HEALTH CARE, POLITICS

Oregon House passes sweeping bill to guarantee access to abortion, gender-affirming care

Democrats in the Oregon House passed a sweeping bill intended to guarantee access to abortion and gender-affirming care Monday evening after a grueling day of debate and parliamentary motions from Republicans who adamantly oppose the measure. 

House Bill 2002, a top priority for Democrats in the legislative majority, represents the state’s response to last year’s U.S. Supreme Court ruling overturning Roe v. Wade and ending the national right to abortion. Abortion remains legal in Oregon and must be provided at no cost to the patient because of a 2017 law. 

But legislators and others who met in private last summer feared that laws in other states criminalizing abortion would affect Oregon providers. The 46-page bill that resulted focuses on protecting gender-affirming care as well as reproductive rights, both personal medical decisions under attack in Republican-led states. 

“A series of basic rights in our country came into question that had decades of precedent behind them,” said Rep. Rob Nosse, D-Portland, as he introduced the measure. 

Nosse decried criticism from Republicans, who have focused on tales of young girls obtaining abortions and the regret or medical complications experienced by some people who obtain abortions or gender-affirming care, as “misleading and provocative.” House Speaker Dan Rayfield, a Corvallis Democrat, repeatedly urged Republicans to mind their language and stick to talking about the bill’s provisions. 

The ultimate outcome – a 36-23 vote, with every Democrat in favor and all but one Republican opposed – was anticipated before lawmakers spent nearly 10 hours on the House floor on Monday. The one Republican who voted for the bill, Rep. Charlie Conrad of Dexter, voted against it at every other opportunity, and it wasn’t immediately clear why he voted for the measure. 

Over the course of those hours, Democrats reiterated their support for reproductive rights and Republicans pleaded to be listened to. 

“We don’t hate women,” said Rep. Emily McIntire, R-Klamath Falls. “We don’t hate trans people, we don’t hate kids. We are here because we love people, we love this state and we want to do everything in our power to do what is best for this state.” 

As Oregon legislators debated Monday evening, the governor of Oklahoma signed a law making it a felony for health care workers to provide gender-related surgeries, puberty-blocking drugs or hormones to children. At least 15 other states, including neighboring Idaho, have similar laws banning or restricting such care.

And 14 states, including Idaho, now ban abortion. In April, Idaho Gov. Brad Little signed a law allowing criminal prosecution of anyone who helps a minor cross state lines to obtain an abortion without parental consent.

The Oregon measure would protect doctors and other health care providers from losing their licenses or facing other repercussions for providing abortions or gender-affirming care, and it would bar state courts from issuing subpoenas or otherwise helping other states prosecute people who provided care that complies with Oregon laws. 

It also would require the state’s Medicaid program and private insurers to cover a range of reproductive and gender-related services, including laser hair removal, tracheal shaves and facial feminization surgery for transgender women.

It would allow minors to receive information about reproductive health care and some services, including contraception and abortions, without parental permission, though children younger than 15 could not be sterilized. And it reiterates requirements that insurance companies cover abortion and reproductive health care.

The measure’s next step is the floor of the Senate. It won’t receive a public hearing before a Senate committee because legislative procedures don’t allow for bills with monetary impacts to receive hearings in the second chamber – something Republicans have argued against

Long debate

Legislators have been able to plan for the measure for nearly a month, since leaders from both parties reached a deal to schedule HB 2002 and a gun control measure for full days of debate on Monday and Tuesday to avoid having to work on a Saturday in April. 

The day got off to a testy start, with Republicans using their courtesies – short speeches at the start of the session intended to introduce guests – to praise their mothers, people they knew who adopted children, women who refused abortions and so-called crisis pregnancy centers, which often resemble abortion clinics but exist to persuade women not to get abortions. 

Procedural moves followed, with attempts from Republicans to send the measure back to committees for more debate and amendments. Efforts to refer the bill to the Judiciary Committee, Rules Committee, Higher Education Committee, Revenue Committee and  Joint Ways and Means Committee didn’t succeed, but they took up most of the afternoon. 

They then tried to postpone the bill indefinitely, and then to postpone it until June 26 – the day after the Legislature must adjourn for the year. After every motion failed, debate on the bill began around 5 p.m.

Personal stories

Lawmakers on both sides of the aisle shared their personal and family experiences with abortion, illustrating why the issue resonates so deeply with many Oregonians. A survey last year from the Oregon Values and Beliefs Center found that a majority of Oregonians know someone who has received an abortion, with four in five Oregonians between 65 and 74 knowing someone who obtained an abortion. 

Rep. Thuy Tran, D-Portland, said it took seven pregnancies before she had her three children. She received abortions during some of those pregnancies because of complications, including the spontaneous loss of a heartbeat.

“My pregnancies, and my abortions, were and are health care,” Tran said. 

Rep. Lucetta Elmer, R-McMinnville, described how she was raised by loving adoptive parents after her birth mother chose to continue her pregnancy. Abortion was legal in Oregon when Elmer was born in 1970, though it wasn’t yet legal nationwide. 

“We all have reasons for making the decisions that we make, but my birth mother did not think of her unplanned pregnancy as an inconvenience,” Elmer said. 

Rep. Pam Marsh, D-Ashland, graduated from college in 1973, the year the Roe decision legalized abortion nationwide and shortly after the Supreme Court affirmed that married couples and then single women could access birth control pills.

Those decisions changed the trajectory of her generation, Marsh said, allowing more women to hold professional careers and start families when they chose. 

“Because we could plan pregnancies, we could also make other plans,” she said. 

Nosse, the bill’s sponsor, recounted that he became a grandfather before he was 50 because his daughter was pregnant as a teenager. Nosse and his husband didn’t think it was the right time for her to have a baby, but they respected her choice to continue the pregnancy. She aborted another unplanned pregnancy in her 20s, then had a second child. 

“Life is complicated. People need to have the right to make personal decisions about their lives and their families,” he said. “I’m glad my daughter had the right to make all those decisions.”

Lawmakers have been touched by gender transitions, too.

One of Rep. Jules Walters’ four children came out as transgender as a 19-year-old in 2021, the West Linn Democrat said. At first, Walters said, she was shocked and afraid – she didn’t know if her son would be able to access care he needed, and she didn’t want any of her children to face discrimination or hatred. 

But since her child came out, Walters said he has flourished. 

“My son is a happier, brighter and more ambitious person than he’s been in a very long time,” she said. “I cannot be more proud of him, and I am thankful for the gender-affirming care he received.” 

Clarity on detransition

Much of the debate on Monday and over the past few weeks has focused on detransitioners, the small group of people who received gender-affirming care and then sought to return to their sex at birth. Supporters of gender-affirming care have cited a 2021 report that found that only 1% of transgender people regret the surgeries they received, though critics have noted that study and others focused on people who still identified as transgender when surveyed. 

As written, House Bill 2002 would require the Oregon Health Plan to cover “revisions to prior forms of gender-affirming treatment.” Legislative Democrats and other supporters say it would clearly cover care for detransitioners who wish to reverse treatment they received. 

Republicans have insisted that the bill won’t cover detransition care, an assertion disputed by the Oregon Health Authority and Department of Consumer and Business Services, which will adopt rules on how to implement the bill and its requirements for coverage of gender-affirming treatment.

Department director Andrew Stolfi  on Saturday sent House Speaker Dan Rayfield, D-Corvallis, a letter specifying that the department’s rules will make clear that people who seek to detransition can have those procedures covered by insurance. 

“[A]n individual who previously received gender-affirming treatment and who is now seeking to reverse the effect of that treatment would be seeking treatment for an incongruence between their gender identity (namely, their appearance) and their sex assigned at birth,” Stolfi wrote. “This conclusion is supported by HB 2002’s explicit inclusion of ‘revisions to prior forms of gender affirming treatment’ in the same section’s list of prohibited exclusions.” 

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Julia Shumway is deputy editor of Oregon Capital Chronicle and has reported on government and politics in Iowa and Nebraska, spent time at the Bend Bulletin and most recently was a legislative reporter for the Arizona Capitol Times in Phoenix. An award-winning journalist, Julia most recently reported on the tangled efforts to audit the presidential results in Arizona.