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Reproductive Health Equity Act

What is the Reproductive Health Equity Act (HB 3391)?

House Bill 3391, also known as the Reproductive Health Equity Act, is a bill that provides for expanded coverage for some Oregonians to access free reproductive health services, especially those who, in the past, may have not been eligible for coverage of these services. It also provides protections for the continuation of reproductive health services with no cost sharing, such as co-pays or payments toward deductibles, and prohibits discrimination in the provision of reproductive health services.

Benefits to those with private insurance

The Reproductive Health Equity Act ensures that people with Oregon private health insurance plans, including employee-sponsored coverage, have access to reproductive health and related preventive services with no cost sharing regardless of what happens with the Affordable Care Act.

The bill includes prohibition of services on the basis of actual or perceived race, color, national origin, sex, sexual orientation, gender identity, age or disability. This protection may be an immediate benefit for trans and gender-nonconforming individuals. For example, an individual who was assigned female at birth and identifies as male goes into a provider for cervical cancer screening, but his insurance only covers these screenings for females. The Reproductive Health Equity Act ensures that insurance must cover services for this individual, regardless of his name, or what gender is on his driver’s license or his birth certificate.

Benefits to individuals who would otherwise be eligible for medical assistance if not for their immigration status

The Reproductive Health Equity Act provides benefits for Oregonians who have been excluded from coverage of the full range of services in the past and who can become pregnant. For example, women who are undocumented including DACA recipients and women who have held lawful permanent resident status for less than five years. These women have limited options for coverage for preventive reproductive health services at no cost sharing under the Affordable Care Act. Now, many of those services are covered under the Reproductive Health Equity Act. Medical care for women up to 60-day postpartum will also be covered.

Abortion benefits

The law improves abortion access in a few different ways. First, it requires Oregon private health insurance plans to cover abortions with no out-of-pocket costs. Second, OHA and the Department of Consumer and Business Services (DCBS) are charged with developing a program that will provide access to abortion services for individuals covered by insurance plans that are exempt from the new coverage mandate. Individuals under these plans will still have access to abortion coverage through the Oregon Health Authority. Finally, it covers abortion services for individuals who would otherwise be eligible for medical assistance if not for their immigration status.

When will benefits be available?

Different benefits outlined in the bill go into effect at different times.

  • The part of the law addressing discrimination went into effect August 15, 2017.
  • Coverage of abortion services for individuals who are undocumented will begin January 1, 2018.
  • All other services for undocumented individuals will be fully implemented by April 1, 2018.
  • The change to cost-sharing requirements for private insurance plans go into effect January 1, 2019.

What is the Reproductive Health Program’s role?

Our role is to administer and fund the program for the full range of services for women who can become pregnant who would otherwise be eligible for medical assistance if not for their immigration status. We have nearly 50 years’ experience serving the entire state of Oregon, including some of the most underserved and underrepresented communities in the state. We have an established and trusted clinic network in place, we are working on expansion of that network. Our goal is to increase access to high quality, client-centered reproductive health services for all Oregonians.

What services are available under this program?

Individuals are eligible for a full range of reproductive health services, including the following:

  • A comprehensive list of FDA approved contraception, and contraceptive-related services including counseling;
  • Voluntary sterilization;
  • Screenings for pregnancy, sexually-transmitted infections (STIs), breast and cervical cancers, genetic cancer risk factors;
  • Counseling on tobacco use, STIs, and relationship safety; and
  • Abortion.

Where can these services be accessed?

Many of the same places individuals may already be going including local health departments, Planned Parenthood, federally qualified health centers, and rural health clinics.

Are services available in the meantime?

Some services are currently available. Individuals who are undocumented may already be eligible for free or low-cost reproductive health services through our Title X clinic network which serves people regardless of citizenship status.

Visit our Find a Clinic page and look for Title X clinics.

For undocumented youth up to age 19, reproductive health services will be available through Senate Bill 558, known as “Cover All Kids.” Families under 300% of the federal poverty level who are ineligible for medical assistance based on citizenship will be eligible for services as of January 1, 2018. These individuals will be able to access services at our clinics in addition to other providers who accept the Oregon Health Plan.

Administrative Rules for the Oregon Reproductive Health Program's coverage of abortion services

To view the Oregon Administrative Rules:

  • Visit the Public Health Division rules page and click on "Division 4 – Oregon Reproductive Health Program."
  • Rules specific to the coverage of abortion services for the time period of January 1, 2018 through March 30, 2018 begin at "333-004-1000 Statement of Purpose and General Provisions."

Proposed Rules for the Oregon Reproductive Health Program

The Oregon Health Authority (OHA), Public Health Division is proposing to permanently adopt OAR 333-004-2000 through 333-004-2190 related to coverage of reproductive health services.

Oregon Laws 2017, chapter 721 requires the Oregon Health Authority to administer a program to reimburse for the cost of medically appropriate services, drugs, devices, products and procedures, including abortion, for individuals who can become pregnant and would be eligible for medical assistance if not for 8 U.S.C. 1611 or 1612. This program will be administered by the Reproductive Health (RH) Program, and is to be implemented April 1, 2018. In light of this new program, the RH Program is re-organizing its structure to reduce administrative burden on both enrolled providers and clients. In order to implement the new structure on April 1, 2018, the RH Program, as part of the OHA, proposes to adopt permanent rules for the coverage of all services provided under the RH Program, including those detailed in Oregon Laws 2017, chapter 721, those covered by the state’s family planning Medicaid waiver program Oregon ContraceptiveCare or CCare, and the state’s Title X grant. These rules mirror, in their entirety, temporary rules under the same rule numbers filed with the Secretary of State effective December 22, 2017 through March 31, 2018. 

The rules pertain to client eligibility and enrollment procedures; covered and excluded services; agency (provider) enrollment, responsibilities, and termination; billing and claims; payment; compliance with federal and state statutes, and agency audits and appeals processes. 

In addition, the Reproductive Health Program permanently adopted rules 333-004-1000 through 333-004-1160 on December 19, 2017, applying to the coverage of pregnancy termination services. Proposed OARs 333-004-2000 through 333-004-2190, which include coverage of pregnancy termination services, are intended to replace 333-004-1000 through 333-004-1160 and those rules are being repealed. 

You are invited to review the proposed rules and to comment on them. If you wish to present oral testimony, a public hearing will be held in Portland, Oregon at 800 NE Oregon St, Room 1C, on February 22, 2018 at 1:00 p.m. You may also file written comments before 5:00 p.m. on February 23, 2018 to the Public Health Division Rules Coordinator at the following address:

OHA, Public Health Division 
Brittany Hall, Administrative Rules Coordinator
800 NE Oregon Street, Suite 930
Portland, Oregon 97232

E-mail comments to: publichealth.rules@state.or.us.  
You may also send comments by fax to (971) 673-1299. 

Final rules will be filed after consideration of all comments.

For more details, please see the Notice of Proposed Rulemaking, the Statement of Need and Fiscal Impact, and the full text of the proposed rules

If you have any questions or would prefer a hardcopy be sent, please contact: Alison Babich, alison.a.babich@dhsoha.state.or.us or (971) 673-0227.


 

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