AUGUSTA – Speaker Sara Gideon today presented a LD 1613, “An Act Regarding Women’s Health and Economic Security,” before the Legislature’s Committee on Health Coverage, Insurance and Financial Services.

Due to the withdrawal of statewide grantee Maine Family Planning from the Title X/National Family Planning Program over the Domestic Gag Rule, Maine’s family planning network faces a funding shortfall of nearly $2 million. This bill seeks to replace these lost Title X funds with state funds in order to sustain Maine’s existing and essential family planning network.

“For many of the 23,000 patients served by Maine’s family planning network, this is the only health care provider they will see,” said Speaker Gideon. “Their clinics are located in parts of our state that already lack doctors and nurses or where an hour drive is the norm to get to an appointment, not the exception. If we fail to support this network, the impact will be felt disproportionately by the very rural communities and Mainers that already face significant health care challenges.” 

Speaker Gideon’s submitted written testimony is below.

Senator Sanborn, Representative Tepler and distinguished members of the Joint Standing Committee on Health Care Insurance and Financial Services, thank you for welcoming me today.  I am Sara Gideon, from Freeport and the Speaker of the House of Representatives. I’m here today to speak in favor of LD 1613 – An Act Regarding Women’s Health and Economic Security.

Due to the withdrawal of statewide grantee Maine Family Planning from the Title X/National Family Planning Program over the Domestic Gag Rule, Maine’s family planning network faces a funding shortfall of nearly $2 million. This bill seeks to replace these lost Title X funds with state funds in order to sustain our existing and essential family planning network. 

Title X was established in 1970 and is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services. As a participant in the program, health care providers commit to providing care to all who need it, regardless of ability to pay. Almost half of the patients who receive Title X services are at 100 percent of the Federal Poverty Level (FPL) and three quarters are below 200 percent of the FPL.  

In Maine, Title X supported a network of reproductive and sexual health care providers in the state including Planned Parenthood of Northern New England, Maine Family Planning and some federally qualified health centers. 50 locations across the state, rural to urban, served more than 23,000 patients each year, providing contraceptive counseling and supplies, STI testing and treatment, cancer screenings, wellness exams, pregnancy tests and comprehensive options counseling, and other essential health services.

This care empowers Mainers to build the lives and families they envision, to decide when and whether to become a parent, and to pursue educational and career goals on their own timelines. And for many of these patients, at a critical time in their lives, it is the only health care they receive.

Data clearly shows that family planning health centers can be patients’ only source of care in underserved communities. In 2016, Title X-funded providers were the sole source of medical care for 60% of their contraceptive clients nationally. Here in Maine, many of these 50 locations fall in locations that are federally recognized as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas/Populations (MUA/Ps). These areas have been determined to have a critical shortage of primary care, dental care, and/or mental health care providers. 

To put that technical language into less complicated terms, for many of the 23,000 patients this is the only health care provider they will see. Their clinics are located in parts of our state that already lack doctors and nurses or where an hour drive is the norm to get to an appointment, not the exception. If we fail to support this network, the impact will be felt disproportionately by the very rural communities and Mainers that already face significant health care challenges. 

In February 2019, the federal Office of Population Affairs within the Department of Health and Human Services announced a set of changes to Title X known collectively as the Domestic Gag Rule. The rules prohibited organizations like Maine Family Planning and Planned Parenthood of Northern New England from providing abortion services and federally funded family planning services at the same location, imposing cost-prohibitive physical separation requirements; strictly curtailed counseling on and referrals to abortion services by Title X-funded providers; and eliminated current requirements that Title X sites offer a full range of medically approved family planning methods and non-directive pregnancy options counseling that includes information about prenatal care/delivery, adoption, and abortion.

In doing so, the federal government inserts itself into a medical conversation that otherwise would and should only involve a patient and their provider. Continuing to accept these Title X funds would have prevented these health care providers from doing their jobs and providing ethical, evidenced based care. As a result, they are left with a significant financial shortfall. 

Every Mainer, regardless of income or where they live, should have access to comprehensive, high-quality, and affordable sexual and reproductive health care from an expert family planning provider in their community. This bill will ensure that this network can continue to provide these vital services.

I am sure there are others that will follow me today that can dive into further details, but I’d be pleased to answer any questions you may have. I’m confident the committee will consider these matters carefully and I respectfully ask that you support LD 1613 and swiftly move its passage.