Several Democratic-led states are looking to their legislature to insulate them from any changes caused by repealing Obamacare.
Chief among them is Oregon, where two state lawmakers introduced a bill earlier this month that seeks to enshrine protections for women’s health created under the controversial law.
New York Gov. Andrew Cuomo also issued an executive order to require insurance plans to cover birth control at no cost to women, a part of Obamacare created to improve gender equity in healthcare coverage. The order also required insurance plans to cover any “medically necessary abortion services” without a copay or deductible.
The moves come as President Trump and Congress move toward repealing the Affordable Care Act. Four House and Senate committees are drafting legislation that can be approved in the Senate via a 51-vote majority through a process called reconciliation.
However, immediate repeal isn’t a sure thing as several GOP senators have expressed concern at repealing the law without an immediate replacement. Most House and Senate leaders want to repeal the law but leave it intact for a few years until a GOP alternative is approved and implemented.
Oregon isn’t waiting to see what happens in Washington before moving to preserve reproductive health protections. The federal law included a slew of new provisions aimed at improving women’s health, including no cost for prenatal visits and no copay or deductible for birth control.
The state hopes to go a step further than current law with the new bill that requires insurers’ plans sold in the state to cover a series of women’s health-related conditions. Conditions include screening for the diseases and pregnancy-related services such as pregnancy tests, abortion and prenatal care, the bill said.
Insurers also must cover contraceptive drugs and birth control.
It also calls for the Oregon Health Authority, a state agency that primarily oversees Oregon’s Medicaid program, to reimburse costs for reproductive health and “medical assistance if not for certain federal requirements.”
Several liberal and pro-abortion rights groups in the state championed the bill, saying it is necessary to remove barriers to reproductive health coverage.
“Preventive services reduce healthcare costs and strengthen our communities and our economy,” said Zeenia Junkeer, director of equity and community engagement for NARAL Pro-Choice Oregon. “In order to have stronger health outcomes, Oregonians need quality medical care to prevent problems before they start.”
Cuomo’s order is similar to the Oregon bill. It also applies to state plans and requires coverage for medically necessary abortions.
The order also bans insurers from charging any copays or deductibles for the procedure.
Cuomo also calls on health plans to cover birth control and contraceptive devices without charging any copay or deductible “regardless of the future of the Affordable Care Act,” the announcement said.
Cuomo said the regulatory actions will “help ensure that whatever happens at the federal level, women in our state will have cost-free access to reproductive health care and we hope these actions serve as a model for equality across the nation.”
Both Cuomo’s order and the Oregon bill would provide an exemption for religious employers, a nod to an issue that caused a Supreme Court battle with the federal government last year.
Oregon and other states have addressed contraceptive coverage before, as Oregon and 28 states already have a law that requires insurers to cover birth control.
However, only four of those states offer any cost-sharing help, according to Usha Ranji, associate director for women’s health policy at the nonpartisan Kaiser Family Foundation, during a recent webinar.
In addition, none of the laws “apply to self-insured plans,” said Ranji, referring to the individual market for people who don’t get insurance through their job.
