A provision in President Donald Trump’s sweeping new tax and spending package could severely restrict access to reproductive and sexual health care in Maine, threatening funding for key providers that serve thousands of patients statewide.
The so-called “One Big Beautiful Bill,” narrowly approved by the Senate on Tuesday and now headed to the House, includes a controversial measure that would block Medicaid payments for one year to any health care provider offering abortion services and receiving more than $800,000 in Medicaid funds annually. This directly targets two of Maine’s largest reproductive health providers: Planned Parenthood and Maine Family Planning.
Though abortion remains legal in Maine up to fetal viability, neither organization uses Medicaid funds for abortion services. Instead, the federal-state health insurance program covers services such as STI testing and treatment, contraception, cancer screenings, and basic primary care. Experts warn the measure could still devastate access to essential health care, particularly for low-income patients in rural or underserved communities.
Maine Family Planning, which operates 18 clinics and a mobile medical unit across the state, relies on Medicaid for around 20% of its annual budget — approximately €1.9 million. Its president, George Hill, said the clinics serve many patients who would otherwise have no interaction with the health care system.
“Seventy percent of our patients come for their only health care visit of the year,” Hill said. “If we lose Medicaid funding, many of them will have nowhere else to go.”
He added that while the organization will continue providing care for as long as possible, it already operates on thin margins and relies on fundraising to fill financial gaps. If the bill becomes law, Hill said litigation could be considered.
Planned Parenthood warned the measure could force nearly 200 clinics across 24 states to close, affecting over 1.1 million patients. More than 90% of those clinics are located in states where abortion remains legal, and many serve medically underserved or rural areas.
Three Republican senators joined Democrats in voting against the bill, including Maine’s Sen. Susan Collins. In a statement, Collins cited the “harmful impact” on Medicaid and rural health care providers. Nearly one-third of Maine’s population relies on Medicaid, according to her office.
This is the second major funding blow for Maine Family Planning in recent months. In April, the Trump administration froze its Title X funding, which accounts for another 20% of its budget. While the state legislature approved short-term funding to help offset the loss, Hill said that support is only guaranteed for one year.
“This isn’t about fraud or wrongdoing,” Hill said. “We’re being targeted because we’re abortion providers — plain and simple. This is a backdoor effort to undermine reproductive rights in states where they’re still protected.”
With the House vote looming, advocates say the bill could have far-reaching consequences for reproductive health care nationwide, even in states that have maintained legal access to abortion.