Maine’s political leaders and reproductive health care providers decried new obstacles to abortion services that were established Friday by the Trump administration and are expected to be challenged in court.

A final rule released by the U.S. Health and Human Services Department would ban federally funded family planning clinics from making abortion referrals and prohibit them from being housed in the same facilities as abortion providers.

Under the new policy, clinic staff would still be permitted to discuss abortion with clients, but it would require stricter financial and physical separation between family planning clinics and abortion providers.

Maine Gov. Janet Mills, a Democrat, said her administration would fight the rule, calling it a “backward policy that will silence health care providers, withhold vital medical information from patients, and prevent women from getting the basic health care they need.”

Maine’s entire congressional delegation blasted the policy change, and women’s groups, organizations representing the clinics, and Democratic-led states are expected to take legal action to block it from taking effect. Administration officials said Friday they expect legal action.

Maine Family Planning, which receives $2 million in Title X funding annually, pledged to do “everything in our power” to halt the rule’s implementation, including plans to seek a court injunction.

As Maine’s sole Title X grantee, the Augusta-based agency operates 18 family planning clinics and shares the Title X funding with health centers across the state, providing comprehensive reproductive health care to 23,800 women, men and teenagers each year.

George Hill, the agency’s president and CEO, said the “gag rule” compromises the scientific and medical ethics of health care providers, interferes with the provider-patient relationship and erects barriers to reproductive health care for low-income, rural and other Mainers.

“We reject all efforts to sabotage Title X,” Hill said in a statement. “We are going to court to make sure Maine patients and providers aren’t harmed by this blatantly ideological attack on health care for low-income people.”

The 312-page regulation posted Friday on an HHS website doesn’t become official until it is published in the Federal Register. It would take effect 60 days after that. Federal officials said there could be “minor editorial changes” to the rule, but they said it’s the final version.

Mills said she would work with Maine Attorney General Aaron Frey, Maine Health and Human Services Commissioner Jeanne Lambrew and the Legislature to determine what can be done at the state level to block the rule.

Last year, when Mills was attorney general, she joined states across the country in a lawsuit attempting to block the Trump administration from making changes to Title X.

Abortion is a legal medical procedure, but federal laws prohibit the use of taxpayer funds to pay for abortions except in cases of rape, incest, or to save the life of the woman.

Planned Parenthood of Northern New England, which serves about 45 percent of Mainers who rely on the Title X program at clinics in Sanford, Biddeford, Portland and Topsham, said the new rule would leave its patients’ health, reproductive rights and very lives “hanging in the balance.”

Spokeswoman Nicole Clegg said the effort to physically separate health clinics and abortion providers is a cost-prohibitive requirement aimed at stopping Planned Parenthood from participating in the Title X program. Clinics could be required to establish and staff entirely separate offices to provide abortion services, which would have no benefit to patients.

“Patients expect their health care providers to speak honestly with them, to answer their questions, to help them in their time of need,” Clegg said. “Imagine if the Trump administration prevented doctors from talking to patients with diabetes about insulin. It would never happen. Reproductive health care should be no different.”

U.S. Sen. Susan Collins, R-Maine, said she is a strong proponent of Title X funding, though she opposes federal funding for abortions. Collins said she warned the Trump administration last summer of her opposition to gag rules that prevent clinics from providing full and accurate medical information and referral services.

“I oppose this misguided rule change that could significantly diminish access for women to crucial contraceptive services, which have been critical in reducing the number of abortions in our country over the past three decades,” Collins said in a statement.

U.S. Rep. Chellie Pingree, D-1st District, said she will fight the new rule because it jeopardizes basic health care provided with Title X funding, including birth control, cancer screenings, sexually transmitted infection testing and treatment and regular checkups.

“The Trump administration has shown it will stop at nothing to undermine the health care of low-income Americans and unravel the reproductive rights of women,” Pingree said in a statement. “Our state can’t afford to lose these services, nor can rural communities across the nation. This decision is rooted in ideology, not evidence-based care, and I will fight its implementation.”

U.S. Sen. Angus King, I-Maine, said the rule would force health care providers to choose between receiving crucial federal funding and providing complete and trustworthy medical care and information to their patients.

“Even worse, this misguided decision will disproportionately impact already vulnerable populations – namely, low-income women or women without health insurance,” King said in a statement. “This rule is dangerous for American women and families, and should never have been considered.”

U.S. Rep. Jared Golden, D-2nd District, tweeted: “The Trump Administration should be working to expand access to healthcare, not block it. With their new rule on Title X funding, the administration places itself squarely between important preventative healthcare services and thousands of Maine women and families who need care.”

Title X serves about 4 million people annually through independent clinics, many operated by Planned Parenthood affiliates, which serve about 40 percent of all clients, according to the Associated Press. The grant program costs U.S. taxpayers about $260 million a year.

Although abortion remains politically divisive, the U.S. abortion rate has dropped significantly, from about 29 per 1,000 women of reproductive age in 1980 to about 15 in 2014. Better contraception, fewer unintended pregnancies and state restrictions may have played a role, according to a recent scientific report. Polls show most Americans do not want the Supreme Court to overturn Roe v. Wade, the 1973 ruling that legalized abortion.

White House counselor Kellyanne Conway dismissed the argument that separating health clinics from abortion providers would be expensive and unnecessary. “They’ve been saying for years they don’t co-mingle their funds, so this should be easy for them,” she told reporters at the White House. “Physically separate and financially separate.”

Religious conservatives see the administration’s action as a way to break down what they call an indirect taxpayer subsidy of abortion providers, the AP reported.

Tony Perkins, president of the Family Research Council, called it “a major step toward the ultimate goal of ending taxpayers’ forced partnership with the abortion industry.”

Kelley Bouchard can be contacted at 791-6328 or at:

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