Consider This from NPR

Episode Title: Republicans targeted abortion providers. Some Mainers lost primary care
Date: November 17, 2025
Host: Juana Summers
Main Reporter: Selena Simmons-Duffin

Episode Overview

This episode examines how a new federal law, aimed at restricting funding for abortion providers, is affecting access to primary care in Maine—where abortion remains legal and widely supported. The focus is on Maine Family Planning, a network of clinics now cut off from Medicaid funding due to their provision of abortion services. The story highlights how the law, intended to target abortion, is also endangering basic healthcare access in underserved parts of the state.

Key Discussion Points & Insights

1. Shifting National Politics Around Abortion

• President Trump and many Republicans assert that abortion should be a state decision. However, not all in his party agree:

  • "Dobbs v. Jackson did not simply, quote, kick back the issue of abortion to the states. The authority to regulate abortion is returned to the people and their elected representatives. Members of Congress and senators are elected representatives."
    — Rep. Bob Onder [01:04]

• Newly passed Republican legislation, “One Big Beautiful Bill,” bans Medicaid payments to large providers offering abortions, signed into law in summer 2025. Planned Parenthood called it a "backdoor abortion ban."

  • "There is no reason we cannot immediately turn off Planned Parenthood's government cash flow."
    — Rep. Bob Onder [01:31]

2. Local Impact in Maine

• Abortion is legal and supported by most Mainers, yet Maine Family Planning clinics are losing Medicaid funding.
  • "A network of clinics called Maine Family Planning is fighting for its survival because it provides abortions. That new provision ... would cut the network out of Medicaid."
    — Juana Summers [03:55]

3. First-Hand Patient Stories

• Ashley Smith’s experience shows clinics fill crucial gaps in basic healthcare, especially for uninsured and low-income Mainers:
  • "They made that process so easy and...painless. From then on, that's where I went when I needed a doctor."
    — Ashley Smith [05:03]
  • "These nonprofit clinics are my only source of health care." (Testifying at legislature)
    — Ashley Smith [05:58]

4. Clinic Operations and Community Role

• Maine Family Planning offers broad services: primary care, STI screenings, annual wellness, vasectomies, and more.

  • "We do most of our yearly wellness visits. We do vulvar biopsies and vasectomies and intrauterine inseminations as well."
    — Nurse practitioner Vanessa Shields Haas [06:51]

• 70% of their patients rely solely on the clinics for healthcare. Half are on Medicaid.

  • "Maybe they're working at a hotel...serving lobster rolls...starting oyster farms. These are entrepreneurs. These are people that are working really hard."
    — Shields Haas [08:16]

• Since the law’s passage, clinics aren’t reimbursed for Medicaid patients:

  • "Since July 4, since the bill was passed, we haven't been reimbursed for visits. Patients who use Medicaid as their insurance...we've been seeing all of those patients for free. We haven't been turning them away."
    — Shields Haas [07:54]

5. The Reality of Funding Cuts

• George Hill, president/CEO of Maine Family Planning, explains the dire consequences:

  • "This is, by volume and velocity, probably the worst that we have seen."
    — George Hill [09:12]

• The new law removes $2 million, or 20% of the clinics' budget.

  • "You have to make some difficult decisions. Either you generate more money, more revenue, or you cut costs."
    — George Hill [09:45]

• November 1: Primary care ended at three clinics, affecting nearly 1,000 patients.

  • "Our mission is to make sure that access to sexual and reproductive health care, the full range...is available to as many patients as possible."
    — George Hill [10:09]

• The state is helping fill some funding gaps, and the clinics are seeking new revenue streams. Commitment to mission remains:

  • "You can't roll up your sleeves and get to work if you're wringing your hands. We're going to keep doing what we're doing. We're not going to stop."
    — George Hill (quoting Pat Schroeder) [10:30]

Notable Quotes & Memorable Moments

• "At the end of the day, this is all about the will of the people."
  — Donald Trump (quoted by George Hill) [00:35]

• "These nonprofit clinics are my only source of health care."
  — Ashley Smith [05:58]

• "Not being able to be reimbursed for the visits...is really crippling financially."
  — Vanessa Shields Haas [08:37]

• "You can't roll up your sleeves and get to work if you're wringing your hands. We're going to keep doing what we're doing. We're not going to stop."
  — George Hill [10:30]

Timestamps for Important Segments

• 00:00–02:33: National abortion policy debate; introduction of new federal law
• 03:55–05:44: Local landscape in Maine, patient testimony (Ashley Smith)
• 06:37–08:10: Clinic services, staff perspectives (Vanessa Shields Haas)
• 08:51–10:38: Funding crisis, leadership response (George Hill), service cuts, call for resilience

Summary Table

| Time | Content | |-----------|----------------------------------------------| | 00:00–02:33 | Federal debate, Republican policy split, law summary | | 03:55–06:01 | Impact in Maine, patient stories | | 06:37–08:10 | Clinic perspective, Medicaid cut effects | | 08:51–10:38 | Leadership response, service cuts, mission | | 10:38–end | Additional credits/reporting |

Episode Tone

The episode is urgent yet empathetic, highlighting the real-life stakes for patients and providers in Maine. The voices of those affected—patients, clinicians, leadership—are prominent, ensuring the story is personal and direct while grounded in policy implications.

For those who haven’t listened:
This episode gives a concise yet powerful account of how national abortion politics have immediate, sometimes unintended local consequences, affecting not just abortion access but general primary care for vulnerable communities in Maine.