Oregon abortion insurance mandate ruled unconstitutional

After years of legal battles, the Oregon law mandating employers to cover abortion in their insurance has been found unconstitutional. However, the question remains whether the ruling will apply to just one pro-life organization or more broadly.

Key Takeaways:

• In 2023, Oregon Right to Life sued to block the state mandate which requires all employers to include abortion in insurance coverage.

• The Reproductive Health Equity Act (RHEA) was passed in 2017 and includes exemptions for religious organizations, but Oregon Right to Life's request to be included in that exemption was refused.

• A judge ruled in 2024 that Oregon Right to Life must include coverage for abortion in their insurance plans, and the group appealed.

• A federal court issued a temporary ruling siding with Oregon Right to Life and found the mandate unconstitutional.

The Backstory:

In 2017, Oregon lawmakers passed the RHEA, which required all insurance companies in the state to include abortion, with an exemption included for religious organizations. Pro-life organizations with strong moral opposition to abortion, however, would still be forced to include coverage for abortion in insurance plans for their employees.

Oregon Right to Life (ORTL) sued in 2023, arguing that the state needs to give a compelling reason why organizations like ORTL are not able to receive exemptions to the mandate, and why it is only provided for religious groups.

“As a pro-life organization, no one questions that we hold deep moral objections to abortion,” ORTL executive director Lois Anderson said in a press release. “We are only asking for what every American expects, to be free to live according to our conscience and operate our organization according to our sincerely held belief that unborn human beings deserve protection from the violence of abortion.”

A year later, U.S. District Judge Ann Aiken ruled that ORTL is not a religious group and therefore, does not qualify for any exemption. “Other than a fleeting reference to ‘Judeo-Christian ethics,’ there is nothing in the articles of incorporation that would suggest any religious element in plaintiff’s organization,” Aiken wrote in her ruling.

Anderson disagreed, and vowed to continue fighting.

“The state’s attempt to force Oregon Right to Life to violate our sincerely held beliefs is clearly unconstitutional and unjust. Regardless of where they stand on the abortion issue, I think most people would agree it’s absurd on its face to mandate that a pro-life organization pay for abortions — yet this is exactly what current Oregon law does,” she said. “Because we’re committed to defending the vulnerable and pushing back against injustice, we’re not about to back down. We have an excellent legal team and the Constitution on our side, and I am confident we will prevail.”

In November of 2025, the Ninth Circuit Court of Appeals allowed the ORTL lawsuit to be reinstated, reversing a lower court's decision to dismiss the lawsuit. The case was sent back to a district court, with the court instructed to reconsider ORTL's complaint that the mandate violates the group's First Amendment rights.

The Details:

ORTL has won a temporary victory in the long-running case.

In a press release, ORTL announced that the insurance mandate has been found unconstitutional.

U.S. District Court Judge Mustafa Kasubhai gave a ruling from the bench, with the full written opinion to be released next week. He also asked both parties — ORTL and the state of Oregon — to submit briefs within two weeks on what kind of relief he should grant.

The state intends to ask for the ruling to apply solely to ORTL, while ORTL wants it to strike down the entire mandate, and the entire RHEA.

For now, the RHEA remains in effect, without Kasubhai issuing any injunction against it.

The Bottom Line:

“From the beginning, we have asserted that Oregon’s RHEA was unconstitutional and violated the rights of pro-life Oregonians," Anderson said. "It was always absurd for Oregon to attempt to force Oregon Right to Life, as a pro-life organization, to fund abortion – the very practice we are dedicated to opposing. Yesterday, the federal court agreed. This is a win for Oregon Right to Life, but more than that, it is a victory for all pro-life Oregonians.”