5 Things Oregon: Health policy preview, My COVID experience, Election results

Thanks to all of you who joined our 2020 Oregon State of Reform Health Policy Conference. I wanted to offer a particular shout out to Eric Hunter and his team at Care Oregon, and to Jeff Heatherington and the Heatherington Foundation. Both served as Event Sponsors of this year’s event. Their steadfast support was really crucial in our continuing to navigate this year of COVID.

Speaking of which, I actually had COVID during the conference (see item #5). I was stuck in my home office where I had been quarantined. So, pardon the sweat on my brow and the exhaustion in my face! It wasn’t my finest physical hour, but we made it through. So, again, thanks for your support of our work at State of Reform. We appreciate it all very much!

 

 

 

 

With help from Emily Boerger

1. ICYMI: Oregon leaders talk health reform

Thank you to the over 350 folks who attended our 2020 Oregon State of Reform Health Policy Conference a few weeks back. We had the opportunity to hear from over 50 speakers from across Oregon’s health care ecosystem, including several national health leaders who joined us during our keynote sessions which we highlight here.

During our Morning Keynote, Sen. Jeff Merkley discussed eliminating the filibuster and “unrigging” the Senate against Democratic priorities. In the Afternoon Keynote, I had the opportunity for an extended interview with former Gov. John Kitzhaber and US Rep. Earl Blumenauer who provided insight into health reform options at both the federal and state level. “If we can use this opportunity with all the pieces of the systems, not just health care, but education, economic development, transportation…we can use the ingenuity and passion and energy of this country to figure out that transitional path from where we are to where we know we have to get,” says Kitzhaber.


2. Election reflection

In the leadup to the election, some Democrats had hoped to widen their party advantages in the state legislature to create a “walkout proof” majority. That goal won’t become a reality, and in the Senate, eyes are still on the District 10 race where Republicans are hoping to undo Democrats’ supermajority. The most recent numbers show Republican Sen. Denyc Boles, who Vice Chairs the Senate Interim Committee on Mental Health, trailing behind Democrat Deb Patterson by 387 votes, or .51%. The Oregonian has called the race, but so far Boles hasn’t conceded and Patterson has yet to declare victory.

Over in the House, Democrats are expected to retain their over three-fifths control of the chamber, but as of now, Republicans have netted one seat. Outside of legislative results, Oregonians also passed a series of health-related measures this election including an increase to the state’s tobacco tax, the decriminalization of personal possession of drugs such as cocaine, meth and heroine, and the legalization of the use of psilocybin at licensed facilities for mental health purposes.

 

3. Health policy preview for 2021

Over the course of two separate breakout sessions during the State of Reform Conference, seven legislators offered their observations on the health care and fiscal policy teed up for Oregon’s 2021 legislative session. Republicans and Democrats agree the COVID-19 pandemic will be the lens through which upcoming health policies will be focused, but there was variation in the other priorities at the top of their respective to do lists.

Legislators on the Republican leadership panel said rural access to health care and increased mental health issues will be top of mind. The Democratic leadership panel agreed about the importance of addressing mental health and highlighted racial health disparities and the budget as key issues.


4. Plan to save ACA may be scuttled

Today, SCOTUS heard oral arguments in California v. Texas. If the ACA is overturned come June, Oregon is at risk of losing billions of dollars annually in federal funds which it receives under the legislation. Without the ACA, Gov. Brown says over 546,000 Oregon residents could lose coverage and the Economic Policy Institute predicts Oregon could lose a total of 42,000 jobs.

US House Democrats had a quiet plan to try to save the ACA next year. They planned to vote to increase the individual mandate penalty at the center of the legal challenge. By re-establishing the penalty at a number greater than zero, they argue, the constitutional grounds for overturning the ACA would be eliminated. Strong wins in November, so the argument went, would make the voter mandate to keep the ACA clear. However, without a Senate majority, Democrats are unlikely to get a vote on a new penalty. In any case, this election has not delivered a clear federal mandate for anything, leaving the strategy more theory than soon-to-be-practice.

 

5. I got COVID. Here is what I learned.

Over the last few weeks, I was diagnosed with COVID. I quarantined in my home office with light but still-worrying symptoms. While the disease was jarring, even more disappointing was my experience with the primary care and public health systems. I’ve written before about how good the care was for my uncle when he was 38 days on a ventilator.

But, it’s clear to me now that if you get COVID, you’re mostly on your own. Testing is still a mess in many cases, and varied across county lines. Even the protocols don’t seem to make sense. For example, if you come in contact with someone with COVID, but you test negative, the protocol is to quarantine for 14 days. If you test positive, you only need to quarantine for 10 days. I know the reasons why this might be the case still, but the gold standard is two negative tests about five days apart. With more testing, we can dispense with this 14-day requirement and better support people in managing through this crisis.