A sweeping bill intended to guarantee access to abortion and gender-affirming care in Oregon as other states limit rights received its first hearing in the state House Monday, with hours of often-emotional testimony.
House Bill 2002 would protect doctors and other health care providers from losing their licenses or facing other repercussions for providing abortions or gender-affirming care. It also would require the state’s Medicaid program and private insurers to cover a range of reproductive and gender-related services, make it a crime to interfere with medical facilities and create a grant program for rural reproductive health clinics.
It’s the result of months of work from a legislative workgroup House Speaker Dan Rayfield, D-Corvallis, formed last summer after the U.S. Supreme Court overturned Roe v. Wade and ended the national right to an abortion.
The Guttmacher Institute, a nonprofit organization that tracks reproductive rights policies, already classifies Oregon as the state that does the most to protect access to abortion. Fourteen states, including Idaho, have laws in effect banning abortion in nearly all circumstances.
The workgroup found that low-income and rural Oregonians can’t access abortions and other reproductive care, Rayfield said. Women in eastern Oregon who relied on clinics in Boise now have to travel further for care. Medical providers have reported harassment and burnout from increased demand as people from other states travel to Oregon for reproductive and gender-affirming care. And the Oregon Department of Justice launched a hotline to provide free legal advice for people confused about the legal status of abortion and other care.
“The right to access an abortion does not mean that abortion is accessible,” Rayfield said.
The measure is shaping up to be one of the most hotly contested bills the Legislature considers this year. By midday Monday, nearly 200 letters supporting the measure and more than 350 opposing it had been submitted to the committee. A line of people waiting to testify stretched the length of the capitol’s main hall, and most who made it into a 60-person hearing room at 3 p.m. opposed the measure, wearing orange stickers emblazoned with “NO on HB 2002.”
Public testimony didn’t start until after 5:30 p.m., following two hours of presentations by legislators and experts chosen by supporters and opponents. It soon became heated — committee chair Rob Nosse, D-Portland, who spent much of the hearing thanking people for their testimony and consoling supporters and critics as they cried, repeatedly banged his gavel and threatened to clear the room as one opponent refused to stop speaking after the two minutes allotted for her testimony. Audience members scoffed and snapped at points, and one supporter of the measure called an opponent names.
A committee vote is scheduled for March 27, and the bill will need approval from the budget-writing Joint Ways and Means Committee before going to the House and Senate floors.
Concerns about children
Both supporters and opponents of the measure framed their testimony around protecting children. The measure would allow children of any age to receive information about reproductive health care and some services, including contraception, abortions and treatments for sexually transmitted diseases, without their parents’ consent or knowledge. Children younger than 15 could not receive sterilization services.
Sen. Elizabeth Steiner, a Beaverton Democrat and physician, said doctors still would try to involve parents in their children’s care wherever possible. In circumstances where a child seeks an abortion or treatment for sexually transmitted diseases, doctors are also bound by law to report suspected rape or sexual abuse to law enforcement because children cannot consent to sexual activity.
“As a politician, I should not be making health care decisions for others,” Steiner said. “As a physician in consultation with my patient, I should.”
Supporters including Sen. Kate Lieber, D-Beaverton, said children know who they are and need support. Lieber, the first openly lesbian Oregon senator, said she remembers her own childhood experience coming to terms with her sexuality.
“It is really important to make sure that we are providing health care to the people who need it, and it is really important to listen to the children telling us how they are feeling,” she said.
Critics contend that the measure would enable children whose brains aren’t fully developed to make permanent changes that they may come to regret, including obtaining hormones, removing their breasts or altering their genitals.
Rep. Ed Diehl, R-Stayton, cited recent medical guidance in western European countries, which have long been more willing to provide puberty blockers and hormones to young people than the U.S. The U.K. closed its youth gender clinic last year while it reviews a surge in young people seeking gender-affirming care. Finland and Sweden also now limit access to such care for minors.
“What we are doing here is inconsistent with all the evidence that Europe is looking at,” Diehl said.
Christina Milano, the cofounder and medical director of Oregon Health and Science University’s Transgender Health Program, said genital surgeries are extremely rare on minors, though she didn’t provide lawmakers with numbers. Physicians with the program are cautious when prescribing care, she said – young people wait a long time to receive treatment because they need multiple appointments, and their parents or caregivers are involved.
The Oregon Health Plan and private insurers have been required to cover gender-affirming medical treatment, including some surgeries, hormone treatment and puberty blockers, since 2015. HB 2002 would expand coverage to other services, including facial feminization surgery, laser hair removal and tracheal shaves for transgender women.
Carolyn Ward, a transgender woman from Eugene who participated in a press conference with Democratic legislators and reproductive rights groups on Monday, said she moved to Oregon from Kentucky a little more than a year ago because she feared anti-trans legislation in Kentucky. She was able to continue receiving hormone therapy, but she can’t afford to pay for hair removal or vocal therapy to mitigate the effects of a testosterone-fueled male puberty. Hearing her voice and seeing or feeling her face causes dysphoria, or a deep discomfort, Ward said.
“I wake up nearly every day and see my facial hair in the mirror, and this causes me an overwhelming wave of crushing dysphoria that is only maintained throughout the day as I am still able to feel those same hairs,” Ward said. “Unfortunately, because I do have fairly sensitive facial skin, I’m only able to shave once every 48 hours, and as a result, I only find myself with a brief reprieve from this dysphoria.”
Camille Kiefel, a Portland woman who previously identified as nonbinary, told lawmakers that she regrets the surgery she received to remove her breasts. She began presenting in a more masculine way as a teen because of trauma related to a friend’s sexual assault, because being a girl meant she was vulnerable.
Kiefel said counselors urged her to transition instead of addressing her underlying mental health issues. She filed a lawsuit in Multnomah County Circuit Court last year against her social worker, therapist and their employers, but the case was dismissed in January without proof of service.
“Today I am more grounded than I have been in my life, but I am mutilated,” she said.
Protections for doctors
The measure declares that any other state’s laws that allow criminal prosecution or civil suits against people who receive or provide reproductive health care or gender-affirming care conflict with Oregon’s public policy. Courts in Oregon could not issue subpoenas or help other states prosecute people who provided care that complies with Oregon laws.
Doctors, nurses, pharmacists, social workers, counselors and others could not lose their licenses to practice in Oregon for providing reproductive health care or gender-affirming care. The measure wouldn’t stop patients from pursuing lawsuits if they feel like doctors provided irresponsible care.
The bill also would make it a crime to interfere with a health care facility, such as by obstructing a patient’s ability to enter or leave the clinic, making loud noises or jamming up telephone lines with spam calls. It would be a class A misdemeanor, punishable by up to 364 days in jail or a $6,250 fine.
Kimberly McCullough, legislative director for Oregon Attorney General Ellen Rosenblum, said that section of the bill is modeled after a Washington law and wouldn’t limit people’s protected rights to protest.
“The interference has to rise to a certain level where it is actually interfering with the facility and the statute sets out the variety of ways that that can happen, so it is a specific harm that is occurring, rather than just the fact that there is unwanted speech occurring,” she said.
The measure also would repeal a decades-old state law that makes it a crime to conceal a newborn’s corpse to prevent anyone from determining whether the infant was stillborn or born alive. McCullough said it’s an antiquated law intended to punish people for having children out of wedlock, and states with similar laws have used them to prosecute women for obtaining abortions. Killing or harming a baby would remain a crime.
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