Oregon Legislature passed bills improving coverage, costs and equity this session
The 2021 Oregon Legislative Assembly adjourned Saturday, June 26th, marking the end of this year’s legislative session. This session was marked by bills that expanded coverage through Cover All People, mandated data collection to improve health equity, and made an effort to reduce overall health care costs to consumers.
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Sen. Lee Beyer, member of the Senate Committee on Health Care, commented on the productivity of the session:
“I think when we stand back in a couple of weeks and look back on everything that was done, it will prove to be one of the more productive meetings of the Oregon Legislature. We passed a lot of things along a lot of different areas and in fact so many things, it was hard to keep track of them all.”
Cover All People, passed through HB 3352, expands Oregon Health Plan eligibility to adults who would be eligible for Medicaid if not for their immigration status. This bill includes DACA recipients in an attempt to close Oregon’s 6% uninsured rate. Governor Kate Brown said:
“By providing families with health coverage and giving them access to preventive and primary health care, Cover All People will reduce health care costs in Oregon. On average, states that expand health coverage have outpaced other states in terms of job growth. Expanding quality health care coverage is linked to individuals obtaining and maintaining employment, benefiting the economy. Health insurance coverage also reduces individual debt, increasing economic activity and productivity.
The Oregon Health Plan, after which Cover All People will be modeled, has some of the lowest Emergency Department visit rates in the nation, resulting in better health care and lower costs. Expansion of health care for adults with low incomes has also been associated with increases in preventive care for their children.”
The program will change from Cover All Kids, which covers all children younger than 19 regardless of immigration status, to include their parents and better aid in the transition of coverage to those who age out of Cover All Kids. Cover All People will not apply to anyone who might be eligible for Medicaid regardless of their immigration status.
Equity was highlighted in this session with bills like HB 3159. This bill requires coordinated care organizations (CCOs) to track data on patient race, ethnicity, preferred language, disability status, sexual orientation, and gender identity to track health care outcomes across different demographics.
The COVID-19 pandemic has highlighted inequities in health care. According to OPB, Latinos represent 13% of Oregonians, but account for 25% of confirmed COVID cases and only 6% of total vaccinations. This bill would allow CCOs to see where those inequities lie, compare their numbers to community statistics, and adjust their programs and operations to best address the inequities in their care.
The legislature also passed bills in an attempt to lower costs. HB 2081 intends to keep down costs in all silos by setting insurer and provider incentives to maintain a consistent health care cost-growth rate. The bill sets up an “accountability mechanism” for those whose cost remains high. The concept of transparency will lead the effort to keep insurers and providers accountable to stay within the cost-growth target.
Another bill to help lower costs is HB 2362. This bill will require health care providers and hospitals to obtain permission from the Oregon Health Authority (OHA) before any merger, acquisition, or affiliation transactions. The bill will create an advisory board of providers and community members to determine the usefulness and validity of a merger. This bill hopes to stop unnecessary mergers that might lead to monopolies and higher costs for the consumer.
The legislature also passed SJR 12, which puts a constitutional amendment on the 2022 ballot to make health care a fundamental human right. The bills chief sponsor, Rep. Andrea Salinas, said:
“No one should have to make the decision between putting food on the table or going to the doctor when they’re ill. I’m proud that Oregon continues to recognize that health care is a right regardless of your income, your race, your ethnicity, your skin color, or where you were born.”