Oregon has delayed two efforts to measure whether transgender residents can actually obtain care that state law says insurers must cover, leaving officials without a clear picture of provider availability, wait times and coverage gaps as federal restrictions intensify. The Department of Consumer and Business Services had been directed to examine insurers’ compliance with House Bill 2002, passed in 2023, and report to lawmakers by Dec. 31. The department has postponed that work, saying collecting detailed information about insurers, providers and individual claims could expose private health information to federal scrutiny. The law’s coverage requirements remain in effect, department spokesperson Jason Horton said. The Oregon Health Authority has also put off gathering information from the regional insurers that administer the Oregon Health Plan, the state’s Medicaid program. The authority had expected those coordinated care organizations, or CCOs, to report how many members needed gender-affirming care by fall 2025. It now plans to renew the request when workloads allow and set a firm response deadline, spokesperson Franny White said. The delays come as the Trump administration moves to restrict gender-affirming care, particularly for minors, and threatens providers with funding cuts and legal action. State regulators say the political climate raises the risk that information collected for oversight could be used against patients or clinicians. Basic Rights Oregon, a leading LGBTQ+ advocacy group, supports pausing the data collection on those safety grounds. But some advocates warn that suspending oversight could make it harder to identify when patients are going without care. Jenn Burleton, founder of the Beaverton-based TransActive Gender Project, said patients risk being overlooked if the state does not track whether the law is working. Oregon State University health professor Jonathan Garcia, who led a study of transgender women’s experiences with Oregon’s health system, said legal coverage alone does not ensure people receive treatment in practice. A state report released last year found gaps in care and no comprehensive data on the availability of gender-affirming services in Oregon. Providers and community members told the Health Authority that some patients travel for hours to reach a trusted clinician and wait months or years for appointments because demand exceeds the number of available providers. Advocates also report that rural areas have lost providers amid threats and concerns about sensitive information being weaponized. Oregon’s commercial insurance review was intended to help determine whether HB 2002 has reduced barriers to medically necessary care. The law bars commercial insurers from denying gender-affirming treatments deemed medically necessary by a patient’s health care provider. Regulators say they will resume the review when they believe it can be conducted without putting patients and providers at risk, but have not provided a date. Separately, a federal rule taking effect Oct. 13 bars states from using federal Medicaid and Children’s Health Insurance Program funds for specified gender-affirming treatments for patients under 18. Oregon says it will continue covering affected services for young people through state funds, as required under state law. The Health Authority estimates about 600 Oregon Health Plan members under 18 receive services affected by the federal change. The agency plans to seek a budget adjustment from lawmakers next year to pay for the coverage. Oregon’s response stands in contrast to states that may suspend such coverage rather than replace federal funding. A coalition of Democratic state attorneys general, including Oregon Attorney General Dan Rayfield, has challenged the federal rule in court. The state has also enacted House Bill 4088, which limits cooperation with certain federal investigations into legally protected reproductive and gender-affirming health care. The tension facing Oregon is now twofold: maintaining protections against federal interference while determining whether people can access care on the ground. Without the delayed reviews, that second question may remain difficult to answer.