Oregonians have free reproductive healthcare coverage; 12 insurers charged beneficiaries anyway

A law that went into full effect in 2019 granted Oregon residents free reproductive healthcare coverage, but state officials found that at least 12 insurers continued to charge beneficiaries, according to a Feb. 1 report from the Oregon Capital Chronicle.  

An audit from the state's Consumer and Business Services Department found that the 12 insurers failed to comply with the law in various ways, according to the report. That included charging copays, applying payments to deductibles that have to be paid before insurance coverage kicks in, or failing to cover mandated benefits that are supposed to be free. 

The 12 insurance companies were Aetna, BridgeSpan Health, Cigna, Health Net Health Plan of Oregon, Kaiser Foundation Health Plan of the Northwest, Moda Health Plan, PacificSource Health Plans, Providence Health Plan, Regence BlueCross BlueShield of Oregon, Samaritan Health Plans, UnitedHealthcare and UnitedHealthcare of Oregon. Collectively those insurance companies cover about 900,000 Oregon residents, according to the report.  

The audit looked at claims from Jan. 1, 2019, through Dec. 31, 2020, according to the report. The department said it would continue working on the issue, including customer refunds.

Reactions from the insurance companies varied. Kaiser, PacificSource and UnitedHealthcare of Oregon said they agreed with the findings. Cigna said it disagreed with certain findings, and Aetna detailed its objection in a 17-page report. 

Aetna alleged that the audit made "general statements and draws inferences from hypothetical scenarios that are not supported by the data that Aetna actually submitted," according to the report. 

Regence and Bridgespan — owned by Cambia Health Solutions — said the department should enact a rule that explains the requirement of the law. 

"We have implemented the [law] in good faith and with best intentions to comply with the statutory requirements as we read them," they said in their response letters, according to the report. 

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