Analysis Law and Policy

Hundreds Rally in Oregon in Support of Bill Guaranteeing Insurance Coverage of Reproductive Care

Evelyn Shoop

"There have been times," said 20-year-old Llondyn Elliot, "where I could not afford prescriptions or doctors' visits, and because of lack of funds was not able to access care."

Hundreds gathered in Salem, Oregon, on Tuesday to rally in support of a comprehensive reproductive health bill currently in the state legislature.

Introduced in early January, the Reproductive Health Equity Act, or HB 2232, requires insurers operating in Oregon to cover a large slate of reproductive health services—contraception (including vasectomies), abortion care, postpartum care, and reproductive health screenings (including screenings for sexually transmitted infections and some types of cancers)—at no out-of-pocket cost to patients. It also seeks to close loopholes that allowed commercial insurers operating in Oregon before the passage of the Affordable Care Act (ACA) exemption from no-cost services.

HB 2232 prohibits discrimination, including discrimination based on gender, which would ensure that transgender Oregonians (whose marked gender may not match their need for screenings such as Pap tests or mammograms) would not be denied proper reproductive care. The bill also requires the state to establish a program to cover reproductive services for those excluded from care based on their citizenship status.

Convening under sometimes-rainy skies at the noon rally on Tuesday, the advocates and Oregon legislators in favor of the Reproductive Health Equity Act saw themselves as setting a model for the nation on reproductive rights. Should Republicans in Congress make good on their promise to dismantle the ACA, for example, it it would remove requirements that insurers cover many reproductive services at no out-of-pocket cost. With HB 2232, Oregon is trying to safeguard as many of the reproductive health protections it can, while also building upon them.

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Speaking to the crowd, Rep. Julie Fahey (D-West Eugene), a chief sponsor of the bill, said, “The Reproductive Health Equity Act reaffirms Oregon’s value that everyone should have access to the care that they need. If congressional leadership in Washington, D.C. won’t guarantee health-care equity, then Oregon must lead the way.”

The country’s current political climate is also what prompted many supporters to come to advocate and meet with their representatives at the state capitol building for the first time in their lives. “I brought my mom with me, and she doesn’t usually do this kind of stuff, and it’s been awesome,” said Paige Schindler, 21, who had come to Salem to speak with Sen. Sara Gelser (D-Corvallis). Schindler showed a poster she’d made for the rally that read, “My Body Is Valid.” It was a statement that she and her mom could agree on.

Fellow Gelser constituent Kathryn Weeks, 33, from Albany, said that President Donald Trump’s election is what motivated her to come to the capitol. “I sort of felt that if his voice counted, that mine should count, too,” Weeks said.

Also in their group was Renee Reichart, a mother of two and a military veteran from Corvallis. “While I was in the military,” Reichart said, “I was able to receive all of the care, prenatal and postnatal care [I needed]. My husband was able to get a vasectomy free of cost to us, which is now our birth control plan.” Living with those privileges made Reichart feel that others, including veterans, should be able to have easy and affordable access to reproductive health services.

Angela Hurley, a foster parent since 2012, was part of a group of 17 people who met with Rep. Tawna Sanchez (D-Portland). “I’m here because I’m a foster parent for teenagers,” Hurley said. She explained that 20,000 foster youth age out of the system each year, who “don’t have the family structure and safety net that teaches them how to access health care …. So their ability to access reproductive health care is extremely challenging, because they don’t feel empowered in the health-care system.” Hurley said she feels like HB 2232 offered a “no wrong door” entry into health care for foster youth, allowing them to access critical reproductive care at any clinic they might walk into.

Maria Gallegos, a 20-year-old from Hillsboro who visited the office of Rep. Susan McLain (D-Hillsboro), said that she came to Salem on behalf of marginalized communities—including low-income people, women of color, people with disabilities, and transgender and gender-nonconforming individuals—who would benefit from affordable access to reproductive services. “I identify as a queer woman of color myself, and a lot of times there’s a disproportionate accessibility reach issue when it comes to getting lifesaving care like reproductive health care,” Gallegos said.

Affordability is a big part of that accessibility reach issue. Even with contraceptive coverage enshrined by the ACA, high-deductible plans or plans that don’t cover certain services like abortion leave low-income people with large out-of-pocket costs, often pushing some kinds of care out of reach. Twenty-year-old Llondyn Elliot, a transgender man and reproductive justice advocate, said that HB 2232 was a step in the right direction. “There have been times,” Elliot said, “where I could not afford prescriptions or doctors’ visits, and because of lack of funds was not able to access care.”

Beyond cost concerns, for transgender Oregonians such as Elliot, receiving proper health coverage can be tricky—simply switching health plans and finding appropriate, quality care is difficult given issues like gender markers on forms. Trans men and gender-nonconforming people may also need reproductive health screenings, like Pap smears and cervical cancer screenings, and can be denied coverage by carriers due to procedural barriers.

The fact that HB 2232 is such an inclusive bill is a point of pride for members of the Pro-Choice Coalition of Oregon, the advocacy group behind the bill, which includes the American Civil Liberties Union (ACLU) of Oregon, the Asian Pacific American Network of Oregon, Family Forward Oregon, the Oregon Latino Health Coalition, Planned Parenthood Advocates of Oregon, NARAL Pro-Choice Oregon, and the Western States Center.

The language for the bill was crafted before President Donald Trump’s election, and Lokyee Au of the Asian Pacific American Network of Oregon, said that although threats to reproductive rights at the national level weren’t the impetus for the bill, the coalition has seen a groundswell of support that supporters attribute to the election. “It’s been really great to have that sort of big momentum and big base in support of this bill,” Au said. According to the ACLU of Oregon, the coalition had to close registration for the legislative visit sessions Tuesday because it couldn’t handle more demand.

In addition to the human right to health care, there is an economic argument to be made in favor of HB 2232. Speaking at the rally, House Majority Leader Jennifer Williamson (D-Portland) characterized reproductive health services as a pocketbook issue, arguing that HB 2232 “will make our state a stronger economy, and we don’t talk about that enough, frankly.”

The idea that state residents need the flexibility to choose when and how to expand their families due to the financial strain many working Oregonians are under was a common theme throughout the day.

Sen. Laurie Monnes Anderson (D-Gresham), a chief sponsor of the bill, said in an interview with Rewire, “When you look at the long-term effects of poverty associated with unintended pregnancies, this is an issue we need to be taking care of right now.”

Monnes Anderson is the president pro tempore of the Oregon Senate, and will play a key role in advocating for the bill within that chamber. She admits that there’s worry, even among her caucus, about any bill that would require the state to spend additional money, given Oregon’s looming budget shortfall in 2017. However, she feels that long-term financial benefits of the bill outweigh short-term concerns.

In all, 63 visits were scheduled in support of HB 2232 Tuesday, including 13 visits with Republican legislators.  Those visits may prove crucial in passing HB 2232. Although Oregon Democrats hold majorities in both legislative chambers, they are relying on Republican support on a variety of issues this session. According to Rep. Fahey, HB 2232 will likely pass through Oregon’s House of Representatives unscathed when it comes up for a vote in mid-March. From there it will move on to the Joint Committee on Ways and Means, and if successful will head to the senate floor, likely in April.

Sen. Monnes Anderson says that the bill’s success in the senate might be hard to predict. A similar bill in 2015, SB 894, the Comprehensive Women’s Health Bill, failed to make it to the senate floor. Monnes Anderson was a chief sponsor of the 2015 bill, which she described as being hobbled from the start because of its late entry into the legislature. “[W]ith something as controversial as using the word ‘abortion,’ there was a lot of communication that had to be done,” she said. Most Republican senators are ultimately pro-choice, she felt, but abortion is such a controversial topic that a lot of discussions about the bill needed to take place in order to gain support. This time around things don’t feel rushed, and the senator said she’s “cautiously optimistic.”

Still, Monnes Anderson isn’t sure how much flexibility the Democrats will have with Republicans once HB 2232 comes up for a vote. Because of the budget crisis, there is a chance it could get stuck in a quagmire of other political concerns.

Yet, she said, “We’ll fight.”

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