A bill that would provide so-called equity payments to family planning providers that furnish an ever-widening scope of medical services to MaineCare patients won narrow approval from a key legislative panel Friday.

The Health and Human Services Committee voted 7-4 to adopt a late-breaking bill from Sen. Cathy Breen, D-Cumberland, that would compensate family planning providers for the many primary care services they provide to an otherwise underserved segment of the public.

“The bill provides an equity payment to providers to acknowledge the wide-ranging spectrum of care they provide – care that often goes far beyond what we think of as family planning,” Breen said. “Reproductive health care providers are on the front line of Maine’s health care system.”

Unexpected non-reproductive health care services offered at family planning clinics include substance abuse treatment intervention and referrals, Narcan prescriptions, depression screenings, domestic violence referrals, and housing and food security referrals.

For many patients who are young and healthy, it is the only health care they’ll get all year, Breen said.

The state is conducting a comprehensive review of all MaineCare rates. Breen said her bill is meant to bridge a gap in the system, much like equity payment programs offered in Vermont and Oregon, rather than pre-empt that state review.

In written testimony, the state Department of Health and Human Services said it agrees with the bill’s goals, but not what it calls the cumbersome and antiquated ways it would achieve them. The department promised to start reviewing and revising MaineCare rates for these providers this year.

The cost of the increased payments the bill calls for has not yet been determined. But supporters say a 9-to-1 federal match means that every state dollar spent on reproductive health care-related services will yield outsized outcomes for all treatments MaineCare patients get at these facilities.

“The reality is that today a patient walking through our doors receives far more than a prescription to birth control or a Pap test and the state’s MaineCare system has not caught up to this shift,” said Nicole Clegg, vice president of public affairs at Planned Parenthood of Northern New England.

Planned Parenthood serves 14,000 people a year at its four Maine health centers, including some who cannot afford to pay for health care. In all, Clegg estimated the agency provides about $4 million a year in free and discounted care in Maine.

While supporters like Planned Parenthood highlighted the expanded health care menu offered by family planning providers, opponents like the Catholic Church focused on the most controversial of family planning services: abortion.

“Catholics support health care that is life affirming,” said Suzanne Lafreniere, a spokeswoman for the Roman Catholic Diocese of Portland. “The health care that is received in family planning facilities throughout the state of Maine is not life affirming. It is life ending.”

Opponents also criticized the way the bill, L.D. 811, came to be before the committee.

It was introduced last year as a “concept bill,” which means it had a title – “An Act To Protect the Reproductive Rights and Freedoms of Maine People” – but no underlying language to say what the bill was actually going to do. It was held over from that pandemic-shortened session.

The bill remained a blank placeholder bill, pending before the Judiciary Committee without language, until Thursday, when it was added to the agendas of both the House and Senate for referral to a new committee, health and human services. It was still blank.

Republicans tried to fight the referral, arguing committees had finished their work for the session, but Democrats won votes in both houses to move the bill to the Health and Human Services and Public Safety Committee. Later Thursday night, Breen introduced new bill language and a title focusing on health care equity.

Opponents accused bill supporters of trying to sneak a pro-abortion bill through the Legislature, and said there would be hundreds of opponents speaking out against L.D. 811, as they had against past abortion bills, if the legislation had been properly introduced and noticed.

“The people of Maine should be appalled,” said Karen Vachon, executive director of Maine Right to Life and a former state lawmaker and health and human services committee member. “This is the people’s house, where the people have a voice. How can you have a public hearing on a bill with no language?”

Breen apologized for the late-breaking nature of the bill Thursday when defending it during the committee referral debate. Her aide has been out sick and she is shouldering a heavy workload as co-chair of the Appropriations Committee during budget review, she said.

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