Republicans fought, stalled and objected. But majority Democrats in the Oregon House waited them out, and late Monday ended up passing, by a vote of 36-23, a broad reproductive health care bill.
House Bill 2002 would require Medicaid and private insurers to cover more procedures under the umbrella of gender-affirming care, and would allow minors of any age to get an abortion without needing to notify a parent, among other policies.
It now goes to the Oregon Senate, where Democrats also have a large majority over Republicans.
HB 2002 aims to protect abortion providers, expand gender-affirming services covered by Medicaid
HB 2002 was crafted by Democrats following the Supreme Court decision last summer overturning Roe vs. Wade and in response to a push by Republican legislators in other states to pass limits on gender-affirming care for youth.
Oregon already has among the most liberal laws in the country with regards to abortion and some of the nation’s strongest legal protections for LGBTQ+ civil liberties.
State law allows for abortions with no restrictions. It also requires state Medicaid and most private medical insurers to cover abortions and some gender-affirming care, including hormone therapy and some surgeries.
Democrats framed the bill as an effort to protect patients’ privacy rights, close gaps in insurance coverage, and increase access to abortion and gender-affirming care in rural parts of the state.
The bill would expand the scope of care Medicaid and private insurance is required to cover in Oregon to include laser hair removal and facial feminization surgery.
Related: From cosmetic to critical: Oregon, other states work to boost trans health coverage
It would also protect health care providers who perform abortions or gender-affirming care from legal repercussions.
“We need to make sure here in Oregon that our law is absolutely clear, so that our providers can provide care in every unique scenario,” said Rep. Rob Nosse, D-Portland, who carried the bill.
Republicans said the omnibus bill does too much, hasn’t received proper scrutiny and would undermine parents’ rights in sensitive medical decisions.
“This is a parental rights issue and a process issue,” said House Minority Leader Vikki Breese-Iverson, R-Prineville. “This is Oregon effectively telling you the government understands the needs of your child better than you do.”
FILE: House Minority Leader Vikki Breese-Iverson, R-Prineville, left, and Rep. Bobby Levy, R-Echo, while in session at the Oregon State Capitol in Salem, March 20, 2023.
Kristyna Wentz-Graff / OPB
Republicans also argued that there hasn’t been a transparent accounting of the full cost of the bill. In a fiscal impact statement prepared in March, the Oregon Health Authority could not come up with an estimate of how much HB 2002 would cost the state’s Medicaid program, but said it could increase the number of procedures that are covered rather than denied on the basis that they are cosmetic.
Republicans attempted multiple procedural moves to delay the vote, challenging whether the summary of the bill met legal standards for clarity and attempting to refer HB 2002 to other committees for debate. Those moves ultimately failed, with the bill finally going to a vote late Monday night. The bill also addresses the limited number of abortion and gender care providers outside the Willamette Valley, an issue that intensified after Idaho’s abortion bans took effect, closing clinics in Boise that were the closest option for some patients in Eastern Oregon.
HB 2002 would create a pilot project to deploy two mobile health clinics to provide abortion, gender-affirming care, and other reproductive health services in rural areas. And it requires student health centers to provide enrolled students with access to emergency contraception and medication abortion.
Republicans, many of whom represent rural districts, oppose the pilot project. They called it another example of Portlanders trying to dictate policy to rural communities without listening to them.
“These Oregonians do not want more of their taxpayer dollars going to something they fundamentally disagree with,” said Rep. Christine Goodwin, R-Canyonville. “Ask them how they feel about a mobile abortion truck parked in their neighborhoods.”
The bill also targets abortion clinic protesters by making it a crime to block people who are trying to enter a health care facility or by making noise or phone calls that interfere with facility operations.
House floor debate demonstrates partisan divide over abortion
Some of the most heated and emotional objections from Republicans came over the bill’s language that would give minors under 15 the right to access reproductive health care information and services, including abortion, without needing parental consent.
HB 2002 would also limit the situations in which a medical provider can disclose to a parent that their child has had an abortion or sought other reproductive health care, if the child objects to that disclosure.
In Oregon, state law already allows minors 15 years and up to consent to their own medical care. The state does not have any statutes currently on the books regarding parental notification or consent specifically for abortions.
Republicans have used the hypothetical case of a 10-year-old girl getting an abortion without notifying her parents, which would be legal under HB 2002.
They argued that the bill would undermine parents’ rights in sensitive medical decisions, and could keep parents in the dark in a situation in which their child had been the victim of rape and abuse.
Rep. Lily Morgan, R-Grants Pass, disclosed her history as a survivor of child abuse while urging her colleagues to oppose the bill and indefinitely postpone voting on it.
Morgan said that while she was never personally pressured to get an abortion, she was intimidated by her abuser to remain silent about her experience. She fears the bill will make it easier for a pregnancy of a child under 15 to be hidden from their parents, allowing abuse to continue.
“I was not empowered or equipped to handle the situation on my own,” Morgan said.
Rep. Lisa Reynolds, D-Beaverton, invoked her experience as a pediatrician in defending the limits to parental notification in the bill and in current state law.
Reynolds said the standard of care pediatricians follow is to involve parents in child’s care, except in exceptional circumstances.
“This is only in the infrequent and heartbreaking circumstances when the parents are not the safe adults in that young person’s life,” Reynolds said.
Reynolds also noted that health care providers are mandatory reporters of child abuse.
“If a 10-year-old is pregnant, a horrific act and crime has taken place,” she said. “I would tend to that child and then I would call law enforcement and child welfare.”
FILE: Rep. Lisa Reynolds, D-Beaverton, speaks on the floor of the House at the Oregon State Capitol in Salem, March 20, 2023.
Kristyna Wentz-Graff / OPB
While no lawmakers cited it, research suggests that a majority of minors involve their parents in the decision to seek an abortion, whether or not they are legally required to.
Lauren Ralph is an epidemiologist with the University of California, San Francisco, whose research focuses on young people’s access to abortion.
Ralph said a handful of studies, including her own research in Illinois, have looked at the issue of parental notification and found relatively consistent results.
Ralph said in states with no parental notification requirement, about two-thirds of minors seeking abortions voluntarily involve their parents in the decision, most often their moms. Between 80% and 90% involve some adult — a parent, relative, teacher, counselor or member of their religious community, according to Ralph.
In her research, younger minors were much more likely to involve their parents, with over 90% of 14- and 15-year-olds involving a parent in their decision voluntarily, and the percentage falling among 16- and 17-year-olds.