. "There's really a commitment not to visit those banned and restricted states," said Kay, who worked with Carpenter to help start the Abortion Coalition for Telemedicine. "We didn't have anybody going to the Super Bowl or Mardi Gras or anything like that," Kay said of the doctors who practice abortion telemedicine across state lines. She said she has talked to other interested doctors who decided against doing it "because they have an elderly parent in Florida, or a college student somewhere, or family in the South." Any visits, even for a relative's illness or death, would be too risky. "I don't use the word 'hero' lightly or toss it around, but it's a pretty heroic level of providing care," Kay said. Governors Clash Over Doctor's Fate Carpenter's case remains unresolved. New York's rebuff of Louisiana's extradition request shows the state's shield law is working as designed, according to David Cohen and Rachel Rebouché, law professors with expertise in abortion laws. Louisiana officials, for their part, have pushed back in social media posts and media interviews. "It is not any different than if she had sent fentanyl here. It's really not," Louisiana Attorney General Liz Murrilltold Fox 8 News in New Orleans. "She sent drugs that are illegal to send into our state." Louisiana's next step would be challenging New York in federal courts, according to legal experts across the political spectrum. NPR and KFF Health News asked Clayton, the Louisiana prosecutor who charged Carpenter, whether Louisiana has plans to do that. Clayton declined to answer. Case Highlights Fraught New Legal Frontier A major problem with the new shield laws is that they challenge the basic fabric of U.S. law, which relies on reciprocity between states, including in criminal cases, said Thomas Jipping, a senior legal fellow with the Heritage Foundation, which supports a national abortion ban. "This actually tries to undermine another state's ability to enforce its own laws, and that's a very grave challenge to this tradition in our country," Jipping said. "It's unclear what legal issues, or potentially constitutional issues, it may raise." But other legal scholars disagree with Jipping's interpretation. The U.S. Constitution requires extradition only for those who commit crimes in one state and then flee to another state, said Cohen, a law professor at Drexel University's Thomas R. Kline School of Law. Telemedicine abortion providers aren't located in states with abortion bans and have not fled from those states - therefore they aren't required to be extradited back to those states, Cohen said. If Louisiana tries to take its case to federal court, he said, "they're going to lose because the Constitution is clear on this." "The shield laws certainly do undermine the notion of interstate cooperation, and comity, and respect for the policy choices of each state," Cohen said, "but that has long been a part of American law and history." When states make different policy choices, sometimes they're willing to give up those policy choices to cooperate with another state, and sometimes they're not, he said. The conflicting legal theories will be put to the test if this case goes to federal court, other legal scholars said. "It probably puts New York and Louisiana in real conflict, potentially a conflict that the Supreme Court is going to have to decide," said Rebouché, dean of the Temple University Beasley School of Law. Rebouché, Cohen, and law professor Greer Donley worked together to draft a proposal for how state shield laws might work. Connecticut passed the first law - though it did not include protections specifically for telemedicine. It was signed by the state's governor in May 2022, over a month before the Supreme Court overturned Roe, in anticipation of potential future clashes between states over abortion rights. In some shield-law states, there's a call to add more protections in response to Carpenter's indictment. New York state officials have. On Feb. 3, Hochul signed a law that allows physicians to name their clinic as the prescriber - instead of using their own names - on abortion medications they mail out of state. The intent is to make it more difficult to indict individual doctors. Der Simonian is pushing for a similar law in Maine. Samantha Glass, a family medicine physician in New York, has written such prescriptions in a previous job, and plans to find a clinic where she could offer that again. Once a month, she travels to a clinic in Kansas to perform in-person abortions. Carpenter's indictment could cause some doctors to stop sending pills to states with bans, Glass said. But she believes abortion should be as accessible as any other health care. "Someone has to do it. So why wouldn't it be me?" Glass said. "I just think access to this care is such a lifesaving thing for so many people that I just couldn't turn my back on it." ____ This article is from a partnership that includes WWNO, NPR, and KFF Health News. Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Yahoo
25-04-2025
- Health
- Yahoo
Maine nonprofit joins lawsuit against Trump administration over reproductive care funding freeze
Apr. 25—Maine Family Planning has joined a federal lawsuit filed this week against the Trump administration for freezing $65.8 million in federal health care grants, including nearly $2 million headed to Maine. The Title X funding pays for reproductive health care, including birth control, sexually-transmitted infection screenings and treatment, cancer screenings and other services. Title X funding is not used to pay for abortions. The Trump administration cited diversity, equity and inclusion, or DEI programs in its rationale for stopping the payments. A lawsuit filed by the American Civil Liberties Union and the National Family Planning and Reproductive Health Association in Washington, D.C., argues that the Trump administration failed to follow federal law by "providing no reasonable explanation or justification for its decision to select these grantees for fund withholding and investigation." The suit says that grant recipients were targeted "based on statements that align with the requirements of the Title X program." The family planning centers provide health care to underserved populations, including rural residents and minorities. Maine Family Planning expected to receive $1.9 million in federal Title X funding, which it would distribute to 63 health centers, including its own clinics, and those operated by Planned Parenthood of Northern New England and other community health clinics. George Hill, president and CEO of Maine Family Planning, said the nonprofit emphasized health equity in its strategic plan and on its website, and noted that providing health care to those in need is its mission. For many people who use the clinics, it may be the only primary care they receive, and the clinics often discover medical conditions that need treating from the screenings that they conduct, Hill said. "We are not going to scrub our website," Hill said in an interview with the Press Herald Friday. "We are going to move forward." Hill said the Trump administration is creating a "false pretext" of civil rights violations to deny funding. The lawsuit states that the Trump administration is claiming "diversity, equity and inclusion" policies are in violation of federal civil rights laws. According to a U.S. Health and Human Services statement, the agency is "conducting this evaluation to ensure these entities are in full compliance with federal law and applicable grant terms, and to ensure responsible stewardship of taxpayer dollars." In part because federal funding is unreliable, Maine Family Planning and Planned Parenthood of Northern New England are requesting $6 million in state funding in a bill that's pending before the Legislature. It passed the Maine House and Senate, and the bill's fate now depends on whether the funding is approved during the appropriations process. Maine would be one of at least seven states to lose all Title X funding if the lawsuit doesn't prevail and the funding freeze becomes permanent. The others include California, Hawaii, Mississippi, Montana and Utah. Lisa Margulies, vice president of public affairs for Planned Parenthood of Northern New England, said in a written statement that "the Trump administration is ignoring their own process and procedures solely to appease extremists who want to ban abortion, and they're willing to restrict access to birth control, cancer screenings and more to do it." While Title X funding does not pay for abortions, it has been challenged because it supports health care organizations that also perform abortions. Planned Parenthood and Maine Family Planning also lost out on Title X funding during the first Trump administration when a "gag rule" went into effect prohibiting the nonprofits from making abortion referrals for some patients. Rather than comply with a rule that went against their mission, the nonprofits exited the program, but reentered when the Biden administration removed the gag rule. Copy the Story Link
Yahoo
22-04-2025
- Health
- Yahoo
Clinics begin closing as Trump admin continues freeze on family planning funds
Clinics around the country that provide contraception and other reproductive health services to low-income patients are running out of funds as they await word from the Trump administration on tens of millions of dollars in grants frozen last month. Dozens of medical providers from California to Maine, including nine Planned Parenthood affiliates, have struggled to stay afloat since more than $65 million dollars for the Title X family planning program was withheld on April 1 — a funding freeze the Trump administration said was aimed at enforcing executive orders on diversity and immigration. Federal officials gave the groups 10 days to submit detailed records showing they don't discriminate in hiring or in patient care, but those who did so by the deadline said they have not received a response. 'It's been radio silence,' said Sarah Stoesz, the interim CEO of Utah's Planned Parenthood chapter. 'For some inexplicable reason, they are taking a meat axe to the healthcare system in America.' Utah is one of seven states to lose all Title X funding, along with California, Hawaii, Maine, Mississippi, Missouri, and Montana. The National Family Planning and Reproductive Health Association, which represents most Title X grantees, estimated that 846,000 patients will lose access to services if the funding isn't restored. The Trump administration did not respond to questions about the status of the funds. Some impacted health providers are considering legal action. Others are pleading with their state legislatures and private donors to backfill the missing federal dollars. And some, having exhausted their emergency funds, are shutting their doors. Two of the eight Planned Parenthood health centers in rural Utah will close at the end of this month after the Trump administration froze $2.8 million in Title X funds the state affiliate was slated to receive. The clinics — one on the northern border near Idaho and the other by the southern border with Arizona — collectively saw roughly 4,500 patients in 2024. While Utah's Planned Parenthood chapter will attempt to continue seeing some of those patients by telehealth, some will need to drive more than 100 miles to reach the nearest physical family planning clinic if they need in-person services. The group is also cutting staff and increasing its sliding scale fees for low-income patients at its remaining Utah clinics as a result of the funding freeze. 'The impact is going to be particularly brutal in red states that don't have a local government that is ready to step up and help support family planning services,' said Shireen Ghorbani, the group's interim president. 'And our county health departments and regional health departments do not always have the capacity, and, in fact, often refer patients to Planned Parenthood for STI testing. So we anticipate that people will defer care or just not receive the care that they need.' The Trump administration is also withholding nearly $2 million from Maine Family Planning — the Title X grantee that supports 60 clinics across the state — over what the organization's CEO George Hill called 'DEIA-related concerns.' That's about 20 percent of its annual budget, a loss Hill said 'will have consequences,' particularly in a rural state where people can't easily find another source of care. 'If the funds dry out and we're unable to replace them, clinics will close. Access will be denied. And a lot of people are simply not going to get contraception if they have to get in the car and drive two hours away,' he said. 'It's gonna be painful, and I resent it deeply.' In addition to the tens of millions of dollars in grants withheld in their entirety over alleged violations of Trump's executive orders and federal law, the administration also gave partial grants to some Title X providers that they report are inadequate to maintain services. Every Body Texas, the nonprofit supporting more than 150 Title X clinics across the state, received $7 million earlier this month — less than half of the $15.4 million they got from the program last year. CEO Kristie Bardell called it 'a major blow,' and warned that without additional funding, they will have to cut services for their more than 180,000 patients. Texas has the largest population of uninsured people in the U.S., and Bardell said the demand for free and subsidized family planning services is higher than she's ever seen. 'When reproductive health care disappears, cancer goes undetected, rates of unintended pregnancy and STIs rise, and the health gap grows wider,' she warned. 'We're risking decades of public health progress — and people's lives.' Even if the funds are released in the coming weeks, the reprieve may only be temporary. A draft budget document obtained by POLITICO revealed that the Trump administration is considering getting rid of Title X — as well as other family planning programs like the HHS' Teen Pregnancy Prevention.
Yahoo
01-04-2025
- Health
- Yahoo
Trump administration pauses some family planning grants as it investigates compliance with laws
The federal government has paused $27.5 million for organizations that provide family planning, contraception, cancer screenings and sexually transmitted infection services as it investigates whether they're complying with the law. The National Family Planning and Reproductive Health Association says 16 organizations received notice Monday that funding is on hold. At least 11 Planned Parenthood Federation of America regional affiliates and all recipients of federal family planning, or Title X, grants in seven states, had funding withheld. The U.S. Department of Health and Human Services declined to say which laws or executive orders the groups are being investigated for violating, though NFPFHA said some of the letters cited civil rights laws. Trump has issued executive orders targeting programs that consider race in any way, some of which have been put on hold by judges. Health and Human Services, which is in the midst of deep layoffs, also said that 'no final decisions on any spending changes for Planned Parenthood have been made.' Republicans have long railed against the millions of dollars that flow every year to Planned Parenthood and its clinics, which offer abortions but also birth control, cancer and disease screenings, among other things. Federal law prohibits taxpayer dollars from paying for most abortions. Providers said the impact on health care will especially hit lower-income people. 'We know what happens when health care providers cannot use Title X funding,' Alexis McGill Johnson, president and CEO of Planned Parenthood Action Fund, said in a statement. 'People across the country suffer, cancers go undetected, access to birth control is severely reduced, and the nation's STI crisis worsens.' The reproductive health association, whose members include most Title X grant recipients, said that about one-fourth of them received the letter, including all the recipients in California, Hawaii, Maine, Mississippi, Missouri, Montana and Utah. Mississippi law bans abortion at all stages of pregnancy. George Hill, president and CEO of Maine Family Planning, which provides abortion services, said that if necessary his organization would go to court to seek the funds. 'The Administration's dangerous decision to withhold Maine Family Planning's Title X funds jeopardizes access to critical health care services for thousands of Mainers. Any delay in disbursement of federal grants will have a detrimental effect on our state family planning network and the patients we serve," Hill said. The Missouri Family Health Council, which pays for programs throughout Missouri and part of Oklahoma, including Planned Parenthood affiliates, also had its funding blocked. Planned Parenthood Great Plains, which includes Missouri, Oklahoma and Kansas, said regional clinics remain committed to providing health care despite the funding uncertainty. 'They want to shut down Planned Parenthood health centers to appease their anti-abortion backers, and they're willing to take away birth control, cancer screenings, and STI testing and treatment to get their way,' Great Plains Planned Parenthood President and CEO Emily Wales said in a statement. 'If blocking health care for low-income patients is what the Trump administration means by 'making America great again,' then we want no part of it.' ___ Associated Press reporters Summer Ballentine and Amanda Seitz contributed to this article.
