PORTLAND — A network of Maine clinics that provides health and reproductive care is asking a federal judge to restore cuts to Medicaid made by the Trump administration as part of a larger effort to prevent federal dollars from flowing to abortion providers.

An attorney for Maine Family Planning, which has 18 clinics across Maine that provide family planning and primary care services, told Judge Lance Walker in U.S. District Court Thursday that the Medicaid funding is not used for abortion and the federal government is jeopardizing patient care by arbitrarily withholding the funds.

“We are arguing that the defunding provision, which takes Medicaid away from a tiny subset of Medicaid providers who also provide abortions, violates the Constitution’s equal protection guarantee because it treats some providers differently from others who are still able to continue to bill Medicaid,” Meetra Mehdizadeh, an attorney with the Center for Reproductive Rights who is representing Maine Family Planning, told reporters outside the courthouse.

At stake is about $1.9 million, which makes up about 20% of Maine Family Planning’s annual budget.

The cuts were approved last month as part of President Donald Trump’s policy and tax bill, known as the “ big beautiful bill.” The bill eliminated Medicaid funding for one-year for nonprofit entities “primarily engaged in family planning services, reproductive health and related medical care” that provide abortions and that had Medicaid revenues in excess of $800,000 in fiscal year 2023.

Planned Parenthood, the nation’s largest abortion provider, is also impacted by the cuts and filed its own lawsuit against the Trump administration in Massachusetts on July 7.

Maine Family Planning, which serves about 8,000 people in Maine through its 18 clinics and a mobile unit, as well as tens of thousands of others through subcontracts at other clinics, filed its lawsuit last month and has asked for an immediate restoration of funding while the case continues.

The clinics provide several services covered by Medicaid, including appointments for birth control, testing for sexually transmitted infections, cancer screenings, routine OB-GYN visits and primary care.

Without Medicaid, Maine Family Planning said it will be forced to stop providing primary care for all patients — regardless of their insurance status — by the end of October.

“This does threaten MFP’s ability to continue to provide care to patients that are on Medicaid, and they’ve had to make the decision to stop accepting new primary care patients,” Mehdizadeh said. “Without relief, we’ll have to end the primary care practice, because it’s not sustainable if they can’t get Medicaid reimbursements.”

The Trump administration has defended its position to eliminate Medicaid funding, saying in court filings and arguments Thursday that Congress and the president have the authority to determine how taxpayer funds are spent.

“The United States wants to reduce abortions,” attorneys for the administration wrote in court records. “There are any number of reasons for those objectives: moral, economic, health- and safety-related, and more. And abortion is not constitutionally protected. … So Congress is free to decline to provide taxpayer funds to entities that provide abortions.”

Emily Hall, a Department of Justice attorney representing the administration, refuted the idea during Thursday’s arguments that the government is discriminating against certain providers in deciding who it will and won’t reimburse. She said the criteria are clearly laid out in the law, with the $800,000 threshold representing an effort to reduce funding for the largest providers, who are likely performing the most abortions.

“Congress is entitled to contract only with entities it wishes to contract with,” Hall said. “And it can decide it doesn’t want to contract with abortion providers.” 

IRREPARABLE HARM

Hall also argued that Maine Family Planning has failed to show that the cuts to funding will cause “irreparable harm,” which is one of the criteria Walker will consider as he decides whether to grant the network’s request for an immediate stop to the cuts.

“The plaintiff does not assert that they will cease to exist or have to close entirely,” Hall said.

Mehdizadeh countered that failure to restore the funding will cause irreparable harm.

“Where an entity is having to change services, cut programs and lay off staff, even if the entity is not going to be permanently destroyed, that is certainly irreparable harm,” she said.

George Hill, president and CEO of Maine Family Planning, said outside the court Thursday that he is worried about the loss of access to critical health care in underserved areas of the state if they can’t secure the Medicaid reimbursements.

“When we talk about irreparable harm, it’s irreparable harm to our patients,” Hill said. “They are going to be going without care.”

Walker, who was nominated to the federal court by Trump in 2018, spent time questioning both sides Thursday. He expects to issue a decision before the end of the week on the request to temporarily restore funding.

A judge in the Massachusetts case involving Planned Parenthood has issued a preliminary injunction in that case, blocking the provision in the law that cuts Medicaid funding to Planned Parenthood and allowing affiliates around the country to continue billing Medicaid.

“Every judge is different and every district is different,” Hill said. “We’re hopeful Judge Walker will follow the facts and reach the same conclusion.”