Citizens from Linn and Benton Counties packed the meeting room at the Corvallis Benton County Public Library on November 19th to hear about Oregon health care legislation in 2015, and to learn about what they can expect from the short session in 2016. Senator Sara Gelser joined Representatives Andy Olson and Dan Rayfield. The forum was facilitated by Tim Roach of Mid-Valley Health Care Advocates, Interfaith Health Care Network, and Health Care for ALL Oregon. Stay tuned for a detailed report in the MVHCA December Newsletter.
From Chris Gray of the Lund Report:
Sen. Michael Dembrow’s bill to study healthcare financing in Oregon died on Friday, but it rose again on Sine Die Monday, as Sen. Alan Bates, D-Ashland, reaffirmed his support in a 16-14 vote on the final day of the 2015 legislative session.
Near the start of the Monday morning Senate floor session, Bates said he was changing his vote “with two broken arms,” and while he’d offer his begrudging support, he highlighted the single-payer aspect of the study and described it as a lost cause.
“I think we’re going to spend $300,000 in this state on something that’s not going to happen,” said Bates, an osteopathic family physician. “I don’t want to spend money on this [study] ever again. Our present healthcare system is barely sustainable and I don’t want to put any more load on it.”
Bates had been a sponsor of House Bill 2828, but in a moment of fatigue and frustration on Friday, his nay vote sank the bill, as its supporters looked on, stunned. His opposition led a Republican supporter, Sen. Jackie Winters of Salem, to switch her vote, and Democratic Sens. Mark Hass of Beaverton and Chuck Riley of Hillsboro also voted it down.
The senator from Ashland was clearly frustrated that Senate President Peter Courtney, D-Salem, had kept the Senate in session at 6 p.m. on a holiday, while Bates had to drive five hours back to Southern Oregon. He complained aloud on the floor about having to make the long return trip, pleading with Courtney to not require an early-morning session Monday.
Bates is equally passionate about shaping public policy and practicing medicine. Since February, he has kept a grueling weekly schedule of four days of lawmaking in Salem, followed by three days at his clinic in Jackson County.
Dembrow never regained the support of Hass or Winters, both of whom supported an unfunded study in 2013, along with Sen. Betsy Johnson, D-Scappoose and three other Republicans, including Sen. Jeff Kruse of Roseburg. All Democrats and one Republican -- Rep. Andy Olson of Albany -- supported HB 2828 in an earlier House vote.
Now that the study looked to actually be going forward, Johnson suddenly had concerns that it might be tainted by a small amount of private funding from the Northwest Health Foundation that will supplement state resources.
House Bill 2828 authorizes $300,000 for the Oregon Health Authority to oversee a comprehensive study of healthcare financing in Oregon, one that will look at a number of possible situations, including single payer, a public option on the insurance exchange, and a full rollout of the Affordable Care Act, possibly with a Basic Health Plan for working-class residents.
Dembrow highlighted the support of Oregon Health & Science University President Dr. Joe Robertson, the Oregon Public Health Association and the Oregon Medical Association. Aside from examining the expansion of a Medicare-like system -- the single-payer option -- Dembrow hinted that HB 2828 could give the state insights into less revolutionary reform efforts.
“The results of this study could strengthen the existing CCO system,” he said, referring to the coordinated care organizations that manage the Oregon Health Plan for low-income residents.
Single-payer advocates have also said they will use the results of the study to serve as the backbone for a ballot measure charging the Oregon Legislature with implementing a universal healthcare system. Measure 91, legalizing recreational marijuana sales, was approved by the voters but carried out by the Legislature, and had a similar implementation structure.
Although Dr. John Kitzhaber, the former Oregon governor, has always taken an ambivalent stance towards single payer, Kruse tied Kitzhaber to HB 2828 like an albatross, now that he no longer supports the study: “Our former governor, who resigned in disgrace, was always a supporter of single payer. … Friends, a move to have the government take control of healthcare is one of the worst things we can do for our citizens.”
Another Republican, Sen. Brian Boquist of McMinnville, was more judicious. He said he did not actually oppose the study, he just thought the Oregon Health Authority was wasting well more than $300,000 in its existing $19.5 billion budget through duplicative programming. “We just need to tell them to go study it,” he said.
Jul 7 2015
From our friends at Asian Pacific American Network of Oregon (APANO):
Oregon Takes Key Step for Affordable Health and Immigrant Inclusion
Basic Health Bill Heads to Governor Kate Brown
Salem, Ore. – Today the Oregon Senate passed HB 2934A with a bipartisan vote of 22-7 (1 excused). This priority bill of the Oregon Health Equity Alliance now heads to Governor Kate Brown for her signature. HB 2934A, directs directs the Oregon Health Authority to work with stakeholders to develop the policy framework for a potential Basic Health Program. A Basic Health Program has the potential to cover 87,000 working Oregonians, providing better care at lower costs, and create an affordable option for legal residents who face barriers due to their immigration status.
“We can and must do right by our working families who contribute everyday to our state’s economic recovery by ensuring they have access to affordable healthcare,” says Alberto Moreno, Executive Director of the Oregon Latino Health Coalition.
“Today is a day of hope for many working Oregonians struggling to afford required health insurance, even with the help of federal tax subsidies,” says Janet Bauer, policy analyst for the Oregon Center for Public Policy. “A well-designed Oregon Basic Health Program would provide quality health coverage for tens of thousands of lower-income Oregonians — at little or no cost to the state.”
“Our immigrant communities continue to face unnecessary and costly exclusions from the Oregon Health Plan, and we look forward to working with the Oregon Health Authority to develop the policy framework grounded in inclusion, affordability and innovation,” says Rev. Joseph Santos-Lyons, Executive Director of the Asian Pacific American Network of Oregon (APANO).
Basic Health is an program option states may elect under the Federal Affordable Care Act to provide choice to individuals who earn 138-200% of the Federal Poverty Level. The 2014 feasibility study of an Oregon Basic Health Plan revealed significant benefits including expanded health insurance coverage, improved benefits, that could potentially be offered through Oregon’s coordinated care organizations. Basic Health could work toward addressing Oregon’s significant health disparities: the lack of insurance, which disproportionately affects communities of color, immigrants and refugees. A Basic Health Program can extend healthcare choices to Oregonians from the Compact of Free Association (COFA) nations of Palau, Micronesia and Marshall Islands, and Legal Permanent Residents who have resided in the US for under 5 years, who currently are excluded from federal Medicaid benefits. It can also advance health equity by increasing access to a range of reproductive care, dental and mental health services. Oregon could achieve all of this at little or no cost to the state budget.
HB 2934A is sponsored by the House Healthcare Committee, and passed the House of Representatives 39-21 on April 20, 2015.
Inclusion, Affordability, and Inovation Coalition/HB 2934A Endorsing Organizations include:
Asian Pacific American Network of Oregon
Children First for Oregon
Coalition of Communities of Color
Coalition of Community Health Clinics
Elders in Action
Healthcare for All Oregon
Mid-Valley Healthcare Advocates
NARAL Pro-Choice Oregon
Oregon Latino Health Coalition
Oregon Law Center
Oregon Center for Public Policy
Oregon Health Equity Alliance
Oregon Primary Care Association
Health Care for ALL Oregon (HCAO) posted this information about health care bills in the Oregon Legislature:
The 2015 Health Care for All Oregon Act previously LC 2548 is now SB 631 with its formal introduction in the Senate occurring on February 11th. The bill has been assigned to the Senate Health Care committee which is chaired by Senator Laurie Monnes-Anderson a supporter of our bill. A hearing is expected in early March.
Our priority bill in the 2015 legislative session is the extension and full funding of the Health Care Study HB 2828. Passage will commission a rigorous study, the results of which will be a recommendation to the legislature as to the best method of funding comprehensive health care in Oregon. HB 2828 will be heard by the House Health Care committee on Monday February 16th at 1pm. Testifying on behalf of the bill will be Senator Michael Dembrow chief sponsor, Representative Smith Warner Co-sponsor and Sam Metz a physician allied with HCAO and key player in the passage of HB 3260 the predecessor to HB 2828. The bill is expect to pass out of the committee and move on to the House Ways and Means committee where it should be funded at the end of the 2015 session.
At the February 11th HCAO Capitol Rally HCAO activists from across the state met with their legislators to discuss our bills and ask their legislators' support. From the report outs both oral and written our bills and especially HB 2828 received strong support. Some fiscally conservative are waiting to see the results of HB 2828 study before weighing in on SB 631.
Our goal in the 2015 session remains 36 sponsors and co-sponsors for our bills. As of the Rally on February 11th the number of sponsors for HB 2828 was 27 and rising. Having just been introduced SB 631 is only beginning to gain sponsors and cosponsors. We do expect as a results of our many legislative visits on the 11th and ongoing efforts we will see sponsorship continue to grow. Thanks go to all who came to Salem for the rally and lobbied their legislators.
Information on the SB 631 hearing will be made available as we receive it. We are presently preparing our panel of experts for the hearing. If you would like to testify at the hearing please contact me by clicking on my name below.
Information regarding our bills will continue to be available on this site.
Mark Kellenbeck, Chair, HCAO Legislative Committee
Summary of Our Bills:
2 pages: Summary of The Health Care for All Oregon Act – SB 631.
This is HCAO’s publically funded universal health care bill.
Full Bill text
1 page: Summary of The Health Care Study Bill – HB 2828.
The is HCAO’s must past bill in 2015.
Full Bill Text
Recap of Voting History:
3 pages: The Oregon Health Care Study Bill - 2013 Passage Voting Census.
This recaps 2013 voting in the House and Senate. We are counting on these votes and desirous of new supporters (especially Republican) in 2015.
Recap of Bill Sponsorship:
1 page: The Health Care for All Oregon Act – 2013 Legislative Sponsors.
This recaps all sponsors in the House and Senate in 2013, we are working to increase sponsorship to 36 (12 new sponsors in 2015).
Talking Points for Single Payer and HCAO Legislation:
2 pages: HCAO Talking Points
2 pages: Talking Points for the Health Care for All Oregon Act SB 631.
This provides strong single payer arguments and explanation of HCAO’s bill as well.
1 page: Key Talking Points for the Oregon Health Care Study Bill
The provides a summary of the bill and strong points supporting the value and passage of the bill in 2015.
Summary of SB 631
Purpose of the Act: The purpose of the Act is to ensure access to comprehensive, quality, patient-centered, affordable, and publicly funded health care for all Oregonians, to improve population health, and to control the cost of health care for the benefit of individuals, families, business, and society.
Who is covered: All persons residing or working in Oregon.
Covered services: Services that are medically necessary, and/or appropriate for the maintenance or rehabilitation of health or the prevention or diagnosis of health problems, excluding elective cosmetic surgery, and including: Primary and preventive care, including health education; Specialty care; Inpatient care; Outpatient care; Emergency care; Home health; Prescription drugs; Durable medical equipment; Mental health services; Substance abuse treatment; Dental services; Women's health services; Chiropractic, Acupuncture, and Naturopathic services; Ophthalmic services, as well as basic vision and vision correction; Diagnostic imaging, laboratory services, and other diagnostic and evaluation services; Inpatient and outpatient rehabilitative services; Emergency transportation; Language interpretation and translation services; Palliative and hospice care; Podiatry; Dialysis; and telemedicine as it becomes available and effective. In 2019, The Board shall submit a plan to the Legislative Assembly to include Long Term Care in the Plan. (The Board will determine which services will be covered under each of the above categories.)
The Plan will cover all services previously covered by Oregon Educators Benefit Board (OEBB), Public Employees Benefit Board (PEBB), Medicare, Medicaid and Medicare Advantage Plans unless strong medical evidence indicates such services should be discontinued.
Choice: Participants are free to choose any state licensed health care providers practicing within the scope of their licenses.
Affordability: No co-payments and deductibles. Providers must accept payments from the Plan as payments in full and may not bill participants for services covered by the Plan.
Financing the Plan: In lieu of premiums, co-payments, co-insurance, and deductibles, the Health Care for All Oregon Plan will be funded primarily by a progressive income tax and a progressive employer payroll tax, which will be collected by the Oregon Department of Revenue and deposited in the "Health Care for All Oregon Fund." The intent is that:
• The revenue raised by the progressive income tax will be approximately equal to the total currently paid by Oregonians for co-payments, co-insurance, and deductibles, with no new income tax on those below about 150% to 200% of the poverty level. (details TBD)
• The revenue raised by the employer payroll tax on public payrolls will be smaller than what is currently paid for employee health insurance. (details TBD)
• The revenue raised by the employer payroll tax on private sector payrolls will be less than the average currently paid for employee health insurance by firms of similar size. (details TBD)
Following arrangements for necessary waivers, exemptions, and agreements, the Legislative Assembly shall enact legislation necessary to assure that all payments for health care services provided to participants from federal, state, county, and local government sources will be paid directly to the "Health Care for All Oregon Fund."
Fund for displaced workers: The Board will provide in the budget funds for up to two years of training and extended unemployment benefits, if necessary, of workers displaced as a result of this Act for the first four years that the Plan is operational.
Health Care for All Oregon Fund: All money in the Fund shall be used only for payments to health care providers, administrative costs, approved "capital expenditures for major facilities and equipment, independent Ombudsman offices for both health care providers and Plan participants, training for workers displaced by the Plan, extended unemployment benefits to workers displaced by the Plan if needed, and incentives/training to ensure an adequate number of health care providers in Oregon.
Governance: The Plan will be governed by a Board of Directors of nine voting members, appointed by the Governor and confirmed by the Senate. Two of the appointed members shall be licensed health care providers, at least one of whom is other than an MD or DO, two shall have significant education and experience in public health, two shall have extensive demonstrated experience in health or
consumer advocacy, and one each shall be from labor and business. There shall be at least one board member from each of Oregon*s congressional districts.
Responsibilities of the Board: The Board is responsible for the development and implementation of the Plan and oversight of Plan management, including, but not limited to: Seeking all waivers, exemptions, and agreements from federal, state, and local government sources that are necessary to provide funding for the Plan; Determining policies and adopting administrative rules; Adopting a biennial budget; Determining the specific benefits package; Overseeing management of the HCAO Fund; Ensuring that health services reimbursed by the Plan are evidence-based and cost-effective; Ensuring access to quality health services; Emphasizing disease prevention and health promotion; Establishing a process to evaluate proposed capital expenditures for major facilities, equipment and services to ensure equitable distribution of facilities and services; Partnering with public health agencies to improve population health; Submitting the Plan budget to the Oregon Legislature; Ensuring that implementation of the Act is equitable for Plan participants, regardless of health status, age, disability, gender, employment or income; Reporting at least annually to the Legislature and the public on the performance of the Plan; Recommending needed amendments to this Act and related legislation; Establishing cost containment mechanisms; Ensuring that Oregon's health care workforce is sufficient in numbers and adequately trained to meet the increasing demands of health care expansion and transformation, possibly using funds to attract or train providers if necessary; Working with Oregon's congressional delegation to change federal legislation or policy to support Oregon's health care expansion and transformation.
Advisory Committees: The Board shall apportion the state into regions for advice and planning purposes with at least one such region in each congressional district. Each region will have a Regional Advisory Committees to solicit input, receive complaints, conduct public hearings, facilitate accountability, and assist the Board. Each region shall also have a Regional Planning Board to identify health care facility and service needs in order to achieve optimum population health and equitable distribution of health services throughout Oregon. The Regional Planning Boards will review both privately and publicly funded major capital projects, and may recommend capital expenditures by the Plan towards health care facilities or equipment.
Oregon Health Authority: The Oregon Health Authority shall implement and administer the Health Care for All Oregon Plan under the general direction, policies, and oversight of the Board. This Act repeals the Oregon Health Insurance Exchange, Oregon Medical Insurance Pool Board, Oregon Medical Insurance Pool, Office of Private Health Partnerships, Family Health Insurance Assistance Program, and the private health option under Health Care for All Oregon Children program when the Plan becomes operational.
Thank you Roberta Hall for this summary.
To follow the progress of this or any other bill, or to read the entire text, click here