And then there’s Oregon


Speaking of pregnancy-related health care, though Texas is doing pretty badly, Oregon is making me proud that I’m from that state. Let’s take a look at House Bill 3391, shall we? Any bolding is mine, as are comments in parentheses about excerpted wording:

A BILL FOR AN ACT

Relating to reproductive health care; and declaring an emergency.

Be It Enacted by the People of the State of Oregon:

SECTION 1. Section 2 of this 2017 Act is added to and made a part of the Insurance Code.

SECTION 2. (1) As used in this section: …(definitions)…

(2) A health benefit plan offered in this state must provide coverage for all of the fol-

lowing services, drugs, devices, products and procedures:

(a) Well-woman care prescribed by the Department of Consumer and Business Services
by rule consistent with guidelines published by the United States Health Resources and Ser-
vices Administration.
(b) Counseling for sexually transmitted infections, including but not limited to human
immunodeficiency virus and acquired immune deficiency syndrome.
(c) Screening for: …(long list of STDs, before continuing with a list of other conditions that may affect or be affected by pregnancy, including pregnancy itself, weirdly stuck in the middle)…
(d) Screening to determine whether counseling related to the BRCA1 or BRCA2 genetic
mutations is indicated and counseling related to the BRCA1 or BRCA2 genetic mutations if
indicated.
(e) Screening and appropriate counseling or interventions for:
(A) Tobacco use; and
    (B) Domestic and interpersonal violence.
(f) Folic acid supplements.
(g) Abortion.
(h) Breastfeeding comprehensive support, counseling and supplies.
(i) Breast cancer chemoprevention counseling.
(j) Any contraceptive drug, device or product approved by the United States Food and
Drug Administration, …(though when there are multiple therapeutic equivalents, the company can choose to cover only one or some of these, mainly so they can make money-saving deals with specific brands. There are some details in subsections A, B, and C, before we get to subsection D)…

(D) A health benefit plan may not infringe upon an enrollee’s choice of contraceptive
drug, device or product and may not require prior authorization, step therapy or other utilization control
techniques for medically appropriate covered contraceptive drugs, devices or other products approved
by the United States Food and Drug Administration

(k) Voluntary sterilization.

 

Well Woman care is a name used to reference standards for pregnancy-related care (including prenatal care for the fetus and certain immediately post-natal care for child and birth parent) that are decades old and occasionally revisited to make sure that the recommendations are up to date with current evidence. Well Woman care is a good standard.

Then we have screening for domestic violence, STDs, a large number of conditions that are sometimes missed or, when not missed, sometimes did not receive coverage back in the days when pre-existing conditions could be excluded from coverage. There has been considerable concern over Trump’s and Republican legislators’ willingness to eliminate guaranteed coverage for pre-existing conditions. Don’t let the dry, legislative language fool you: this is a very specific concern created by very specific proposals in DC and amounts to a big Fuck You to those who think that skimping on coverage during pregnancy is a good idea. It’s not everything I would want, but this is a very, very good thing.

Note also that abortion, contraceptives (including surgically implanted devices) and counseling related to abortion are all also required to be covered.

Finally, the language

Screening and appropriate counseling or interventions for … abortion

appears to be possibly vague as to whether the abortion itself is covered or whether “interventions for” means only things like treating complications related to abortion, I am assured by those with knowledge of Oregon law that, Yes, Oregon, there is mandated coverage for your actual abortion, so long as you have any coverage at all.

So far as I am aware, if HB3391 becomes law, Oregon will be the first state in the US that mandates private insurers cover abortion services.

And just so you know, it passed the House, today it passed the senate, and to become law the only remaining step required is to convince the governor to sign it.

The governor Kate Brown. The queer Kate Brown who is the first out LGBT person to be elected governor of any state. The staunch feminist. The longtime Democrat (hey, I had to say something that wasn’t praise here). That Kate Brown.

Fuck yeah, Oregon!

 

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