In this edition of “5 Things We’re Watching,” we take a look at fentanyl use in Oregon, updates on federal health policy that could impact the state, and coverage of the latest Bridge Health Care Program Task Force meeting.
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State of Reform
1. Bridge Program task force discusses federal financing options
The Bridge Health Care Program Task Force met Tuesday to discuss the goals, priorities, and roadmap for the creation of an insurance option for those at risk of losing Medicaid coverage at the end of the PHE. Stakeholders spent a portion of the meeting discussing three federal financing options—Section 1115 waivers, Section 1331, and Section 1332 waivers—for covering those in the 138-200% FPL range.
The 1115 option would expand Medicaid coverage to individuals up to 200% FPL, the 1331 option would enroll people 138-200% FPL in a Basic Health Program, and the 1332 option would “allow people 138-200% FPL to choose between a Bridge Program offered by CCOs and getting tax credits towards Marketplace coverage,” according to meeting materials. The task force is tentatively scheduled to vote on their federal pathway recommendation on June 14. The task force has seven more scheduled meetings before the Bridge Program proposal is due September 1st, 2022.
2. State leaders react to Roe v. Wade draft opinion
Following reporting last week that indicated the U.S. Supreme Court plans to overturn Roe v. Wade, some state leaders were quick to speak out against the decision, affirming that access to abortion services would continue in Oregon. If the decision is overturned, 26 states are certain or likely to ban abortion, according to the Guttmacher Institute.
Oregon is one of at least 16 states that have enacted laws that would keep abortions legal even if Roe is overturned. This past year, lawmakers appropriated $15 million to the Oregon Reproductive Health Equity Fund to increase abortion access.
3. OHA awards $31 million to community organizations focused on equity
The Oregon Health Authority recently announced it has partnered with 147 community-based organizations across the state to fund work aimed at eliminating health inequities. OHA awarded a total of $31 million to the organizations, which will use the funds to focus on issues including adolescent and school health, communicable disease prevention, emergency preparedness, and climate change.
Some of the largest funding allocations went to Eastern Oregon Center for Independent Living ($1,025,000), Latino Network ($860,000), the Haymarket Pole Collective (753,000), and the Oregon Community Health Workers Association ($665,000). The full breakdown of the grantees and funding amounts is available here.
4. Fentanyl use on the rise in Oregon
Oregon’s overdose deaths increased by 25 percent last year compared to a 12 percent increase nationwide, according to provisional data from the CDC. This increase coincides with a surge in fentanyl use across the state and across the country, with law enforcement seizures of pills containing illicit fentanyl increasing 50-fold in recent years.
Recent data from the drug testing laboratory Millennium Health finds a 58% increase in fentanyl positivity in Oregon drug tests for the first quarter of 2022 compared to all of 2021. Over the course of 12 months, fentanyl positivity grew 57% in Multnomah County, 59% in Lane County, 88% in Umatilla County, and 197% in Jackson County.
5. Inflation’s impact on Medicare
The March consumer price index revealed an 8.5% annual rate of inflation between March 2021 to March 2022. “If such rapid price escalation persists for an extended period, it will have broad implications for many federal programs, including Medicare,” says State of Reform Columnist Jim Capretta in his latest column.
High rates of inflation impact the Medicare program in several ways through changes to CMS’s “market baskets,” through real cuts in physician fees, and to Medicare Advantage rate changes, writes Capretta. “For 2023, CMS already has announced a growth rate of 4.88%. Together with other trends and modifications, CMS expects the average payment for MA enrollment to grow by 8.5% in 2023.”