5 Things Oregon: Four implications of Saxton departure, Topical Agenda, U.S. Senate HELP Committee

We are hard at work building our agenda and recruiting speakers for our 2017 Oregon State of Reform Health Policy Conference coming up on October 11th! It’s a considerable lift, to be honest, taking weeks of time to put together.

It’s also the primary way we fund our work on this newsletter. We don’t ask you for a subscription. We ask you to come to a conference once a year, network with folks and dialog on some really great topics.

We’d love to have your support this year in the form of your presence on October 11th. And, as always, thanks for reading our stuff.

DJ 5 Things Signature


1.  Four (existential?) implications of Saxton’s departure from OHA

Stakeholders are getting nervous about the future of Oregon Medicaid.  Funding is a question with the tax referral set for January.  But anxiety is more about the vision for and the shape of the 2018 CCO procurement.  Lynne Saxton’s departure exacerbates that nervousness.  I lay out four implications of Saxton’s departure here that represent concerns for the agency moving forward.

In many ways, Saxton was the last tether to the visionary leaders behind the CCO model at the State of Oregon.  Moreover, the OHA may need visionary leadership even more than other agencies due to an organizational culture that has critics say stifles “efficient operations,” or which is too “bureaucratic”.

Patrick Allen, the interim OHA director, is a highly respected and capable leader, moving over from success running the DCBS.  The task before him at the OHA is big, complex, and sensitive.  He has his work cut out for him.


2.  Health care tax to kick in, raising premiums

A funding provision of the ACA, Section 9010, levies a fee, or tax, on all fully insured policies. That means exchange, group, Medicaid, and Medicare. Generally speaking, those taxes are passed through to the individual payer, or to the public agency, like Medicaid. It is set to kick in January 1st.

According to a new report from Oliver Wyman, in Oregon, this will be equal to an additional $468 annually per small group family product. It’s another $145 on top of an individual product, according to an Oliver Wyman report. The state will need to cough up another $14m in funds from the state budget to cover the premium hikes in Medicaid, though a 63% of that will come from FMAP, assuming the feds don’t change the match.  All told, the Oregon health care system will pay about $180m more as a result of the tax.


3.  ICYMI: Scan the 2017 Topical Agenda

In case you missed it, we released our Topical Agenda last week with the structure and panels set for our 2017 Oregon State of Reform Health Policy Conference.  It’s coming together really well, and probably couldn’t be better timed.  With 19 breakout sessions and three plenaries, as always, it will be a full day of networking, dialog, and engagement with senior leaders from across the spectrum of health care.

We release our list of about 70 speakers on September 13th, which will give you about a month to review things. Not every speaker will be 100% confirmed at that point. We are still lining things up, to be honest!  But our Convening Panel has been great, and we’re getting very close to finalizing things. As always, if you have suggested speakers, drop me a note. And, if you want to be one of the over 400 senior health care executives and health policy leaders in the audience, you can register here!


4. U.S. Senate HELP committee holds hearings

Bi-partisan hearings on health reform will be held for the first time this year in the US Congress next week. The Senate HELP (Health, Education, Labor, and Pensions) Committee will convene both governors and state insurance commissioners to talk through prospective changes that both parties can get behind.

The committee is hoping to vote on a bill by the end of October, which would be a significant and divergent result from the rest of 2017.  I’m told from Hill staff that the likely shape of the bill will include fully funding the cost sharing reductions (CSRs) for the exchange market, and will codify and streamline authority for HHS to grant 1332 waivers.

Notably, this bill would usually go to the Finance Committee, where health care spending and taxation is typically dealt with and where Sen. Ron Wyden is the leading Democrat. However, Chairman Orrin Hatch has said he won’t work on health care at all this year. “As far as I’m concerned, it’s over.”


5.  Read: “Worst mental health crisis in decades”

This recent story in The Atlantic has been generating buzz among social scientists, policy makers, and parents – or at least any parent that has had to deal with the issue of phones in their kid’s hands. It’s a read worthy of your time for a glimpse into the future of the American demography and economy.

The iPhone was released in 2007, making what’s known as the iGen (kids born between 1995 and 2012) the first generation to live entirely in a world of smartphones. The result: “It’s not an exaggeration to describe iGen as being on the brink of the worst mental-health crisis in decades. Much of this deterioration can be traced to their phones.”

“Eighth-graders who spend 10 or more hours a week on social media are 56 percent more likely to say they’re unhappy than those who devote less time to social media. But those who spend six to nine hours a week on social media are still 47 percent more likely to say they are unhappy than those who use social media even less. In 2011, for the first time in 24 years, the teen suicide rate was higher than the teen homicide rate.”