SALEM, Ore. -- Every few months, Linnea Osterberg's pharmacist takes pity on her, and gives her a break on the cost of the birth control pills she takes to control her severe cramps.

State of Oregon web site photo

The Oregon Capitol Rotunda in Salem.

Try as she might, the self-employed photographer from Portland hasn't been able to find a health insurer offering an individual plan that will cover the cost of contraceptives -- in her case, up to nearly $600 a year.

"Even if my doctor writes a letter saying why birth control is being prescribed, they plain old don't care," said Osterberg, 31. "They will not cover it, no ifs, ands or buts."

Bills that would solve her problem by requiring private insurers to cover the costs of prescription birth control have been floating around the state Capitol in one form or another since 1993, only to die quietly in one committee or another.

But 14 years on, with Democrats in control of the House, Senate and governor's office for the first time in years, it looks like the proposal has some real traction. A hearing is scheduled for Wednesday in front of the House Human Services and Womens' Wellness committee.

Twenty-six other states have already moved to establish such mandated coverage, leaving Oregon behind the curve.

Over the years, Oregon opponents of the bill have included the quietly influential Catholic lobby, thanks to the church's opposition to all forms of contraception, and private health insurers, who tend to bristle at any talk of government mandates.

But supporters were encouraged that lawmakers from both parties signed off on a 2005 bill mandating that insurers fully cover mental health treatments, suggesting that they're open to at least some government-imposed requirements on private insurers.

"This is cost-effective," said Nancy Bennett from Planned Parenthood of the Columbia/Willamette, one of the groups backing the contraception bill. "It is much cheaper to cover the cost of the prescription birth control than the cost of labor and delivery for an unplanned pregnancy or an abortion."

Given the power switch in Salem, opponents of the bill are left evaluating their options.

"We have moral issues with mandating contraception," said Kelsey Wilson, who lobbies for the Catholic Conference. "We are still exploring the issue."

Breaking down just how many insurers in Oregon offer coverage of contraceptives, and how many do not, is difficult to do, since there are so many different plans offered throughout the state. But nationally, figures from the Guttmacher Institute, a reproductive rights organization, show that about 50 percent of traditional fee-for-service health plans offer no coverage for contraceptives.

HMOs offer somewhat more complete coverage, Guttmacher found, while newer types of managed care plans offer a bit less coverage. But almost nine in 10 plans cover sterilization services, the nonprofit found.

Guttmacher's research also shows that offering coverage of the most-used contraceptive methods -- the pill, an IUD, a diaphragm, hormonal implants or injectable contraceptives -- would cost an average of $1.43 per month per employee. Under traditional cost-sharing plans, employees themselves would pay about 36 cents a month.

The bill also includes a requirement that Oregon hospitals must inform victims of sexual assault about emergency contraception, like "the morning-after pill," and dispense the pill if women ask for it. If taken within 72 hours of sexual intercourse, such a pill can significantly decrease the chances that a woman will get pregnant.

In 2003, Oregon lawmakers established a fund, fed by private donations, to pay for emergency contraception for sexual assault victims who want it. But Bennett said not every hospital is making use of the funding.

"We are not saying that it isn't already happening," she said. "It's just not uniform yet."

Andrea Easton, a lobbyist for the Oregon Association of Hospitals and Health Systems, said the group's members are still evaluating the mandate to offer emergency contraception.

According to the Attorney General's office, most of the state's largest hospitals, including Oregon Health & Science University, Salem Hospital and Sacred Heart in Eugene have been regularly reimbursed from the fund for emergency contraceptive costs for sexual assault victims. Smaller hospitals -- including Mid-Columbia Medical Center in The Dalles, Holy Rosary Medical Center in Ontario and the Coquille Valley Hospital -- have not sought reimbursements over the last two years, the Attorney Generals' office said.

Missing from the proposed Oregon legislation is any clause that would allow hospitals or doctors to opt out of providing emergency contraception to patients if they have moral, ethical or religious objections to doing so. Such clauses have been added to emergency contraception legislation now under consideration in the Colorado and South Dakota state legislatures.

Similarly, though 18 states allow certain employers and insurers to refuse to comply with a mandate to cover birth control, the Oregon proposal contains no such language.

There's no Oregon law requiring pharmacists who have moral or ethical obligations to the morning-after pill to dispense it. But the Oregon Board of Pharmacy does require pharmacies to ensure that patients can get their pills, despite an individual pharmacist's concerns.

As for Osterberg, she said she's shopped around for other policies, but with no luck, so she's left to the mercy of her neighborhood pharmacist.

"Every four or five months, the pharmacist feels sorry for me, so they give me a break," she said. "It's totally a lot of money."