AUGUSTA — House lawmakers gave initial approval Tuesday to a bill that would require Maine’s Medicaid program and private insurance companies to pay for abortion services.

The 79-63 vote followed roughly two hours of emotional yet respectful debate and fell largely along party lines, with every Republican opposing the measure and all but eight Democrats voting in support. The proposal, which would make Maine the 16th state to spend public funds on abortions, is the first of several abortion-related bills expected to get strong consideration this session.

“No one – no politician, no insurance company – should ever come between a person and their health care provider,” said bill sponsor Rep. Joyce McCreight, D-Harpswell. “We have created a system that opens the door for those with means to pay, while slamming it for those less fortunate. It is unfair and it is discrimination.”

With Democrats controlling both chambers of the Legislature and Democrat Gov. Janet Mills in the Blaine House, abortion rights defenders are hoping to score major legislative victories in Maine this year even as they fight against attempts to restrict access to abortion in other states.

The bill now heads to the Maine Senate, where Democrats hold a smaller majority.

Debate on both sides of the bill mirrored many of the arguments often heard in the decades-old political and cultural fight over abortion.

Abortion opponents objected to the prospect of taxpayer dollars being used to pay for a procedure that many people regard as taking the life of an unborn child. They also predicted that using state funding from MaineCare – the state’s Medicaid program – will lead to a spike in abortions and increase the costs of the procedures.

“This is not about health care,” said Rep. MaryAnne Kinney, R-Knox. “A life is taken every time an abortion is performed. And just because it’s legal does not make it right. It’s an extreme form of birth control.”

A federal law known as the Hyde Amendment prohibits the use of federal funds to pay for abortion services but allows states to pick up the costs. Fifteen states – including Massachusetts, Connecticut and Vermont – have opted to use state tax dollars to pay for abortions through their respective Medicaid programs.

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MaineCare already covers abortions in cases of rape or when the mother’s life is at risk because of the pregnancy. The bill, L.D. 820, would expand that coverage to elective abortions while also requiring private insurers that provide coverage for maternity services to also cover abortions.

While the number of abortions performed in Maine fluctuates from year to hear, the long-term trend appears to be downward. There were 2,653 performed in 2005 but only 1,836 in 2015, a 31 percent drop, according to the Maine Center for Disease Control and Prevention.

The expansion would cost MaineCare $227,546 in fiscal year 2019-20 and $375,843 in each of the following three years, according to a fiscal analysis.

Rep. Richard Pickett, R-Dixfield, said that as someone who believes life begins at conception, he does not want any of his tax dollars “to be used in any way, shape or form to pay for that procedure.” Pickett also said he did not hear any testimony during an extensive public hearing that Maine women were unable to obtain abortions because of the restrictions on MaineCare dollars.

“Maybe they had to wait a day or travel a bit,” Pickett said. “But, again, why do we need taxpayer monies for a service that is already provided to them?”

While House Speaker Sara Gideon, D-Freeport, had to gently remind speakers about House protocol, the debate was lengthy but civil as lawmakers on both sides shared deeply personal stories about their families, friends or themselves.

Rep. Margaret O’Neil, D-Saco, told her colleagues that she was raped twice while in college and that the prospect of becoming pregnant compounded the trauma she had experienced. Speaking with a halting voice, O’Neil said having access to emergency contraception allowed her to prevent a pregnancy but other women — and particularly those in abusive relationships — may not have that option.

“It scares me to think of a woman having that choice taken away from simply because she does not have the right insurance coverage or she does not have the money to access the appropriate health care procedure,” O’Neil said.

Lawmakers are considering several abortion-related bills this session.

Later Tuesday, the majority of members on a legislative committee voted to endorse a bill sponsored by Gideon on Mills’ behalf that seeks to expand women’s access to abortion services statewide.

That bill, L.D. 1261, would allow trained and certified physician assistants and advanced practice registered nurses to perform the most common surgical abortions as well as dispense prescriptions for a drug-induced abortion. Roughly a half-dozen other states already allow non-physicians to perform such services.

The Health Coverage, Insurance and Financial Services Committee voted 5-4 to endorse the bill, with four lawmakers absent. Democrats hold an 8-5 majority on the committee, meaning the bill will likely to go to the House floor with an “ought to pass” recommendation after the other members have cast votes.

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During floor debate on the MaineCare bill, Republicans pointed to the other abortion-related measures as they criticized the Democratic majority and a bill they view as using tax dollars for an immoral purpose.

“This is a bad idea,” said Rep. Roger Reed, R-Carmel. “I just hope all across Maine the taxpayers are watching closely what is going on here in this State House. If they aren’t upset over this bill, they probably won’t be upset over anything.”

But several bill supporters countered that their tax dollars are also spent on wars or other programs they do not support.

“We all pay for things that we don’t like with our tax dollars,” said Rep. Colleen Madigan, D-Waterville. “Our country is a pretty contentious place, in case you haven’t noticed.”

Abortion rights supporters praised the House vote.

“We all deserve health coverage that includes all medically necessary care,” George Hill, CEO of Maine Family Planning, said in a statement. “This legislation will be a dramatic step toward making that a reality for the women of Maine. It will make Maine one of the most progressive states in the country on abortion rights. We urge the Maine Senate to follow suit and pass L.D. 820.”

The Maine Senate will now debate the bill.

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