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Health Care Working Group to meet through December 2018

Representative Andrea Salinas (D-District 38, Lake Oswego)  wants all Oregonians to have access to quality, affordable health care and serves as the Chair of the Healthcare Workgroup. 

Mid-Valley Health Care Advocates wants to ensure that the working group address how a new healthcare program will be financed. To stay in the loop on this work group, and receive email updates, click here (https://public.govdelivery.com/accounts/ORLEG/subscriber/new?topic_id=ORLEG_1069)

New dates to come. 

You may also view live streaming of the meetings.

General Notes

Most important committee for most bills – Joint Ways and Means. Member list at https://olis.leg.state.or.us/liz/2017R1/Committees/JWM/Overview. Click on member name to find contact information.

The human services subcommittee of Joint Ways and Means is especially important. See https://olis.leg.state.or.us/liz/2017R1/Committees/JWMHS/Overview

In general, if you are talking with a Republican legislator, the most important thing to lobby for is increased revenue. Of the revenue issues, the highest priority is the healthcare industry tax increase, which is necessary to get federal matching money. If you know your legislator supports a bill of interest, thank them for doing so.

Info for Legislative Constituent
Contact Teams

8/1/2018 Version

Now is the time for legislative constituent contact teams to talk with all of the candidates running for the legislature, and to also meet with the senators who are in office until 2020. We want to –

  • Determine where they stand on equitable, affordable, universal health care in Oregon, if we do not already know. We want to document what we learn about this.

  • If they are supportive, let them know we will want their help in getting something on the ballot.

  • Build relationships with these candidates and legislators. It is most important to do so for those who become legislators, but even losing candidates may be useful leaders in their community.

  • Thank them if they joined in sponsoring SB 1046.

  • Thank then if they voted yes on any of the following (for legislators that voted yes on a lot of these, you don’t have to thank them for each one):

    o   SB 558 (2017) – Cover All Kids
    o   HB 3391 (2017) – the Reproductive Health Equity Act
    o   HB 2931 (2017) – increase healthcare industry fees to continue to fund the Medicaid expansion and other healthcare programs, upheld with the Measure 101 vote
    o   HB 2828 (2015) – fund a study of healthcare financing.
    o   HB 3260 (2013) – define a study of healthcare financing, and put into law criteria for a good healthcare system.
  • Find out how they plan to raise the revenue necessary to continue funding the Medicaid expansion in the next biennium and beyond
  • Learn about and document their ideas for healthcare improvements in the next session.

To help HCAO-Action document what is learned, please send information regarding the points above to the coordinator of legislative contact teams in your region. If you do not know who that is, send information to Charlie Swanson at cswanee@msn.com.

HCAO-Action has endorsed a NO vote on the following ballot measures:

HCAO-Action has endorsed a YES vote on PDX 03 – “Limits candidate contributions, expenditures; campaign communications identify funders.” See https://tinyurl.com/yb42nv9r or https://www.honest-elections.com/official-ballot-title.html

Candidate Forum?

We encourage you to organize a candidate forum in your area where legislative candidates will engage with issues surrounding healthcare and answer audience questions. Here is a link to a 2016 forum of this nature organized by Mid Valley Health Care Advocates - https://lwv.corvallis.or.us/mid-valley-health-care-advocates-spotlight-legislative-candidates/  or   https://tinyurl.com/ya3cdqkn

Karen Christianson <karenc318@gmail.com> has organized such candidate forums and is willing to be a resource for suggestions.

Steps to following a bill

Go to the Oregon State Legislature website: https://www.oregonlegislature.gov/

1.    On the main page, glide cursor over “Bills and Laws,” and click on the year of the “…Regular Session” you are interested in, e.g., “2017” or “2018”.

2.    Click on “Senate Bills” or “House Bills” and choose from the range of bill numbers listed.

3.    If you know the title or subject of the bill but not its number, type the subject, e.g. “coordinated care transparency” in any search window.  This may give a summary article only but may provide the bill number and the session year so you can use steps 1 and 2.

4.     If you want to follow this bill online, go to the bill’s page you found in step 2 above and click on a eSubscribe icon or link at the bottom or top of the page.  “Citizen Engagement” tab should pop up and give you a link, e-Subscribe to Alerts.  Click on that link and scroll to the bottom of the page to see where to enter your contact information.  Also, as the measure moves or is revised, these movements/changes can be seen by perusing the tabs on the measure’s page: “Overview,” “Analysis,” and “Meeting Material/Exhibits.” (These will also be emailed through the e-subscription.”

5.    You can click on the names of various committees and bills to add to your e-subscription. We recommend selecting Senate Health Care Committee, House Health Care Committee, Joint Committee on Ways and Means (which is where HB 2122 is headed after House Health Care Committee), then scroll down to select other bills like HB 2115, or any others to follow. Click “Submit.” Click “Finish.”

6.     You can save the any page to your browser’s bookmarks..

7.    To find out which legislators are on the committee you want to follow, go to the main olis oregon  (https://www.oregonlegislature.gov/) page and click on Committees, e.g., “House Committee on Health Care” hyperlink. You can click to read each member’s biography and contact information to determine whom to approach in the committee.

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Summary of the RAND study on health care financing in Oregon

--by Charlie Swanson, HCAO Legislative committee chair

 The RAND study found that

  •  “Should Oregon want to achieve universal coverage, Single Payer and Health Care Ingenuity Plan (HCIP) are the most promising options.”
  • Single Payer (SP) would cost roughly the same as the status quo, whereas HCIP would be significantly more expensive.
  • SP is the only option that significantly reduces financial barriers to care.
  • SP is the only option for which the % of household income going to health care decreases as income decreases - all of the other options are significantly regressive.
  • With SP, all income groups except those above 400% of poverty level would have lower health care costs than any other option.

RAND recommends that Oregon “seek legal counsel to determine whether an ERISA challenge is likely and to assess possible steps to minimize the possibility of a successful challenge.” ERISA is a federal law protecting employee retirement and health benefits which prohibits states from interfering with health care provided by self-insured employers or multi-employer multi-state plans. Such plans cover 25% of Oregon’s population.

RAND did not appropriately examine how SP reduces administrative costs, primarily because RAND completely ignored the effect of administrative simplicity in provider offices under SP.

  • RAND referenced appropriate studies finding SP would lead to average administrative savings of 11% of total health care costs, but then claimed Oregon administrative savings would be only 1.7% ($600 million annually).
  • 11% savings in Oregon would be $4 billion annually, or $3.4 billion greater than what RAND reported.
  • RAND assumes provider reimbursement is 10% lower with SP than the status quo, which amounts to $3.1 billion.
  • The extra $3.4 billion in administrative savings is greater than the $3.1 billion decrease in reimbursement, leading to a likely increase in provider net compensation on average.
  • Billing and insurance related activities (BIR), a significant part of administrative activity in the U.S., consume substantially more time in provider offices in the U.S. than in countries with SP.
  • SP administrative simplicity would allow providers either to see more patients (and thus increase compensation), spend more time with patients (thus increasing the quality of care), or spend less time in the office (leading to less burnout). All of these factors would help mitigate the expected increase in congestion due to increased demand.

Some of RAND’s financial details seem questionable, so the study does not provide us with the sound quantitative data we need to design an appropriate tax structure to finance a single payer system in Oregon. RAND also did not respond to a request to explore the possibility of the state becoming a Medicare Advantage plan provider.

A work group formed by legislators following the 2017 session could address outstanding issues regarding how best to implement an affordable, publicly funded universal healthcare system in Oregon.

Health Care for All Oregon    •    http://hcao.org/

+1 503 206 6709    •   1443 SE 122nd Ave, Portland, OR 97233    •   info@hcao.org

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