FILE - The Maine State House is seen at dawn, Jan. 3, 2024, in Augusta, Maine. The Democratic-controlled Maine Legislature has approved a bill that would protect health care workers who provide abortion and gender-affirming care from legal action brought in other states. If signed by Democratic Gov. Janet Mills, Maine would join more than a dozen states that shield medical providers and others from out-of-state investigations regarding abortions. (AP Photo/Robert F. Bukaty, File)

The Democratic-controlled Maine Legislature gave final approval Friday to a bill that would protect health care workers who provide abortion and gender-affirming care from legal action brought in other states.

If signed by Democratic Gov. Janet Mills, Maine would join more than a dozen states that shield medical providers and others from out-of-state investigations regarding abortions. Republicans were firmly against the bill to shield against out-of-state lawsuits.

The Maine Senate voted 21-13 on Friday, a day after a 76-67 vote in the House.

The votes came after attorneys general in 16 states, including Tennessee, threatened legal action if Maine proceeded with a shield law preventing out-of-state repercussions for those who provide abortions and what they called “gender transition surgeries for children.”

Maine Attorney General Aaron Frey called those accusations “meritless” and said shield laws were necessary due to other states’ efforts “to punish beyond their borders lawful behavior that occurs in Maine and other states.”

“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 said previously in a statement.

There was spirited debate over the measure in Maine.

On Thursday, the Maine House censured two lawmakers after one of them accused legislative colleagues of bringing the wrath of God in the form of a mass shooting and recent storms by enacting such laws. The lawmaker, and another who agreed with him, were required to provide a formal apology on the House floor to be allowed to speak and to vote.

“We are grateful and proud of all of the lawmakers in the legislature who endured threats of violence, abhorrent political rhetoric and rampant disinformation to stand and vote to protect safe, legal, medical care in Maine,” said Lisa Margulies, from Planned Parenthood Maine Action Fund.

Abortion is legal in Maine at all stages of pregnancy with a doctor’s approval. And lawmakers last year approved a bill to allow 16- and 17-year-olds to receive limited gender-affirming care, which does not include surgery, in some cases without parental consent. However, Maine law does not permit gender-reassignment surgery without parental consent for minors.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022 and ended a nationwide right to abortion, states have moved in opposing directions. Most of those under Republican control now have bans or other restrictions in place. Fourteen states now ban abortion in all stages of pregnancy, with limited exceptions. Most Democrat-dominated states have moved to protect access.

At least 13 states have shield laws protecting medical providers and others from out-of-state investigations regarding abortions — and at least nine, including Maine, have executive orders laying out similar policies.

It’s a similar situation with gender-affirming care for minors.

At least 24 states have adopted laws in the past three years banning or limiting treatments including puberty blockers, hormone therapy and gender-affirming surgery — which is rare for younger patients — for minors. At least 12 states have shield laws that apply to gender-affirming care and two have executive orders.

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