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Health Care Working Group to meet through August 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)

Meetings will be held from 8 to 11 a.m., each Thursday monthly through August 2018, at the Oregon Nurses Association Offices (18765 SW Boones Ferry Rd # 200, Tualatin, OR 97062):

  • Thursday, April 19, 8:00-11:00 am
  • Thursday, May 24, 8:00-11:00 am
  • Thursday, June 21, 8:00-11:00 am
  • Thursday, July 19, 8:00-11:00 am
  • Thursday, August 23, 8:00-11:00 am

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: March 2018 Update

3/4/2018 version

Now that the 2018 session has ended, the most important item for HCAO-Action to discuss with legislators is probably the plan to close the funding shortfall in healthcare that we know will be coming in the next few biennia. Measure 101 was a stop gap measure that covers the shortfall only through June 2019. We know that federal matching funds for the Medicaid expansion will decrease in the next biennium. The federal government may also change other policies to endanger health care funding.

Ask your legislators what they think should be done before the 2019 session to plan for the revenue increases that we know will be needed to protect the healthcare of Oregonians.

Review of bills of interest to HCAO-Action in the 2018 session

Affordable Health Care as a Fundamental Right – HJR 203, the HOPE amendment, died in the Senate Committee on Health Care. The Oregon Nurses Association (ONA) did polling on the measure, and the polling results were essentially the same as HCAO polling done in March of 2015. With the small margin of support that the polling indicated, senators were not willing to risk what they perceived would be the potential harm that the loss of the HOPE amendment on the 2018 ballot would bring about.

As would be expected, younger voters and voters of color were very strongly in favor of the HOPE amendment. Arguments that having the HOPE amendment on the ballot would drive turnout to help all things progressive were not sufficiently believed by senators to persuade them to risk what they felt was too great a chance of a potential loss.

CCO reform – HB 4018 passed both chambers. The first vote in the house was 32-26, with Republicans Helfrich and Parrish for and Democrats Barker, Clem, Evans, McKeown, and Witt against. After changing the bill from requiring CCO governing boards to follow open meeting laws to requiring them to follow a relatively decent open meeting process described in the bill, it was approved in the senate 28-1 (Baertschiger against), and then approved 59-0 in the house.

The Oregon Health Authority will write rules to implement the open process, which should be functional by the beginning of the next contract period. This change is an important step in the right direction.

Prescription Drug Pricing Transparency – HB 4005 passed both chambers. The vote in the house was 46-14, with Republicans Barreto, Boles, Bonham, Esquival, Findley, Hayden, Heard, Kennemer, Nearman, Reschke, Sprenger, Stark, Whismant, and Wilson against. The senate vote was 25-4, with Republicans Baertschiger, Bentz, Girod, and Hansell against.

The bill will only require pricing transparency information if the price increases more than 10% in one year for a drug for which one course or a one month supply costs more than $100.

Others – HB 4076 (small donor funded elections) and HB 4156 (some controls on Rx prices charged by insurance companies) died in the House Committee on Rules and Health Care, respectively.

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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