Despite a new Oregon law championed as preserving birth control coverage in the state even if Republicans succeed in dismantling a federal mandate to cover it, nearly 1 million Oregonians are covered under policies that now qualify for exemptions.
Those policies are called self-insured, or self-funded policies. They’ve grown in popularity among large national companies like Walmart and Costco because they only have to adhere to federal laws, and thus aren’t subject to state laws such as Oregon’s Reproductive Health Equity Act, the law requiring contraceptive coverage for state-regulated insurance policies. Large, self-funded employers in Central Oregon include St. Charles Health System, with 4,437 employees; Safeway, with more than 1,000 local employees; and Fred Meyer, with about 650, according to Economic Development for Central Oregon.
Moving forward, it will be an employer-by-employer choice as to whether they’ll continue to offer the benefit if they are self-insured. For their part, insurance experts say employers aren’t likely to drop no-cost contraceptive coverage so they remain attractive to employees.
“My sense (is) that the change in coverage requirements for contraceptives will have little impact,” Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, wrote in an email. “Almost all major employers will continue to offer this coverage to offer competitive benefits coverage.”
Indeed, large, self-insured employers that responded to inquiries said they plan to keep the coverage. That includes Costco and Home Depot, both of which have roughly 300 employees in the region, according to EDCO. Central Oregon’s largest private employer, St. Charles Health System, doesn’t plan on changing its policy, according to a spokeswoman.
The Affordable Care Act mandated that employers cover contraceptives with no out-of-pocket costs to members. It later allowed a limited set of employers to opt out on religious grounds. Last week, the Department of Health and Human Services released interim rules that broaden that exemption by allowing any employer to refuse to cover contraceptives for moral reasons.
Enrollment in self-insured policies comprises 46 percent of all private health insurance enrollment in the state. About 983,000 Oregonians have self-insured policies.
Rep. Jeff Barker, a chief sponsor of the Reproductive Health Equity Act, said he was surprised to learn so many Oregonians are covered under policies that could get exemptions from the mandate.
“I crafted it trying to be sure all women were covered,” said Barker, a Democrat from Aloha. “That was the goal.”
Barker said he doubts most companies will drop the coverage. If some do, he said he would look into the cost of a state program to provide contraceptives for those women.
People in the commercial market, meaning those who buy their own individual policies or have insurance through a student plan or large or small employer that’s not self-insured, won’t be affected by the new federal rules. That’s because of Oregon’s state coverage mandate, which takes effect Jan. 1, 2019.
“Everyone with commercial coverage can expect that their access to contraceptives will not change based off the latest Trump administration rules,” said Jake Sunderland, a spokesman for the Oregon Department of Consumer and Business Services, which regulates insurance in the state.
Nationally, seven other states have laws like Oregon’s, but those laws don’t apply to self-insured employers, which provide insurance to roughly 60 percent of workers nationwide, according to the Kaiser Family Foundation.
Several states and the American Civil Liberties union are suing the Trump administration to challenge the new rules.
— Reporter: 541-383-0304,