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Vanessa Shields-Haas is a nurse practitioner at Maine Family Planning.
I am a nurse practitioner in Maine. We have a catastrophic health care crisis unfolding in our state. Nearly half of Maine’s hospitals are at risk of closing and others are merging and reducing services due to the regressive budget bill enacted by the Trump Administration and Congress earlier this summer.
An estimated 60,000 Mainers will lose their health care coverage due to Medicaid and Affordable Care Act cuts. This budget bill also restricts Mainers from using their Medicaid coverage, known as MaineCare, to access health care at Maine Family Planning (MFP), a trusted provider of primary care and sexual and reproductive health services for over 50 years.
I run one of the 18 MFP clinics where we are watching this four-alarm health care fire unfold.
With the passage of President Donald Trump’s tax and spending bill, MFP is no longer permitted to bill for Medicaid services we provide to thousands of Mainers. While we continue to provide free care for Medicaid patients in the short term, it’s unsustainable in the long term. This policy aims to squeeze us financially so we either close or stop offering abortion care services to our patients.
Abortion care is legal in Maine and it comprises just one of the many services we provide to our communities throughout this rural state. The care our clinics provide is life saving, spanning from chronic disease prevention and management through mammograms and colonoscopies, to preventative care, to menopause management, vasectomy, and fertility services.
Fifty percent of our patients use Medicaid, and we are the sole access point to the health care system for 70 percent of our patients. Daily challenges for people in our state include an inability to get scheduled for acute care needs, traveling hours to access care, and waiting six to eight months for specialty and primary care appointments.
Knowing how hard it is to access care in Maine, the idea of rupturing a local, trusted health care organization with statewide reach is cruel and impacts my community and state in a profound way. There are limited alternative places for my patients to go. MFP is the leading provider of sexual and reproductive health and gender affirming care in the state.
My patients are fishing and hauling lobster traps on Penobscot Bay, starting aquaculture farms along our working waterfront, serving lobster rolls to hungry tourists, working as fishing and hunting guides, building boats, tending to the homes and lawns of second home owners, and farming. It is not just the rugged beauty of this state that makes Maine such a special place to visit, but also Mainers themselves.
Many of these hard-working Mainers are self-employed, working in industries that are largely seasonal, raising young children, or finishing college or vocational training, and using Medicaid for health care coverage. On any given day, I could see a woman experiencing menopause, a young adult in need of contraception, a 45-year-old male receiving his first colonoscopy, a 32-year-old mother in need of an annual pap smear, and a patient seeking mental health services for anxiety or depression. We have multi-generational contact and deep connections with families; we’ll see a patient for two decades, and then their teenage child will start coming in for care.
Cutting off access to reimbursement for Medicaid services means cutting off care to our most vulnerable. At MFP, we are resilient and pride ourselves on making sure anyone can get access to health care, regardless of their ability to pay. However, we also rely on the federal government to fund safety-net health care for low-income families, and we feel deeply that patients have the right to receive care from the provider they choose and trust.
It’s egregious that the Trump Administration and Congress are prioritizing tax breaks for billionaires over the fundamental right of access to health care, while the health care system is overburdened from the strain of trying to provide more care with fewer resources. For more than fifty years, MFP has provided health care access for tens of thousands of Mainers. We are part of the solution to health care access in this great, rural state, not part of the problem.
