Lawmaker seeks coverage for menopause

Rep. Shelly Boshart Davis, R-Albany, told a legislative committee of nine men and women Tuesday that she'd rather be driving a tractor on her family's farm than talking to them about her struggles to get hormone replacement therapy as her body approaches menopause.

"While this is not the topic I wanted to get on my soapbox on," said Boshart Davis, 45, "I feel like it is my responsibility as a geriatric millennial/Gen X, perimenopausal woman to help those currently in perimenopause, menopause and postmenopause to better their lives," she said, referring to the three stages that represent the winding down and cessation of an individual's reproductive years.

When left unaddressed, health conditions that are sometimes brought on by these life stages can be detrimental to the heart, brain, bones and overall sense of well-being. That's why Boshart Davis said she's sponsoring a bipartisan bill along with 10 other representatives and senators to require more health insurance plans than already do to cover treatment.

House Bill 3064 doesn't have the ability to mandate paid treatment by all health care plans, but it does do so for certain plans within the state's reach, such as those insuring many public school employees and state employees.

Such legislation has surfaced elsewhere in the nation. In 2024, Louisiana passed a bill. California's legislature also approved a bill last year, but Gov. Gavin Newsom vetoed it, saying its requirements were problematic. Backers of Oregon's bill are working on amendments to steer clear of those troubles.

Boshart Davis said she noticed last year that something suddenly was off. She turned to her gynecologist for help but found none, sought out podcasts and books to grasp what she was experiencing and eventually found a knowledgeable nurse practitioner who prescribed her a course of hormone replacement therapy.

But her health insurer wouldn't pay for it and she learned it might cost her about $200 out of pocket. Boshart Davis said her health insurer first wanted her to try a substitute or a lower dose than her nurse practioner thought best.

She said she hopes to prevent others from having to encounter similar frustrations and delays.

"I lived being denied menopause care," Boshart Davis told the House Behavioral Health and Health Care Committee. "I lived being denied medication through insurance. I can't quite put it into words what that was like for me. And I don't think the word devastating really quite explains it."

In the complex world of insurance, with a multitude of companies and coverage plans, it's unclear precisely which health care plans in Oregon don't cover treatments for symptoms that arise in the years before, during and after menopause. But Boshart Davis' bill aims to require those under the authority of the state to - with some restrictions - offer coverage of treatments such as estrogen and progesterone, antidepressants and medications to stave off osteoporosis. The bill specifically names the Oregon Educators' Benefit Board and the Public Employees' Benefit Board.

Mary Anne Cooper, government relations director at Regence BlueCross BlueShield of Oregon, said her company is already covering the care called for under the bill. But her company supports the need for the bill because it believes in equal coverage for all Oregonians. She asked, however, that the bill include an amendment calling for only treatments approved by the U.S. Food and Drug Administration to be covered.

Rep. Cyrus Javadi, R-Tillamook and vice chair of the committee, was the only man among the 11 lawmakers who signed onto the bill.

"As a husband, a father to five daughters, and someone who believes we don't do enough in this area, supporting better medical coverage for menopause care was an easy decision," Javadi told The Oregonian in an email.

And, he noted, "menopause affects half the population."

Rep. Lucetta Elmer, R-McMinnville and a sponsor of the bill, said she hopes the bill helps advance the conversation about reproductive health and post-reproductive health to the point they are no longer the butt of jokes.

"As a young woman experiencing monthly menstrual cycles, we hear 'Oh, she's emotional today. Must be on her period.' Or a woman is pregnant carrying life and it's 'Hmm, looks like you're eating for two,'" Elmer said.

"In post-reproductive years we hear 'Oh, you think it's hot in here? You having a hot flash?'" Elmer continued. "And those are funny, but in all seriousness we don't really talk about the issue and then it hits us. And it can be devastating."