AUGUSTA — The majority of members of a legislative committee voted Monday to reject a LePage administration bill to require doctors, drug treatment providers and other professionals to report pregnant women suspected of drug abuse.

The 8-5 vote came after doctors and substance experts warned that some pregnant women struggling with addiction might avoid going to the doctor altogether for fear of losing custody of their child at birth. But while a LePage administration official downplayed those concerns – casting the mandatory reporting as “a way to shake things up” – lawmakers struggled Monday with how best to address the surge in drug-affected babies born in Maine.

“With every law there are always the unintended consequences, and we might not see so well the baby who didn’t get prenatal care, who did not get help beforehand because of the fear of what happens when the doctor sends this information on to the government,” said Sen. Eric Brakey, R-Auburn, co-chairman of the Health and Human Services Committee. “I think everyone has the best intentions with this. I just don’t think this is the best way to go.”

Five committee members who were absent – three Democrats and two Republicans – will have 24 hours to cast their votes on the bill before it is sent to the House and Senate for consideration.

The number of newborns who experienced symptoms of drug exposure increased more than fivefold from 2006 to 2016, when 8.2 percent – roughly 1 in 12 – of the 12,478 babies born in the state were deemed to be “drug-affected.” Babies born to mothers addicted to opioids experience withdrawal and sometimes have to be treated with the same medications as a recovering addict.

Under current law, doctors already are required to notify the Maine Department of Health and Human Services when they suspect a baby was “born affected by illegal substance abuse” or when a baby may require treatment for exposure to legal substances, including alcohol. The proposal from Gov. Paul LePage would have expanded that mandatory reporting law to when doctors and other professionals – including substance abuse treatment providers – suspect a pregnant woman is abusing drugs or alcohol.

Fifteen states require health care workers to report suspected drug abuse during pregnancy, and three states – Alabama, South Carolina and Tennessee – have made drug abuse during pregnancy a crime, according to a 2015 report by the investigative journalism organization ProPublica.

As originally written, the LePage proposal appeared to violate federal health privacy laws that prohibit drug treatment providers from sharing information about patients except in very narrow circumstances. But while the bill’s sponsor, Rep. Frances Head, R-Bethel, proposed an amendment to address those concerns, the changes didn’t sway the staunch opposition from doctors and the medical community, who warned the bill could have “devastating” impacts by undermining patients’ trust in their doctors.

“Our concern with this bill is the word on the street would be if you go to a doctor while you are pregnant and you are using, the doctor will report you to the department,” said Peter Michaud, representing the Maine Medical Association. “That was the essence of my testimony that the bill would scare people away from necessary and important prenatal care.”

DRIVING WOMEN INTO SECRECY

Doctors say it is important that pregnant women receive treatment rather than subject their unborn babies to the stress of withdrawal or continued drug abuse.

That point was driven home Monday via a letter from one of Maine Medical Center’s top addiction specialists, Dr. Jonathan Feller, who runs a special program for pregnant and postpartum women struggling with addiction. Feller said the bill, L.D. 1556, “lacks foundation in evidence-based research and is likely to undermine rather than positively promote maternal, fetal and child health.”

“Rather than encouraging women to seek treatment, L.D. 1556 will drive these women into secrecy about their pregnancies to avoid contact with mandated reporters,” Feller wrote to committee members. “Women will avoid treatment rather than seek it out. They will avoid prenatal care. They will avoid addiction treatment.”

One of LePage’s senior policy advisers, David Sorensen, sought to undercut such claims that reporting would create a disincentive for mothers to seek prenatal care. Appearing on LePage’s behalf, Sorensen suggested that the steadily rising number of drug-affected babies shows that expectant mothers abusing drugs during pregnancy are still choosing to deliver their babies in Maine hospitals, despite the current mandatory reporting requirement.

“The bottom line is that the status quo just isn’t working and we see this as an opportunity to shake things up and to try something new, to expand the department’s involvement in drug-affected babies,” Sorensen said. “We just see it as something that needs to change. … We think it’s worth a shot and see what happens.”

But Rep. Scott Hamann, D-South Portland, seized on the juxtaposition between the multiple warnings from medical professionals and Sorensen’s comment about taking a shot to “see what happens.”

“To me that’s not a very convincing argument, especially when on the other side you have all of the experts weighing in,” Hamann said.

TREATMENT DURING PREGNANCY

Lawmakers are struggling with how to respond policywise to an opioid epidemic that killed 376 Mainers last year. While overdose deaths from heroin and prescription opiates are up nationwide, Maine has seen some of the largest annual increases in the nation in recent years, according to a comparison of federal data.

At one point during Monday’s work session, Rep. Deborah Sanderson, R-Chelsea, and other bill supporters noted that getting women into drug treatment or assistance programs while they are still pregnant will help both them and their babies. Newborns of women abusing drugs and alcohol can suffer from severe and sometimes life-threatening withdrawal symptoms after birth.

“No one is trying to drive (women) away,” Sanderson said. “We are trying to wrap services around them.”

Dan Morin, who represents the MaineHealth system that includes Maine Medical Center, said health providers spent months developing proposals to address opioid treatment but “they’ve all been turned away” by the committee. And several of those sought to expand treatment to the uninsured, a population that often has the most difficult time getting access to drug treatment in Maine. Meanwhile, Morin said the LePage administration proposed L.D. 1556 “without any input from the largest health system in the state.”

“How about getting them off substances when they are uninsured before they are pregnant?” Morin said. “That was a bill we put before you, but it wasn’t important enough to fund.”

Kevin Miller can be contacted at 791-6312 or at:

kmiller@mainetoday.com

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