Oregon’s 2023 legislative session ended a month ago, and lawmakers passed hundreds of bills despite a historic walkout that halted the advancement of key bills for six weeks.
Republican lawmakers held the longest walkout in state history (and the second-longest in the country) over an abortion and transgender healthcare bill (House Bill 2002) and other issues. They eventually compromised with Democrats on the bill, and returned to help pass hundreds more, including key initiatives addressing healthcare workforce and behavioral health issues.
State of Reform discussed the session, and key health-related bills that were passed, with Sen. Cedric Hayden (R-Fall Creek) and Rep. Ben Bowman (D-Tigard). Hayden served as vice chair of the Senate Committee on Health Care, while Bowman served on the House Committee on Behavioral Health and Health Care during the session.
Both lawmakers cited the healthcare workforce shortage as an issue they were able to make progress on. Bowman said Senate Bill 2697 puts minimum staffing levels in place, making nurses’ work more sustainable, while simultaneously improving the quality of patient care.
“Oregon is facing a healthcare workforce crisis, and we took decisive action to support our existing workers and recruit future workers,” Bowman said. “We also passed a suite of healthcare workforce investments that will benefit Oregonians for years to come. Labor leaders and hospital leaders deserve major credit for working together over many months to arrive at a consensus.”
Hayden also noted the passage of SB 2697.
“I hope the package for hospital staffing and nurse ratios makes an impact,” Hayden said. “But while we can legislate that all we want, in another bill (HB 2665), we effectively rate-capped nurses so the legislature has to be consistent and intentional if we’re going to address workforce issues, which, more than actual funding from the state, is the real reason people are struggling to access cost effective care, particularly in rural communities.”
Hayden said the legislature needs to take further steps to address the healthcare workforce shortage, however.
“We have to do more to address the workforce in terms of skills, housing, and ensuring our healthcare workers can afford to practice in Oregon. So while we took important steps this session, that work isn’t nearly accomplished.”
— Hayden
Both lawmakers noted that progress was made in the behavioral health sector as well. Bowman said bipartisan support was crucial in the passage of HB 2757, which expands and provides funding for coordinated crisis service systems.
“The legislature passed HB 2757, funding the 988 mental health crisis hotline across Oregon, a statewide investment to address the mental health crisis that will literally save lives,” Bowman said.
Hayden noted the passage of HB 2395, which allows specific individuals to distribute and administer short-acting opioid antagonists and distribute kits to assist in substance abuse treatment.
“I was specifically involved in amending HB 2395 to ensure parents have rights and a say in their children’s health as it relates to drug addiction issues,” Hayden said. “The opioid bill as passed will be impactful as we work to address the addiction crisis in our state.”
Bowman said the passage of HB 2513 will improve Ballot Measure 110 implementation. Voters passed the measure in 2020 to offer Oregonians charged with drug offenses treatment options as an alternative to a stint in prison. But the state has had numerous challenges arise while implementing the measure.
“After voters approved (the measure), its initial implementation was not smooth. HB 2513 is a key step in rectifying faulty implementation, making needed improvements in (the Oregon Health Authority’s) oversight capacity.”
— Bowman
Hayden also highlighted SB 91, which requires the Department of Human Services to request Centers for Medicare and Medicaid Services approval of a waiver to obtain federal financial participation in the cost of a program to pay parents of minor children with disabilities to provide attendant care services to children.
“We made huge strides, although with miles to go, in helping families of children with disabilities access home healthcare services they are otherwise lawfully entitled to,” Hayden said. “SB 91 needs more than the $3 million it was given, and we’ll need to come back for another bite at that in a subsequent session.”
Bowman highlighted SB 972, which will create a state-based health insurance marketplace in Oregon.
“This will provide the state more flexibility, offer greater cost savings, and ultimately improve access to healthcare for Oregonians,” Bowman said.
While the lawmakers made progress on many health issues, both Bowman and Hayden pointed out several areas that will need further attention in future sessions.
“Two bills I sponsored didn’t cross the finish line, and I think it’s an important part of how we reduce healthcare costs overall,” Hayden said. “One bill would have looked at standing up a committee on scope of practice related to insurance mandates. We need a cleaner process that looks at scope and payment holistically on a continuum rather than one-off bills.”
Hayden said he also introduced a scope-billing bill for cardiac screening.
“It’s frustrating to see that bill die because cardiac care is the number two thing we spend money on as a state, and early detection saves lives and will reduce costs. An $800,000 fiscal [spend] was the hurdle, yet saving eight high-risk lives that would have been at the high end of hospitalization costs for cardiac care would have paid for that bill in a biennium.
Unfortunately, we don’t budget that way based on cost-avoided savings. But we’ll bring that back because, ultimately, when we stood up (coordinated care organizations) and said we were going to transform medicine when we adopted the (Affordable Care Act), that hasn’t happened yet, over a decade later. It’s time we got serious about bending cost curves.”
— Hayden
Bowman said more can be done about the troubling trend of multinational corporations that buy small healthcare practices and networks.
“These large corporations pressure practices, which are traditionally owned by a practitioner or group of practitioners, to maximize profits at the cost of low-income and poorly-insured patients,” Bowman said. “State law usually prevents corporate influence in primary care, but the weakening of these regulations and a lagging regulatory framework have allowed these companies to find and exploit loopholes. I plan to continue working on this issue to keep healthcare local and focused on patients rather than shareholders.”