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Insurance Coverage for Contraception

Oregon law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception and to cover dispensing a 12-month supply of prescription contraceptives.

What is required?  If a health-insurance plan provides coverage for prescription medication, it must provide coverage for Food and Drug Administration-approved prescription contraception.  Health-insurance plans must also reimburse providers and pharmacies for dispensing a 12-month supply of contraceptives.

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 medication.

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 contraception is 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.  

Or. Rev. Stat. §743A.066 (Enacted 2007).

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