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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 for women 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.

Proposed rulemaking and public comment

Notice of Proposed Rulemaking and Request for Public Comment for Reproductive Health Program Coverage of Pregnancy Termination Services (pdf)

HB 3391 (Oregon Laws 2017, chapter 721) requires the Oregon Health Authority (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. At this time, the Reproductive Health Program, as part of the Authority, proposes to adopt rules applying to the coverage of pregnancy termination services to be effective January 1, 2018. Additional rules applying for the coverage of the remainder of services detailed in statute will be effective April 1, 2018 and will be adopted under a separate permanent rulemaking. These current proposed rules applying to coverage of pregnancy termination services will be subsumed by the rules to be effective April 1, 2018.

Members of the public are invited to comment on the proposed rules at a hearing scheduled on December 6, 2017 at 11:45 am in Room 1C of the Portland State Office Building (800 NE Oregon Street, Portland, OR 97232). Comments may also be directed to Brittany Hall, Rules Coordinator, at Brittany.a.hall@state.or.us or 503-449-9808, until December 7, 2017 at 5:00 pm.

For further questions about these rules, please contact Alison Babich, RH Program Provider Liaison at Alison.a.babich@state.or.us or 971-673-0227.

Questions?

Have questions or want more information? Contact us at rh.program@state.or.us.

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