The American Civil Liberties Union of Maine has filed a lawsuit against the state Department of Health and Human Services over abortion coverage for women eligible for MaineCare.
The suit contends that the state's failure to pay for abortions for low-income women - except in extreme circumstances - violates the Maine Constitution.
It takes Zach Heiden just a couple minutes to walk from his office at the ACLU of Maine to the Cumberland County Superior Courthouse in Portland to file the lawsuit. But the suit itself, he says, has been a long time coming.
"Uh, either 10 months or 10 years, depending on how you count," he says.
Heiden says low-income women haven't had equal access to abortions ever since the enactment of the Hyde Amendment in 1977. It bars the use of federal funds to pay for abortions except when a woman's life is threatened, or if the pregnancy is a result of rape or incest. That means women who are eligible for MaineCare - the state version of Medicaid - have limited abortion coverage. And Heiden says that violates their rights under the Maine Constitution, as well as a law that stipulates the state will not interfere with women's reproductive decisions.
"MaineCare currently covers the full range of prenatal and pregnancy related care if women choose to continue their pregnancy," says Heiden. "But it doesn't cover abortions if a woman doesn't want to continue her pregnancy. We think that's coercive."
The lawsuit is on behalf of three health care providers - Maine Family Planning, the Mabel Wadsworth Womens Health Center, and Planned Parenthood of Northern New England, where Nicole Clegg is Vice President of Public Policy.
"Abortion rates are at a historic low - they're the lowest they've been since abortion's been legal - except for low-income women," says Clegg.
Where the reverse is happening, according to the Guttmacher Institute, a non-profit advocacy organization. A 2011 study found that unintended pregnancy and abortion rates for poor women were five times those of higher-income women. Kate Brogan of Maine Family Planning says an abortion costs about $500.
"Ya know, with the economy with the way it is, we see more people struggling trying to find the money to pay for it, when they have MaineCare and MaineCare should pay for it. And it's just not fair," says Brogan.
And there are additional economic barriers, says Andrea Irwin of the Mabel Wadsworth Womens Health Center in Bangor.
"Where we are in Bangor, we see women from all over northern and eastern Maine, so women might need to travel hundreds of miles away," Irwin says. "So they have to look at transportation costs."
And the lawsuit comes at a time when Irwin says abortion providers have been under heightened scrutiny.
"Given all the recent attacks on women's health care providers, we're really determined to take a stand and move forward in a direction that's bringing more access to care we represent," says Irwin.
There is precedent for states to provide funding for abortions. Seventeen states currently provide funding - thirteen of which are the result of a court order. But Adrienne Bennett, spokeswoman for Maine Governor Paul LePage, points out that a majority of states do not cover abortions with their Medicaid programs. In a written statement, Bennett called the lawsuit a "frivolous public relations stunt."
The national ACLU and the Planned Parenthood Federation of America are supporting the lawsuit. Zach Heiden of the ACLU of Maine says he hopes to see a resolution within a year.
