Sixteen Republican attorneys general lambasted a Maine bill that would shield health care providers from civil or criminal proceedings initiated by other states for providing gender-affirming or abortion care to their residents.

A letter signed by Tennessee Attorney General Jonathan Skrmetti and 15 other attorneys general from states that vote or lean Republican said that Maine’s proposal is “constitutionally defective.”

The shield law proposed by Maine Democrats aims to protect health care providers from subpoenas or warrants, health record requests, extradition requests and other civil or criminal proceedings if they provide care – including abortion and gender-affirming care – that has been banned in a patient’s home state.

If the bill, L.D. 227, is approved and signed by Gov. Janet Mills, Maine would join 17 other states and Washington, D.C., in passing laws shielding health care providers from legal action by states that have banned or restricted abortions. Eleven states plus Washington, D.C., have enacted similar laws protecting providers of gender-affirming care for non-residents.

To what extent states can take legal action against health care providers in other states is a murky area of the law that emerged after the U.S. Supreme Court struck down a nationwide right to abortion and some states adopted bans. Some states also have restricted access to gender affirming care, raising similar legal questions about whether they can prevent residents from crossing state lines for treatment.

The question is currently being tested in pending court cases, including a case where the Texas attorney general’s office is requesting Seattle Children’s Hospital to release documents about patients and doctors regarding gender-affirming care. The hospital refused, and the case is now in court.

“It’s a brave new world, post-Dobbs,” said Lisa Margulies, an attorney and vice president of public affairs for Planned Parenthood of Northern New England, referring to the 2022 U.S. Supreme Court decision that overturned Roe v. Wade.

Skrmetti’s letter argues that L.D. 227 has “far-reaching” and “unprecedented” provisions and “seeks to contravene the lawful policy choices of our states’ citizens by imposing on the rest of the country Maine’s views on hotly debated issues such as gender transition surgeries for children.”

Maine Attorney General Aaron Frey said Tuesday that he was “thoroughly dismayed” by the letter, calling it a meritless attempt to intimidate the bill’s supporters that is filled with misconceptions.

He said the legislation was hardly “unprecedented,” given that at least 17 states and Washington, D.C., already have passed shield laws. He said his office has reviewed L.D. 227 and is confident it will withstand legal challenge.

“Unfortunately, shield laws have become necessary due to efforts in some objecting states to punish beyond their borders lawful behavior that occurs in Maine and other states,” Frey wrote in a letter to Skrmetti Tuesday, referencing the Seattle case.

“Harmony between our states would be best preserved and promoted by the exercise of restraint by all parties seeking to control health care related policy choices in other states,” Frey wrote. “I welcome your respect for Maine’s ability to decide what access to health care people in Maine receive, free from interference by out-of-state actors.”

MAINE REQUIRES PARENTAL CONSENT FOR SURGERY

Maine law does not permit gender reassignment surgery without parental consent for minors. Under limited circumstances, 16- and 17-year-olds can receive gender-affirming hormone therapy without the permission of their parents.

“We have never provided gender reassignment surgery for minors,” said John Porter, a spokesman for MaineHealth, the parent company of the Barbara Bush Children’s Hospital at Maine Medical Center in Portland. False rumors have circulated for years that Maine Med does gender reassignment surgery for minors.

MaineHealth also does not refer minors to other health care providers for gender reassignment surgery, Porter said.

Jeff Austin, vice president of government affairs for the Maine Hospital Association, said “the hospital association is not aware of any hospitals performing the surgery” for minors.

The letter challenging the Maine bill focuses in part on a provision in L.D. 227 that would allow providers here to seek “damages against law enforcement, prosecutors, and other officials in our states who are enforcing our own valid state laws, even laws whose constitutionality has been confirmed by federal appellate courts.”

Margulies, of Planned Parenthood, said in a statement that “this threat from Republican attorneys general makes clear that people opposed to safe, legal, life-saving medical care in Maine will continue their attacks with complete disregard for standard of care medicine, and patient and provider needs. If there was any doubt that reproductive health care and care for transgender people is under attack in Maine, this threat from out-of-state actors should serve as the latest proof that Maine needs to protect our providers, our health care infrastructure and access to this care. We cannot let politicians or politically motivated attorneys general interfere with safe, legal medical care in our state.”

Twenty-two states have approved laws banning gender-affirming care, according to the Human Rights Campaign. Twenty-one states have banned or limited abortion rights since Roe v. Wade was overturned.

Skrmetti, in his letter, argued that “as currently drafted, L.D. 227 violates the United States Constitution and flouts the federalist structure that allows each of our states to engage in self-government responsive to the will of our citizens.”

But Mary Bonauto, senior director of civil rights and legal strategies at GLBTQ Legal Advocates & Defenders (GLAD), said that “states have complete authority on how to control and expend their resources, which is all shield laws like L.D. 227 do. The attorneys general of these states can avoid any of the consequences they fear by not imposing on lawful health care in Maine.”

State Rep. Joshua Morris, R-Turner, said in a statement that “this is clearly an extreme bill that will make America’s children less safe. It’s no exaggeration that this bill will allow some of the worst of our society – child traffickers and abusers – to feel welcome and safe in Maine.”

The bill does not protect criminals who cross state lines to seek care for children without parents’ consent, the bill’s proponents have said.

Staff Writer Emily Allen contributed to this report.

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