Here’s what Oregon’s controversial abortion, gender-affirming care bill would do

Senate Republicans are more than two weeks into a quorum-denying walkout that’s partially intended to block a vote on a Democratic bill over abortion and transgender health care. 

The 46-page House Bill 2002 is an omnibus measure with dozens of provisions related to reproductive and transgender health care, including protecting doctors from prosecution, mandating insurance cover hair removal and facial surgeries for trans people and allowing minors of any age to obtain an abortion without their parents knowing. It’s the Legislature’s main response to last year’s U.S. Supreme Court decision overturning the national right to abortion. 

Democrats, who hold a majority in both the House and Senate, say voters elected them to protect abortion and LGBTQ rights. Republicans have fiercely opposed the bill, describing it as an attack on parents’ rights to make health care decisions for their children. 

The measure passed the House on May 1, with every Democrat and one Republican supporting it. Senate Republicans began their walkout two days later, preventing the bill from progressing there. 

In the meantime, both parties and their ideological allies have spread conflicting messages about what the bill would do. Here’s a primer on what the measure does and some of the questions raised by political talking points. 

What does the current law say about medical care for children? 

Under current state law, licensed medical providers can provide birth control and information about it to people of any age.

The same law allows 15-, 16- and 17-year-olds to consent to medical and dental diagnoses and treatments without their parents’ consent. That includes vaccinations, routine physicals and injury treatment.

Teens 15 or older are also able to consent to gender-affirming care, such as hormone blockers that suppress naturally occurring testosterone or estrogen. While the law allows teens to consent to gender-related surgeries, standards of care followed by doctors don’t recommend surgeries for minors. 

What would House Bill 2002 change about care for children?

The bill wouldn’t change anything about minors’ access to gender-affirming care. Kids younger than 15 still would need their parents to agree to medical procedures.

Doctors already must follow standards set by professional organizations or risk losing their licenses. Standards of care for children and teens who identify as transgender don’t include surgeries, but can include counseling and medication to block hormone surges that come with puberty.  

HB 2002 would allow minors of any age to access abortions, birth control, treatment for sexually transmitted diseases and prenatal, delivery and postnatal care without their parents’ knowledge. Doctors who testified on the bill said they still try to involve parents wherever possible, but they need flexibility if a parent is an abuser. 

Abortions for young teens are extremely rare: The Oregon Health Authority has records of nearly 58,000 abortions between 2015 and 2021, and 121 were performed on girls younger than 15. 

Oregon has no laws requiring parental consent or knowledge of abortion, though medical providers including Planned Parenthood and Oregon Health and Science University require patients 14 or younger to have parents consent.

What if an abuser forces a child to get an abortion to keep a rape secret? 

Children can’t legally consent to sexual activity, so a pregnant child is a rape victim. Doctors are already required by law to report suspected rape or sexual abuse. 

Does the bill make it legal to hide a baby’s body?

The measure would repeal a state law that makes it a Class A misdemeanor, punishable by up to 364 days in jail and a fine of up to $6,250, to conceal a newborn’s corpse with the “intent to conceal the fact of its birth or to prevent a determination of whether it was born dead or alive.”

Attorneys with the Department of Justice said it’s an unused antiquated law that was written to punish people for having children out of wedlock, and similar laws in other states have been used to prosecute women for obtaining abortions. 

Killing or harming a baby would remain a crime. 

What does HB 2002 change for transgender care?

State law already requires Oregon’s Medicaid program and private insurers to cover some procedures, including hormone replacement therapy and some surgeries. Other procedures, such as hair removal and surgeries to make a face look more feminine or masculine, are considered cosmetic and not covered by insurance. People now pay thousands of dollars out of pocket for those treatments. 

HB 2002 would require insurance companies to cover electrolysis, facial feminization surgery, tracheal shaves and any other treatments prescribed by a doctor as necessary gender-affirming treatment. 

What about those who change their minds? 

Much debate has centered around detransitioners, or the subset of people who receive gender-affirming care and then seek to return to their sex at birth.

Rep. Ed Diehl, R-Stayton, tried to add an amendment to the bill requiring insurance cover treatment, such as breast reconstruction surgery or implant removal, for detransitioners. His amendment, voted down by the Democratic majority on the House health care committee, also would have given patients who received gender-affirming more time to sue providers and required the Oregon Health Authority to create a document for patients about health and medical risks of gender-affirming care. 

Diehl shared emails with legislative policy analysts, who concluded that “looked at in isolation, HB 2002 would not require coverage of ‘detransition’ services.” However, they added that existing guidelines followed by public and private insurers require covering detransition treatment. 

Ultimately, the Department of Consumer and Business Services would adopt rules implementing HB 2002 and insurance companies would be required to follow those rules. Department Director Andrew Stolfi sent House Speaker Dan Rayfield a letter before the House vote indicating that the department would make it clear that people who seek to detransition could have those procedures covered by insurance. 

How much would it cost?

The bill’s total price tag is about $6.2 million, according to legislative budget analysts.  The biggest costs are:

  • $2.3 million for a pilot program to provide reproductive health care in rural areas. That includes money to buy two mobile clinics and pay a registered nurse and community outreach worker.  
  • $1.6 million for grants to student health centers at seven universities and Lane Community College to ensure access to emergency contraception and medication abortion. 

How does the bill respond to laws in other states?

Much of the bill’s text is dedicated to protecting medical providers from losing their licenses or facing other repercussions for providing abortions or gender-affirming care, as long as the care they provide is legal in Oregon and complies with professional standards. 

The bill also would bar Oregon courts from issuing subpoenas or otherwise helping other states prosecute people who provided care that complies with Oregon laws. 

What else is the Legislature doing about abortion and trans care?

Democratic lawmakers have also proposed a constitutional amendment, Senate Joint Resolution 33. It would repeal an unenforced ban on same-sex marriage in the state constitution and prohibit discrimination or the denial of rights on the basis of gender identity, sexual orientation, pregnancy or health decisions related to pregnancy. 

Republicans in the Senate proposed an amendment that would repeal the same-sex marriage ban but not add any new language to the constitution. The ongoing walkout has prevented the Senate from considering the measure or the Republican amendment.

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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.