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Michael Dunne: I'm Michael Dunne. The State of Oregon has done a lot to thwart efforts from the Trump administration and the White House to impose its agenda on the state. From lawsuits to court orders to outright refusal, Oregon has thumbed its nose at the White House, but while these efforts create headlines, one policy has quietly been shuttered. Today on the show, you'll hear from an Oregon Capital Chronicle reporter who says Oregon is not enforcing its once historic transgender care mandate, and fear of the White House could be the reason why. Then, in the second part of the show, we check in with our own Love cross about her series Oregon Ready and learn about an event she is hosting this weekend with the author of a new book, which, while fiction, underscores the terror of a potential Cascadia earthquake. Jake Thomas, a freelance reporter writing for the Oregon Capital Chronicle. Jake, it's great to talk to you. Thanks so much for coming on.
Jake Thomas: Thanks for having me.
Dunne: Yeah, I read your story you recently put up on the Oregon Capital Chronicle. Can you remind folks about the law passed in Oregon three years ago, about insurance coverage for transgender medical services.
Thomas: Right. So, I think a lot of that's a good question. A lot of people have kind of forgotten about it. So, in 2023, or the Oregon legislature passed what was called House Bill 2002, and the law was really geared towards two things, it was geared towards making sure that there was access to reproductive health services, and that was in response to the Supreme Court getting rid of Roe v. Wade. And there was all the other part of the bill was that it was intended to make sure that transgender people can get healthcare services to get gender affirming care, and that was done because a lot of for a long time, a lot of commercial insurers had they would deny a lot of treatment that transgender people needed, and they would call it cosmetic, and so they would deny a lot of treatment. So transgender people would tell stories of just like really having to argue with their insurance companies to get like facial feminization surgery, or to get you know electrolysis, or to get all kinds of other treatments.
Dunne: And so this law passed, and so I imagine it was there was some enforcement that that that that was a penalty if insurance companies didn't do this, but so it passed. But what's going on now? Talk about the bulk of your story because it isn't necessarily being enforced like the law said it would.
Thomas: The law split up enforcement responsibilities between the Oregon Health Authority, which is in charge of the Oregon Health Plan, which is the state's version of Medicaid, and then it gave commercial insurance to the Department of Consumer and Business Services. And to be really clear, the law is being enforced, so that the Department of Consumer Business Services is enforcing the law. So, if an insurance plan that's subject to the law is not covering gender affirming care as specified by the law. There will be enforcement. That's what the department told me. But the big thing that's not happening right now is the is the Department of Consumer Business Services. They were supposed to do an examination of all commercial carriers that were subject to HB 2002 to make sure that they're actually following the law that they're they were in fact offering this care without throwing up the bureaucratic hurdles that that's happened in the past and they were also supposed to deliver a report to legislators by about the end of the year about the implementation of HB 2002, that's not happening. Meanwhile, the Oregon Health Authority, which is in charge of Medicaid again, they are they were supposed to do an analysis of Medicaid insurers to see how many of their members needed gender affirming care and to see if there was enough providers.
Dunne: Okay, and so how come? How come this this delay in this report? How come it's it isn't being you know carried out like perhaps it should be?
Thomas: Yeah. So there. So, what I was told by both agencies. So, the Department of Consumer and Business Services. They told me that they're worried about the Trump administration. Basically, they said, given recent federal actions directed to people who provide and receive this care, they have reason to believe that these sort of oversight activities could put Oregonians' private health information at risk. And the department didn't really explain what they meant by that, what they were worried about. But it is clear that the Trump administration has been very aggressive in trying to block access to gender affirming care, particularly for minors. They've done things like they've subpoenaed hospitals and they've threatened prosecution, and they've tried to cut federal funding, and they have been very. They've done some other regulatory things that would make it harder for even adults to get this care. So, they made very clear that they're they really want this to stop, particularly for minors. And so that that's those rationale given by the Department of Consumer and Business Services. On the Medicaid side, the Oregon Health Authority, they said that they halted this their efforts to get to get information on how many people need gender affirming care and Medicaid. They stopped this because there's just so much going on with Medicaid. Like there's if you've been paying attention to the program, there was, there's been financial instability of making sure that the department is paying Medicaid insurers adequate rates. There has been there's looming federal cuts to Medicaid that everyone's preparing for in the Medicaid system. There was an insurer in Lane County that that didn't renew its contract, so there's just been so much going on that the health the health authority said that they're just it would just it's just too much burden at the moment to be to have to go through all these claims data and check it against how many members need care and just to try to get this figured out at this at this time,
Dunne: In your in your story, you talk to some transgender advocates. You know, what are they saying about you know the impacts of this on people who want to have gender affirming care?
Thomas: So, it's there's not a uniform opinion. So, I talked to Jen Burleton, who is a she's a Beaverton-based founder of Transactive Gender Project. She works with you know families who have transgender kids. She's a consultant. She's been involved this for a long time. She says that the state should press ahead with these oversight activities, just to make sure to see if this law because the state made this effectively made this promise to transgender people that they would be able to access this care, and she said that the state needs to follow through on this. That they need to make sure that this care is in fact accessible, there is indications that there's not enough care already in the state, particularly in rural areas, and there's wait lists, and so we're never going to get a handle on that if we don't do these oversight activities, and so she's saying that that the state is just giving in playing into the federal efforts to disrupt this care. However, Basic Rights, which is the Basic Rights Oregon, which is the state's leading LGBTQ plus advocacy group, they support pausing these oversight activities. They did that, and their rationale is that there's just Donald Trump, you know, President Trump's administration has been so aggressive in in targeting medical care for transgender people that that right now that this this there's information that could be weaponized, and so they think this is the right move to do at this time when there's just this climate of fear and so many people are worried about it. That that that doing these oversight activities could create data and could create records that could be obtained by federal authorities.
Dunne: My follow up question to that would be: is there thinking that we need to kind of wait this out and see what happens in 2028 or maybe even with if the midterms turn out to be positive for Democrats taking back the House and perhaps the Senate is that where we're kind of at is we need to sort of wait to see what happens.
Thomas: Yeah, I think it'd be fair to say is that there, the people who are really worried about this, that that they are just waiting for like a change in the political environment, and they do say like basic rights work, and they do point out they point out to me that that that even though that we're not doing these the health the health. Authority and the Department of Consumer Business Services aren't doing these big oversight activities to kind of get a big picture of how of access to gender affirming care. They point out that this the law is still in effect. So if you're covered by a commercial health insurance plan and you need gender affirming care, that is covered. So similarly, with Medicaid, the Oregon Health Plan, that's been gender affirming health services have been required since 2015. So that these so these require so that's been in place for a while. So, these this still remains the law of the land. Like if you need gender affirming care, you still the law still on your side. But we have to know just if are we losing providers? Are there big gaps somewhere? Are there like what kind of need is not being met? Because I don't think anybody would say that there's enough providers who could provide this kind of care right
Dunne: This is kind of a question I ask for a lot of topics here in Oregon, but obviously we're sort of two states where the you know urban state, the I-5 corridor, Multnomah County down to Eugene, and then we're also a very rural state. And as you mentioned before, this kind of this this reporting, this kind of information lack that probably hurts rural Oregonians more than urban is that fair to say?
Thomas: It's hard to say because there's um uh because so what I've heard my reporting in the question reporting this article is that um is that so there are there's not a clear map of just like what areas are lacking gender affirming care services. What I did hear is that is that is it some of the more like you hear about surgery, like getting gender affirming surgery. You know, like that's people that comes to people think about that, and I've heard that that is available. You can get that done. There is OHSU still does surgeries. They can even fly you out of state if it's a problem. So that that is possible. You can get that, but really, what people don't might not think about as much is that you need to get follow up care. Like after that, you need to be you need to get like primary care. You need to be talking to have a doctor to get hormone therapy and get the right medications, and electrolysis, which is just hair removal, that's a big issue. So, there's all these issues that people don't really think about, and we don't really know how accessible those are. But I have heard just anecdotally in the course of my reporting that if you're not in the Portland metro area, or then you might have more trouble getting these sort of services, and in fact, I was going through some testimony for a bill that was passed in the last session that was meant to protect sensitive information, and there was a doctor who testified that just with all the political and legal threats, they're seeing a loss of these networks that they've been trying to set up to provide this gender affirming care.
Dunne: He is Jake Thomas, freelance reporter writing for the Oregon Capital Chronicle. Really enjoyed your article. Great work. Thank you so much for coming on and talking with us.
Thomas: Of course, thank you.
Dunne: Let's now chat with our own Love Cross as she updates us on the Oregon Ready series and also talks about a related event coming up this weekend. KLCC's Morning Edition host Love Cross, Love, it's great to see you in studio.
Love Cross: Thank you for having me, Michael.
Dunne: You've shifted chairs from Studio A to Studio C. Thank you so much for coming into my domain. You know, let's talk about something you've been focused on for a long time now, remind folks about your Oregon Ready Series.
Cross: So I started this year with the Oregon Ready Series as a means to help me get prepared or better prepared for any disasters that might come my way. You know, the Eugene Water & Electric Board has a pledge to prepare, which offers a month-to-month guideline for people to get prepared for disasters one small step at a time, and I, to be honest, wanted to do this last year on my own, and I just never got around to it. And so, I thought one good way to push myself into this disaster preparedness world was to tell 1000s of listeners. I was doing it, and so and so I jumped right in in January, and we've had lots of great discussions over the past several months about it.
Dunne: Yeah, yeah. Just remind folks what some of the categories were that you embarked upon.
Cross: So, we've talked about go bags. We've talked about wildfire smoke, the anxiety that that can bring when you know smoke billows into the Willamette Valley, brings up those memories’ of 2020 wildfires and other fires, of course. And along those same lines, you know, we've had ash fall in our yards in the past. This summer, we actually kind of escaped that in the mid and south Willamette Valley. But how to you know safely clean that up from your yards? Lots of conversation about water storage because one of the main things that I have learned is that water is you know that's life or death. You need to have water, and if the water system was down for a few days, you need to be able to fend for yourself. So, lots of questions about water storage. I journeyed down to the Winston area to talk about defensible space and how communities can come together and create defensible space communities through a Firewise program. So just all kinds of topics relating to disaster preparedness.
Dunne: Were there a couple of aha moments for you where you were embarking upon this journey and you said, "Wow, I had no idea, or "This is something completely new to me.
Cross: So, one thing that was interesting and surprising was the prevalence of radio communicators throughout the area. You know, Eugene EMCOM is one that really would serve as a means of communication. If other methods go down, they also have volunteers that kind of know what's going on in their neighborhoods, that then they can communicate that up to the emergency people that would be responding in a situation like that. Sure. So that was really eye opening. And then, like I talked about, the water storage. You know, I actually mentioned this to you a few months ago on your show. I had a water line break on our street a couple of months ago, and it was in the morning, and of course you're using water in the morning, and I thought, oh no, the you know they turn on the tap, nothing happens. But because I had gone through this process of storing water, I was able to do my whole most of my morning routine, and it was very empowering. So I just realized how important even just having some gallons of water really is.
Dunne: So you're kind of pulling this forward to a very interesting event coming up this weekend. Talk about what you're going to be doing.
Cross: Yeah. So, we are speaking with a Portland-based author. She's a climate journalist. She actually grew up in Southern Oregon. I had read her book Tilt. Her name is Emma Patee. I had read her book "Tilt" last year. It came out in 2025 to much acclaim, and it's basically the fictional account of a 37-week pregnant woman who finds herself in IKEA shopping for a crib when Cascadia, the big one, happens. Wow! And so, it's her journey of traveling by foot from IKEA into Portland to try to get to her husband and the people that she encounters along the way, and this author Emma Patti because she's based in Portland, we've invited her down for a conversation about what we can learn about preparing for disasters or the big one through her book. Again, it's a fictional account, but it's all the places that we know, all these landmarks that she knows. She describes, you know, being in IKEA when this happens, and she looks over and there's a gal in an Oregon State Beaver sweatshirt. So, it was very relatable because it was, you know, it was locations that I know and that I recognize, and because she's done so much work on climate journalism before, it's she's really passionate about it, so we're taking this work of fiction and having a conversation about disaster preparedness around that. And the book Tilt is fabulous. If you haven't read it, it's a very easy read. And again, it even has a map that's drawn of Portland, so all these locations that are familiar to our local readers
Dunne: And when and where is this going to take place?
Cross: Exactly, we are having this at Campbell Community Center this Saturday from 4 p.m. to 6 p.m. It is a free event, of course, but we do require registration because we want to make sure we have room for everyone who has signed up. And you can find all of those details at klcc.org.
Dunne: Yeah, a couple more questions, love about it because I'm fascinated about this, and I'm going to try and go. You know, some people might say, "Oh, why is fiction entering into this discussion about something so real?" But you know, I do think sometimes that a fictional account of a real-world crisis, it can spark a lot of awareness and action. What do you think?
Cross: I absolutely agree. It you know, it's one thing to just think, "Oh, this could happen," but then when you're immersed in a fictional novel about something like this, it really takes you through exactly what would happen, and I think that it just helps you envision and imagine it in such a different way. This earthquake, you know, one of the passages in the book, she talks about. I've always thought I'd be prepared for earthquakes, and it would happen in the middle of the night, and I would jump out of my bed, and I would get, you know, I would drop cover and hold on, grab my go bag. But she never expected it would happen when she's in IKEA, and I think, I mean, I feel that way too. I feel like, okay, I'm home, I'm in my bed, this is going to happen. But it could happen anywhere, and so being prepared, no matter where you are, and then also this journey that the protagonist takes walking to downtown Portland, very pregnant, and the people she encounters along the way showed the real power of community, and that's something that's been a thread throughout Oregon Ready, too.
Dunne: When you read this book, it's a great story. And because of the research that you've done, were you like, okay, that could happen, this could happen, that could happen?
Cross: Absolutely, and things like she's thinking, why don't I have any water with me, or why you know she's asking herself these questions, and it really does make you think, if I was in that situation, how would I handle that? And there's so much that would be unknown in those situations, and so just kind of going through that through a fictional character. I like to read a lot of historical fiction, and this felt like historical fiction in a different way. Like if it had already happened, and you're looking back, was it was a really great read.
Dunne: So, Love, my last question for you is: you know, both talking about coming up and interviewing this this great author, but also just looking back at in what you've done, has this changed you? You know, this Oregon Ready series, not just so much just being better prepared, but has it changed you in terms of your outlook of what we as private citizens need to do going forward?
Cross: It definitely has, and I just mentioned that thread of community that's kind of been throughout it, and that's one thing that has just stood out. It seems like every disaster preparedness expert that I have talked to talks about how people have to band together because we expect that our you know elected officials and emergency managers are going to come in and save the day, and that is the goal that they're aiming for. But if we did have a major earthquake that, like the Cascadia subduction zone quake, it would take time for them to get those resources in place. And so, therefore, being self-sustaining, the more that we can help ourselves also allows those emergency officials to help the more vulnerable populations of our community. So, doing what you can to ensure you're going to be prepared is actually helping the larger community in that way, and I had never really come at it from that point of view before.
Dunne: She is Love Cross, our Morning Edition host, and also the person bringing us the Oregon Ready Series. Love, thank you so much.
Cross: Thank you, Michael.
Dunne: That's the show for today. All episodes of Oregon On The Record are available as a podcast at klcc.org. Tomorrow on the show, you'll hear how one reporter entered into the world of online sports betting and found out that these massive corporations talk a good game about protection for problem gamblers, but in practice, incentivize them to go all in. I'm Michael Dunne, host of Oregon On The Record. Thanks for listening.
