Last week, the American Civil Liberties Union of Maine, along with the national ACLU and Planned Parenthood Federation of America filed a lawsuit seeking to restore abortion coverage for low-income women who qualify for MaineCare, the state’s Medicaid program. 

Under state law, MaineCare may only cover abortions if necessary to save the life of the mother or if the pregnancy is the result of rape or incest. Under the so-called “Hyde Amendment,” federal law also prohibits federal funding from being used to cover most abortions.

The lawsuit was filed in Cumberland County Superior Court on November 24 on behalf of the Mabel Wadsworth Women’s Health Center, Maine Family Planning and Planned Parenthood of Northern New England. All three groups provide comprehensive women’s sexual and reproductive health care, including abortions. 

While Maine law bans MaineCare coverage for most abortions, the state will cover pre-natal care. The lawsuit argues that state policy “interferes with a woman’s fundamental right to decide whether or not to continue a pregnancy and discriminates against women who decide to have an abortion.”

The plaintiffs argue that the ban on abortion coverage for MaineCare recipients violates the “liberty and safety clause” of the Maine Constitution, which provides that all people have an inherent right to pursue and obtain safety and happiness, as well as the “equal protection clause,” which holds that no person shall be denied the equal protection of the laws. 

“When a woman finds out she’s pregnant, she will make a decision, ideally one that is best for herself, her health, and her family,” said Donna Burkett MD, medical director at Planned Parenthood of Northern New England, in a statement. “When she 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 should not be pressed into a decision, potentially one contrary to her well-being, due to lack of resources. All too often, we see a woman delay her decision, potentially jeopardizing her health, because she couldn’t afford to care for herself.”

The group contends that the current policy also causes “substantial negative effects on the health and well-being of women with low incomes” because pregnant women with medical conditions such as heart disease, diabetes, chronic hypertension, and obesity are denied coverage for the abortions they need to prevent damage to their health, including “excruciating pain, damage to major organ systems and in some cases shortened life expectancy.” The lawsuit also points out that some women with cancer, high blood pressure, or certain mental illnesses require medications that can harm fetuses. 

The suit further states that “Women who discover that their fetuses have severe or fatal anomalies are denied coverage for abortions that are necessary to prevent mental anguish and unnecessary suffering. Women who experience intimate partner violence are denied coverage for abortions even though the pregnancies may exacerbate the abuse and the birth of the child may forever tie them to their abuser.”

The group argues that without state assistance, low-income women must often forgo paying for other necessities, such as food, rent, heat, or transportation to pay for an abortion. The average cost of a 10-week abortion is about $451, according to the National Network of Abortion Funds. 

Maine is among 32 states that only cover abortions in cases of rape, incest or if the mother’s life is immediately at risk. However, 13 states — including Massachusetts, Vermont and New Hampshire — have been required by court orders to provide Medicaid coverage for abortions. 

In a statement, LePage administration press secretary Adrienne Bennett called the ACLU lawsuit “nothing but a frivolous public relations stunt.”

Maine DHHS under the LePage administration has been cracking down on abortion providers for billing MaineCare for “abortion-related services.” In October, the Family Planning Association announced it was appealing a DHHS order to repay over $180,000 in reproductive health care services that the state deemed “abortion-related” because the services occurred on the same day the women received abortions.