Director's Policy Corner

There is a lot happening in the world of women’s health. In this ongoing series, we’re featuring important policy updates affecting women's health services in Oregon and beyond. This edition focuses on what studies revealed about how much young Oregonians know about reproductive and sexual health policy in the state.

Many see Oregon as a leader in sexual and reproductive health policy. Through many laws and other efforts, Oregon ensures access to care for all Oregonians. For example: 

• Oregon is the state most protective of abortion rights in the country.  
• House Bills 2879 and 3343 have made strides in access to birth control. 
• In 2017, Oregon passed one of the most robust reproductive health care acts in the nation. The bill, known as the Reproductive Health Equity Act (RHEA), provides coverage for reproductive and sexual health services to everyone. The state has also made it a priority to support gender-affirming care, which is covered by Oregon’s Medicaid program. 

Combined, Oregon’s laws result in six key reproductive and sexual health policies in the state:  

1. Abortion is legal without restrictions.  
2. Pharmacists can prescribe contraception without a doctor’s visit.  
3. Anyone who qualifies can receive free sexual and reproductive health care, no matter their citizenship status. 
4. Insurance plans must cover abortion at no cost.  
5. For people who use the contraceptive pill, patch or ring, insurance must cover dispensing 12 months’ supply at a time.  
6. Insurance must cover hormone replacement therapy and gender-affirming surgery.  

For policies to work, people need to know they exist. Researchers asked: How aware are Oregonians about these six key policies? They focused on people aged 15-24 because this age group often faces important reproductive health decisions. Knowing how much this population understands about their rights and services can help improve education and access to care.  

Younger Oregonians need better knowledge of reproductive health laws

To measure this awareness, researchers surveyed female, transgender male and non-binary patients ages 15-24 who had seen a health care provider for birth control in the past year. 

The results showed some differences in respondents’ knowledge. For example, more than half of people knew that abortion is legal in Oregon without restrictions. However, only 4 out of 10 people were aware that insurance must cover abortion care. 

Notably, researchers found that the lowest number of correct answers were among people 15-24 years old. Some of that age group’s responses showed that: 

• Around 6 out of 10 did not know that pharmacists can prescribe birth control without a doctor visit. 
• Over 6 out of 10 were unaware that insurance plans must cover abortion services at no cost.  
• Just under half of respondents didn’t know that insurance must cover a 12-monthly supply of contraception. 
• More than 6 out of 10 were unaware that insurance must cover hormone replacement therapy and gender-affirming surgery. 

Meeting young people’s sexual and reproductive health needs is a public health concern. Those in the 15-24 age range are often in the prime of their reproductive years, making them more likely to need access to sexual and reproductive health services. Despite the state’s efforts, young Oregonians show a significant knowledge gap. 

 “We want young people in Oregon to know about these policies,” says Maria Rodriguez, M.D., M.P.H., OB-GYN and director of the OHSU Center for Reproductive Health Equity, “These results tell us that we still have work to do in raising the public’s awareness of everything the state has put into place.” 

Why don’t young Oregonians know more about reproductive health policies?

Making laws alone is not enough to guarantee people will know about them. Reasons for low awareness of some of these policies may include:  

• Not enough funds for communications, awareness campaigns or public educational initiatives targeting youth and young adults. 
• Stigma around topics like abortion, contraception and gender identity. 
• Barriers to accessing services, such as not having insurance coverage or transportation. 
• Language barriers in educational content or when speaking with a care team member. 

What’s ahead for public health efforts in reproductive health

Public health experts and workers in reproductive health care aim to boost awareness of these policies through education, advocacy and community engagement. These efforts may include: 

• Targeted public heath campaigns 
• Improved education efforts both in and out of school 
• Removing access barriers that prevent or reduce a patients’ ability to interact with the health care system effectively 

When Oregonians know about these policies, they can make informed decisions about their sexual and reproductive health.