ANTI-CHOICE LAWS
Refusal to Provide Medical Services
ABORTION REFUSAL CLAUSE
Oregon allows certain individuals or entities to refuse to provide abortion services.
To whom does the refusal clause apply? Physicians, medical staff members, and hospitals.
What does the refusal clause allow? No physician is required to participate in or give advice about abortion if he or she discloses this election to the patient. No hospital employee or medical staff member who notifies the hospital of an election against participating in abortion may be required to participate. No private hospital is required to admit a woman for the purpose of abortion. The refusal of a private hospital to participate in abortion, in accordance with a policy not to admit women for abortion, may not be a basis for civil liability where the hospital notifies the woman seeking admission of its policy. Public hospitals are not permitted to adopt policies of refusing admission to women seeking abortions.
Does the law require the refusing entity to notify the persons affected? Yes. Private hospitals must notify women seeking admission for abortion services of their policy. Physicians must disclose their refusal to the patient.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.
Does the law provide a mechanism for women to otherwise obtain specific reproductive health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.
Or. Rev. Stat. §§ 435.475, .485 (Enacted 1969; Last Amended 1983).
FAMILY PLANNING REFUSAL CLAUSE
Oregon allows certain individuals or entities to refuse to provide family planning and birth control services.
To whom does the refusal clause apply? Individuals and hospitals.
What does the refusal clause allow? Any employee of the Department of Human Services, who objects in writing on the basis of personal or religious beliefs, may refuse to offer family planning and birth control services. A refusal to provide family planning or birth control services may not be the basis for discrimination, discipline, or loss in pay or benefits.
Must the refusal be in writing? Yes.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for family planning services? No.
Does the law provide a mechanism for women to otherwise obtain specific reproductive health services, information, or referrals if an individual and/or entity exercises a refusal clause? No. However, the employee's immediate supervisor is authorized to make arrangements for eligible persons to obtain family planning and birth control services from another employee.
Or. Rev. Stat. § 435.225 (Enacted 1967; Last Amended 1971)
INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE
Although Oregon law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception, certain employers and/or insurers may require that their plans exclude coverage for contraception.
To whom does the refusal clause apply? Religious employers for whom contraceptive methods are contrary to their religious tenets.
What does the refusal clause allow? A religious employer may require issuers of its health insurance plans to exclude coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? No. The law carefully defines the term "religious employer" as a nonprofit organization that has the purpose of inculcating religious values and primarily employs and serves persons who share the religious tenets of the entity. This exemption appropriately applies to religious entities but not broad-based entities that operate in the public sphere.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause? No.
Or. Rev. Stat. § 750.055 (Enacted 1967; Last Amended 2007); Or. Rev. Stat. § 750.333 (Enacted 1993; Last Amended 2007).
PRO-CHOICE LAWS
Contraceptive Equity
Oregon law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception.
What is required? If a health insurance plan provides coverage for prescription drugs, it must provide coverage for Food and Drug Administration-approved prescription contraceptive drugs or devices.
To which insurance plans does the law apply? A prescription drug benefit program, or a prescription drug benefit offered under a student health insurance policy or health benefit plan, including a hospital expense, medical expense or hospital or medical expense policy or certificate, health care service contractor or health maintenance organization subscriber contract, any plan provided by a multiple employer welfare arrangement or by another benefit arrangement defined in the federal Employee Retirement Income Security Act of 1974, as amended.
Does the law provide additional protections for women? Yes. Insurers must cover outpatient consultations, examinations, procedures and medical services that are necessary to prescribe, dispense, deliver, distribute, administer or remove a prescription contraceptive, if covered for other prescription drugs.
Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage? Yes.
To whom does the refusal clause apply? Religious employers for whom contraceptive methods are contrary to their religious tenets.
What does the refusal clause allow? A religious employer may require issuers of its health insurance plans to exclude coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? No. The law carefully defines the term "religious employer" as a nonprofit organization that has the purpose of inculcating religious values and primarily employs and serves persons who share the religious tenets of the entity. This exemption appropriately applies to religious entities but not broad-based entities that operate in the public sphere.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause? No.
Has a court considered the constitutionality of this law? No.
H.B. 2700, 74th Leg., Reg. Sess. (Or. 2007).
Emergency Contraception
EMERGENCY CONTRACEPTION (EC) FOR SEXUAL ASSAULT VICTIMS
Oregon law ensures that sexual assault victims receive access to emergency contraception (EC) in hospital emergency rooms. As part of the minimum standards for the examination and treatment of a sexual assault victim, a physician or other health care provider must provide a sexual assault victim with medically and factually accurate written and oral information about EC, offer her EC, and dispense EC upon request.
Or. Rev. Stat. § 435.252-.256 (Enacted 2007).
Oregon law establishes the Sexual Assault Victims' Emergency Medical Response Fund. The Fund pays for sexual assault victims' medical assessments, which include the offering and provision of emergency contraception upon request.
Or. Rev. Stat. § 147.005 (Enacted 2003); Or. Admin. R. § 137-084-0001, -0010, -0020.
MEDICAID COVERAGE OF EMERGENCY CONTRACEPTION (EC)
Oregon provides Medicaid coverage of emergency contraception without a prescription.
NARAL Pro-Choice America Survey of State Medicaid Offices
Low-Income Women's Access to Abortion
Oregon allows women eligible for state medical assistance for general health care to obtain public funds for abortion. Or. Admin. R. 410-130-0562; Or. Dep't of Human Servs., Office of Medical Assistance Programs, Medical-Surgical Servs. Rulebook, 410-130-0562 (July 1, 2006) at http://www.dhs.state.or.us/policy/healthplan/guides/medsurg/130rb1208.pdf.
A court held that a previous regulation that limited state medical assistance for abortions to cases of life endangerment, as well as one elective abortion for a woman 18 or older and two elective abortions for a woman under 18, was unconstitutional under the Oregon Constitution. The court found that the regulation was inconsistent with legislative policy and that it imposed arbitrary limitations. Planned Parenthood Ass'n v. Dep't. of Human Res., 687 P.2d 785 (Or. 1984).
Low-Income Women's Access to Family Planning
Oregon provides increased access to reproductive health care services through a Section 1115 family planning waiver. The waiver allows the state to cover family planning services for all men and women of childbearing age with incomes at or below 185% of the federal poverty level who are not enrolled in traditional Medicaid state and federal health care programs.
Beneficiaries of family planning coverage available through the waiver are not required to pay premiums or co-payments for covered services. Covered services include: contraceptive education and counseling; contraceptives (includes FDA-approved over-the-counter drugs, injectables and implants); office visits, examinations and HIV blood screenings/sexually transmitted infection testing in conjunction with a family planning encounter.
The waiver will expire on Oct. 31, 2009.
Or. Family Planning Demonstration Fact Sheet, Ctrs. for Medicare and Medicaid Servs., Oct. 19, 2006 at http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/MWDL/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=2&sortOrder=ascending&itemID=CMS047335&intNumPerPage=2000 (last visited Dec. 5, 2008), NARAL Pro-Choice America Survey of State Medicaid Offices
Other Pro-Choice Law
Oregon has created additional protections for privacy and choice by adding pro-choice language to its state code to express its support of individuals' right to access birth control.
"It is the public policy of this state that all Oregonians' right to freedom from unreasonable government intrusion into their private lives, and specifically the right of consenting individuals to obtain and use methods of contraception without interference by governmental entities shall be safeguarded[.]"
H.B. 2700, 74th Legis. Assem., Reg. Sess. (Or. 2007).
Protection Against Clinic Violence
A person who intentionally damages the property of a medical facility, uses the property of a medical facility to interfere with its efficiency, or damages property by intentionally interfering with the service of a medical facility is guilty of the felony of criminal mischief. Or. Rev. Stat. § 164.365 (Enacted 1972; Amended 2003).
State Constitutional Protection
The Oregon Constitution protects the right to reproductive choice to a greater extent than the federal Constitution. A court struck down under the state constitution an administrative rule limiting state medical assistance for abortions to the extent it denied funding for medically necessary abortions. Planned Parenthood Ass'n v. Dep't of Human Resources, 663 P.2d 1247 (Or. Ct. App. 1983), aff'd on other grounds, 687 P.2d 785 (Or. 1984). A similar restriction has been upheld by the U.S. Supreme Court under the federal Constitution. Williams v. Zbaraz, 448 U.S. 358 (1980).
