A reproductive health care provider in Bangor is short tens of thousands of dollars that MaineCare said it would reimburse months ago, according to clinic leadership.
Mabel Wadsworth Center, an independent feminist health care organization, first requested a rate increase in February 2024 to fully cover the cost of long-acting reversible contraceptives, which include IUDs and birth control implants.
As an independent clinic, Mabel Wadsworth buys contraceptive devices directly from manufacturers — and unlike family planning organizations like Maine Family Planning or Planned Parenthood, it doesn’t get a discount, said Kate Waning, the center’s co-director.
The center typically pays between $1,100 and $1,300 for each IUD or implant, but MaineCare only reimburses $920, according to Waning. She cited price increases from manufacturers in her initial request to MaineCare, according to emails reviewed by the Bangor Daily News.
“So we’re basically losing a couple hundred dollars per device that’s inserted for a MaineCare patient, which obviously we can only do that for so long before it really starts to affect our clinic revenue,” she said. “We’re a nonprofit and every dollar counts.”
The clinic may have to stop providing those services if it has to keep footing part of the bill, clinic leaders said. The conflict with MaineCare comes at a time when federal Medicaid cuts are already threatening Mainers’ health care access and funding for reproductive health and family planning services more broadly face mounting restrictions across the country.
After months of correspondence with MaineCare, the agency told Waning in December 2024 that it would adjust its reimbursement rates to be equal to or just below the acquisition costs for the three most commonly used long-acting reversible contraceptive brands, emails show.
“The new rates should be implemented no later than the end of February 2025,” a MaineCare representative wrote to Waning, adding that the agency would retroactively cover the extra cost for services provided in the second half of 2024.
After hearing this news, Waning expected the center would be reimbursed between $50,000 and $60,000 — a significant amount for a small, nonprofit clinic, she said.
But after being told the rates would be adjusted, Waning didn’t see any change for months. She followed up on the email thread five times between March 2025 and June 2025 and got no response.
Finally, in June 2025, a MaineCare representative wrote, “Unfortunately, I don’t have a good update for you. Because this rate update was combined with another policy revision, the rate increase has been delayed.”
The email gave no other information about why MaineCare hadn’t followed through with the rate adjustment it had promised.
Lindsay Hammes, spokesperson for Maine’s Department of Health and Human Services, which oversees MaineCare, did not return multiple requests for comment.
For now, Mabel Wadsworth is still providing the service while being reimbursed at less than the cost of the devices.
“We’re still providing the same services to everyone regardless of their insurance status,” Waning said.
The center inserts about 100 of these devices for MaineCare patients each year, she said. If those people lost access to the service, they’d likely have to find another provider or choose a different birth control method.
“Potentially by the end of the year, if nothing changes, we might have to look at stopping that for MaineCare patients,” Waning said. But clinic leaders are struggling to do so, she said, “because it’s so against our values” to turn someone away from a service because of their insurance provider.
It can be difficult for MaineCare patients to find a provider who can insert long-acting reversible contraceptives, according to Waning, who added that Mabel Wadsworth often gets referrals from primary care offices that don’t have providers who are trained to insert them or that don’t offer the service because they’ve had challenges with reimbursement.
This type of contraceptive is the most effective form of reversible birth control and the second most popular after birth control pills, according to Cleveland Clinic. Many patients choose IUDs and implants because they’re very effective at preventing pregnancy while also being low-maintenance compared with birth control pills, which can become less effective if someone forgets to take them at the same time every day.
“It’s an essential piece of health care for many of our clients,” said Sarah Parker, the treasurer on the Mabel Wadsworth Center’s board of directors.
It’s important for MaineCare patients to have access to whatever birth control method is best for them, she said, because “people should be able to choose how they would like to manage their health care and manage their reproductive lives.”
Maine’s reproductive health care landscape is shifting substantially due to the Trump administration’s targeting of large abortion providers for federal funding cuts.
Although Medicaid dollars cannot be used to pay for abortions at organizations like Maine Family Planning and Planned Parenthood, the federal government has slashed funding for other services performed at abortion clinics that receive more than $800,000 in federal funding per year.
Maine Family Planning is set to close its primary care practice by the end of the month after a federal judge struck down its lawsuit arguing against the funding cuts.
Unlike those larger clinic networks, Mabel Wadsworth does not receive federal Title X funding and only gets state money through MaineCare reimbursements, Parker said, and the center is not directly affected by those cuts.
That means the clinic is more protected from political whims, Parker said, but also that it needs to fundraise and secure grants to keep the clinic running. The discrepancy in MaineCare reimbursements puts a strain on Mabel Wadworth’s financial model.
“When you have a large part of that money that we raise go to something that theoretically should be already paid for … it’s one more hurdle that we have to get over in order to provide the health care that we provide not just the citizens of Bangor, but really the entire state,” she said.
