Maine’s two largest abortion providers have filed lawsuits over cuts made in the Republican budget law that threaten the health care services they offer.

The new law makes deep cuts to Medicaid funding for family planning and reproductive health providers that offer abortions. In Maine, that includes Planned Parenthood of Northern New England and Maine Family Planning, nonprofit organizations that operate family planning clinics and health centers across the state.

Between the Medicaid cuts and a federal freeze of Title X funds for family planning services in Maine, half of Maine Family Planning’s funding is in jeopardy, said George Hill, president and CEO of the organization.

“They’re coming after us because we provide abortion care,” Hill said. “Because we believe that it’s part of the full range of sexual and reproductive health care.”

Opposition to abortion by President Donald Trump and Republican lawmakers is fueling the targeting of health care providers that offer abortions, especially since a 2022 U.S. Supreme Court decision stripped away abortion rights on a national level. Since then, 12 states have passed abortion bans, according to the Guttmacher Institute, an abortion rights group.

Maine has expanded abortion rights.

Maine Family Planning is the state’s Title X grantee, tasked with distributing federal funding to more than 60 health centers across Maine for reproductive health services, excluding abortion. In April, the federal government froze nearly $2 million of that funding, which has not been returned.

No federal funds pay for abortions, but the two agencies offer an array of services paid for in part by federal Title X and Medicaid funds, including cancer screenings, treatment for sexually transmitted infections, birth control, gender-affirming care, primary care and vaccinations.

Planned Parenthood of Northern New England — which serves Maine, Vermont and New Hampshire — stands to lose $5.2 million from cuts in the budget law and Title X. Maine’s share of the cuts total $1.4 million, according to Planned Parenthood.

Planned Parenthood officials are requesting additional funding from state governments in northern New England, including Maine, to make up the shortfalls, if the lawsuits are unsuccessful in reversing the cuts. Gov. Janet Mills is weighing Planned Parenthood’s request, according to her staff.

Maine Family Planning leadership is considering a similar appeal to the state.

Could Maine see reductions in reproductive health services?

Yes, if the courts allow the law as written to stand.

The new law axes Medicaid funding for Maine Family Planning and Planned Parenthood for a year. The two agencies are arguing that it’s illegal for the budget bill to target their funding.

A provision in the law cut Medicaid funding for groups “primarily engaged in family planning services, reproductive health, and related medical care” that provide abortions and had Medicaid revenues in excess of $800,000 in fiscal year 2023.

Planned Parenthood sued the Trump administration July 7, securing a temporary restraining order against the provision. Maine Family Planning brought a lawsuit against the administration Wednesday.

Federal Medicaid dollars already can’t cover abortions. In 2024, abortions made up 18% of all services provided by Planned Parenthood of Northern New England in Maine, said Lisa Margulies, vice president of public affairs at Planned Parenthood of Northern New England.

Planned Parenthood argued in its lawsuit that the provision would make it harder for patients to access non-abortion services like cancer screenings, STI testing and treatment, vaccinations and birth control visits.

Planned Parenthood of Northern New England also provides behavioral health care and connects patients with social services, and Maine Family Planning provides primary care to 700 patients annually across clinics in Ellsworth, Presque Isle and Houlton.

Even in states like Maine, where abortion is legal, funding shortfalls can limit access, Margulies said.

“We have very strong laws protecting abortion rights in Maine, but those laws mean nothing if people can’t access care and what we’re seeing is federal attacks that attempt to jeopardize that access to care,” Margulies said. “Abortion opponents know that if you hamstring providers financially, you’ve effectively ended access to abortion.”

How many patients could this impact?

Combined, Maine Family Planning and Planned Parenthood of Northern New England see close to 15,000 patients annually. In many cases, it’s the only primary care provider this population of patients will see per year, leaders of the nonprofits have said.

Most of the patients at the two nonprofits do not get abortions, as Maine records about 2,000 abortions annually, according to state statistics.

Half of Maine Family Planning’s patients are enrolled in the Medicaid program, while 27% of Planned Parenthood of Northern New England’s patients have Medicaid.

Maine Family Planning operates 18 clinics across the state, many in rural areas, as well as a mobile medical unit that provides important services to patients, Ellen Taraschi, a nurse practitioner with Maine Family Planning, said in a statement Wednesday.

“With our mobile clinic, we are able to meet Mainers where they are at, and the reality is that many of our patients have no transportation and can’t travel for care,” Taraschi wrote.

Planned Parenthood’s clinics in Maine include locations in Portland, Topsham, Biddeford and Sanford.

If patients lose access to free reproductive health care, they might forgo care entirely, Margulies said.

“You’re really just losing access to health care entirely for people with the least resources and at the most need,” Margulies said. “Especially in rural areas and especially for those folks who are already most vulnerable, including women, people of color, the LGBTQ population.”

Why was Title X frozen?

Title X is a federal program to provide comprehensive family planning care by providing grants to public and nonprofit agencies. The Trump administration has frozen Title X funds to nonprofits that offer abortions.

Out of more than 100 Title X grantees in the country, Maine Family Planning is one of three that continues to have its funding frozen.

The organization joined a lawsuit against the Trump administration in April over the frozen Title X funds. The lawsuit was filed by the American Civil Liberties Union and the National Family Planning and Reproductive Health Association.

Hill, the Maine Family Planning CEO, expects the court will have an answer by the end of September.

Title X funding makes up 25% of Maine Family Planning’s budget. The funds flow to more than 60 health centers in Maine, including $400,000 to Planned Parenthood of Northern New England, Margulies said.

What would happen if funding is not returned?

It’s unclear and depends on a number of factors, primarily whether these nonprofits would receive additional money from other sources, such as the state, other donors or through additional fundraising.

Planned Parenthood of Northern New England and Maine Family Planning are both still seeing Medicaid enrolled patients. However, Maine Family Planning officials decided this month to not take new primary care patients until long-term funding questions are answered.

Hill said Maine Family Planning has no plans to close clinics at this time.

“Worst-case scenario, of course, is that we can’t afford to deal with it anymore and we’re going to reduce our clinic footprint and that will make services less available,” he said.

Planned Parenthood of Northern New England officials say they haven’t pinpointed what cuts would be made or whether clinics would close. But long term, they’ve said services could be in danger of being curtailed or shuttering.

“The idea of a $5 million hit across our three states is really challenging to contemplate and so we are doing absolutely everything we can to ensure that we keep our doors open for anyone who needs it,” Margulies said. “But certainly, this is not something we can sustain long term.”