5 Things Oregon: Health legislation, MFAR comments, Sen. Arnie Roblan

Mental health, public health, and health care financing: we’re spending our time on those topics in this edition of 5 Things We’re Watching in Oregon health care. It’s what I do while I wait for the Blazers to get back over .500.  (I may have time on my hands…)  So, thanks, as always, for reading our stuff.



With help from Emily Boerger



1. Oregon leaders respond to CMS MFAR proposal

CMS’s proposed Medicaid Fiscal Accountability Regulation (MFAR) rule would cut more than 60% of state and federal financing for Oregon’s Medicaid system, according to a letter from OHA Director Pat Allen. Allen’s comments are just one in a series of letters from state leaders calling on the Trump administration to withdraw the MFAR rule.

The rule would alter the way states are able to finance their share of Medicaid, specifically targeting provider taxes and inter-governmental transfers (IGTs). Gov. Kate Brown submitted a joint letter with Massachusetts Gov. Charlie Baker in opposition to the current version of the rule, as did Sen. Jeff Merkley who wrote that with the proposed changes “Oregon would need to generate $1.3 billion per year in general fund dollars through increased state taxes.”


2. Health bills we’re watching

From vaping and CCO transparency, to behavioral health and insulin costs, we’ve compiled a list of health-related bills worth tracking this year. One bill would require OHA to report CCO financial information to the legislature every 6 months, and would prohibit CCOs from withholding required information from OHA based on the ground that the information is a trade secret.

Another bill would make changes to prior authorization requirements with the goal of making it easier for enrollees to access treatment or care. And this bill, would cap the out-of-pocket cost of insulin at $100 for a 30-day supply, following the lead of Colorado on this in 2019.

3.  Lessons from the coronavirus

The coronavirus has transfixed me these last few weeks, causing me to have a range of conversations with folks about our ability to respond to the outbreak here. I’ve learned about a central paradox in public health: we probably aren’t ready for a pandemic, but being honest with the public about not being ready may cause more harm than good. So, it’s better to convince ourselves we’re ready, I guess, and not ask tough questions in public.

In the Washington State case, we learned that anti-viral drugs first developed to ward off AIDS appear to have efficacy. We have learned that it’s increasingly possible we’ll just live with the coronavirus, as we do with influenza, and that we’ll start to catch pneumonia like we catch the flu. From Hong Kong, we’ve learned to expect a run on toilet paper if the virus hits here.

And, we know that Oregon’s rate of hospitalizations from the flu this year was slightly higher than the last three. The flu has already killed 10,000 Americans this year alone, but that new threats are scarier than existing threats, even if mortality rates are the other way around.

4. Video: Sen. Arnie Roblan on mental health

Senator Arnie Roblan represents Oregon’s 5th Senate District on the central Oregon Coast. Roblan serves as Chair of the Senate Committee on Mental Health and is a member of the Joint Committee on Ways & Means, among other committee appointments. He joins us in this edition of “What They’re Watching” to discuss mental health legislation in the 2020 legislative session.

“My real goal is to make sure that we put mental health in the priority that it needs to be put in our state. We have an enormous opportunity to help a lot of people make changes in their lives and give them the services they need to be productive members of our society… This session is really to highlight that issue, and to start really having a conversation about how do we integrate the mental and physical health priorities so that people can go to a place and get the help they need in a timely manner and in the most efficient way.”


5. Q&A: Sen. Denyc Boles on mental health

In this Q&A, Sen. Denyc Boles continues the conversation on work being done this session to prioritize mental health care in Oregon. Boles is Vice Chair of the Senate Committee on Mental Health and is a member of the Senate Committee on Housing and Development.

In her conversation with Reporter Madeline Shannon, Boles discusses the success of certified community behavioral health clinics throughout the state, and a bill moving through the legislature that directs OHA to evaluate the impacts of these kinds of clinics. “It makes sense to continue the financial support to these health clinics so they can continue to do the work they’re doing. Also, anecdotally and empirically, it looks like this is a good model to consider,” says Boles.