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Bill

SB 1137

Relating to autologous breast reconstruction.

2025 Regular Session Introduced by Tom Andersen and 28 co-sponsors

Oregon requires health insurers to cover autologous breast reconstruction surgeries equally with implant reconstruction, effective January 1, 2026.

Effective date, January 1, 2026.
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Bill Summary · SB 1137

Legislative bill overview

SB 1137 establishes insurance coverage requirements for autologous breast reconstruction—surgical procedures using a patient's own tissue to rebuild the breast following mastectomy. The bill mandates that health insurance plans cover these procedures to the same extent as implant-based reconstruction, eliminating cost barriers that may currently exist for patients choosing this surgical option.

Why is this important

Autologous reconstruction offers medical benefits including lower complication rates and longer-lasting results compared to implants, but higher out-of-pocket costs can make it inaccessible to many patients. By requiring equal insurance coverage, the bill removes financial obstacles that might otherwise force patients into a particular reconstruction method regardless of medical suitability or personal preference, expanding genuine choice in post-mastectomy care.

Potential points of contention

  • Increased insurance costs: Broader coverage mandates may raise premiums for all policyholders, with particular impact on plans serving smaller employers or individuals purchasing coverage independently
  • Definition and scope disputes: Ambiguity about which surgical techniques qualify as "autologous reconstruction" could lead to coverage denials and administrative appeals
  • Surgeon availability concerns: Autologous procedures require specialized surgical expertise; mandated coverage doesn't guarantee access to trained surgeons in rural or underserved areas

Compiled from official sources — confirm details with the bill’s official record.

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