Q&A: Rep. Cedric Hayden, Vice Chair of Oregon’s House Committee on Health Care
Representative Cedric Hayden represents Oregon’s House District 7, covering Eastern Lane and Douglas Counties. Hayden currently serves as Vice Chair of the House Committee on Health Care and on the Joint Ways and Means Subcommittee on Human Services. Outside of the legislature, Hayden operates several businesses and is a dentist in a hospital-based dental practice.
In this Q&A, Hayden discusses addressing health care costs, controversial bills in the legislature, and being a Republican in a Democratic supermajority.
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Emily Boerger: To start off, what do you see as some of the defining health care topics and issues in the legislature this year?
Rep. Cedric Hayden: You know, the hot topic in health care is the cost of health care – it always is and probably always will be. So, one of the things we’re working on is the funding package, and health care is expensive not just from the Medicaid perspective, but it’s expensive from the commercial side of it also…One of the balancing acts is how do you fund the Medicaid population, the fee-for-service population, and be able to keep your commercial health care option available for folks out there.
A portion of that is pharmacy costs. So, there’s always a lot of bills on pharmacy costs. I have a bill, HB 3397, which basically deals with giving opportunity to buy our pharmaceuticals under Medicaid in one centralized area. What we do now is we allow coordinated care organizations (CCOs) to go out and negotiate and cut their own deal — which they like from the standpoint of they have control over those dollars; they can save some money… But I look at it from the perspective of, we’re buying pharmaceuticals at retail, at Rite Aid, rather than buying them at a wholesale manufacturer or something like that. Meaning, we don’t leverage purchasing power. We let each of the CCO’s individually go cut their deal and so you can’t get into the larger inter-state compacts where you could say, join California or join these other states that get together and negotiate.
Also, one of the most controversial bills, honestly, in health care that is working its way through [the legislature] is whether vaccinations should be mandatory in the state of Oregon. That kind of explains itself, but that’s a controversial bill going through.
So, those are a few examples of the stuff we’re working on.
EB: What’s your perspective on the vaccination bill?
CH: I actually don’t support the House Bill 3063 A. I’m opposed to that.
Now, for me it’s not about vaccinations or not vaccinations, it’s about mandating the protocol. And I use the example — when it came through our committee, I voted against it — I said, “you know, is giving an 18-month-old a Hep B vaccination something that should be mandated?” If a parent wants to do that, and that is the protocol that they have to start their Hep B vaccinations, if the parent wants to do that, I’m okay with that. But I don’t believe that there is any public health concern if parents say they want to delay that. Anyway, that’s the argument. What is the balance between government being able to mandate these requirements, or not be able to go to school?
EB: Individually, what are your top priorities? Are there any bills that you are particularly excited about?
CH: So, I’ll counter that last conversation with, I’m the chief sponsor of a bill to add dentists to providing vaccinations. I believe in access, education, and you know, a compassionate approach. I believe in that. Take for example my kids, are they vaccinated? Yes. Did I delay some of them? Yeah, I did. I liked that option. But to me, the argument of vaccination, is sometimes it’s about access. Dentists are certainly qualified to provide that technical procedure… they’re geared toward that type of educational, compassionate conversation and I think we can help. So that is a bill that I chief sponsored that we’re moving through.
Another one that I’m proud of and is still moving is the peer respite centers, HB 2831. It’s kind of a bigger lift, a little more notoriety to that bill moving through.
And, kind of attached to that, I do work in the foster care space, we’re moving a bill along that would help foster care kids, HB 3015. Currently if you’re in the state of Oregon, if you’re a foster care child, you get qualified for higher education scholarship. We’ve funded our education institutions to be able to provide that. But, if a child gets adopted, they get severed from that scholarship. I think that’s not the correct approach. So we have a bill where we’re rolling that back for 14 and older, and hopefully in the future we’ll expand. So if you’re originally qualified to have a scholarship for education, you ought to be able to keep that regardless of if you get connected with a family or not.
EB: To go back a bit, you mentioned HB 2831 as one of the more talked about bills. Can you tell me more about the centers and the purpose they’d serve?
CH: So here’s the function: In our mental health space, and I’ve often said this, mental health in Oregon is one of the last frontiers that we really haven’t tackled. When we did health care transformation, for right or for wrong, we didn’t really wrap behavioral and mental health into that, we kind of let those funding programs and processes stay separate.
Mental health hasn’t fully ever [joined the transformation process] so it has created kind of these siloes, or lack of coordination between the services we spend a lot of money on. We spend about $3.4 billion in mental and behavioral health services in Oregon, but they’re pretty fragmented.
So people have the option of being with their coordinated care organization, but if they get arrested they get separated from continuity of care for behavioral health services that they have. They go to a county jail, county jail may hold them for a while, and then send them to state hospital. And at each one of those steps, somebody separate is responsible for their health care and the funding streams are different.
And so, what this option would do is provide a temporary place, with a bed, you know housing, and it would allow people in a mental health crisis to be able to be stabilized… Keep their health care providers available to them, give them a place to correct the crisis and get things stabilized again, and stay in their local communities. So the idea is to add something between no services and county jail/ full state hospital. And we really, honestly in Oregon don’t have anything in that space, so that’s what we’re trying to do.
EB: Earlier you mentioned the vaccination bill, any other controversial bills moving forward?
CH: Other bills that are a little bit controversial – they’ve got an employer subsidy program, HB 3262. The state of Oregon Department of Human Services is currently in some trouble with our federal partners on misspending funds that are supposed to go low-income people to help them get food and help them get services. The state of Oregon misappropriated some of those funds, or didn’t spend them correctly, so we have to pay that back. And it’s interesting that you have HB 3262 that would actually charge employers for things like TANF, SNAP, Social Security, federally-funded programs that low income people receive. If you hire that person, they want to turn around and charge the employer for the federally funded service that that person receives. And so we were just like, “why are we doing this employment law here?” And I asked the question, “Is that even legal? Wouldn’t you be getting yourself in more trouble if you mandate an Oregon-based employer pay for federally-funded services?” So it’s a very strange bill, I thought… But that would be an example of one that I would be shocked if it wasn’t on party lines.
EB: Shifting gears a bit, what is it like as a Republican working in a legislature with a large Democratic majority? Particularly from a health care perspective?
CH: I’d say about 90 percent of what we do in health care is somewhat bipartisan. It’s more just individual, “I don’t like that process or a I don’t like that process.” And then there’s some bills, very few bills that come out on party lines, but it does happen from time to time. Like the vaccination bill — the mandate came out on party lines. But, increasing the access to vaccinations through oral health, through a dentist, passed the floor 58-0.
The point is, even though what gets printed in the media is often the four or five bills out of the 150-160 bills that we hear — you know, the controversial is the fun one to print about — boring, technical, bipartisan stuff that kind of grinds through, there’s much more of that [in the legislature].
But to the credit, and to the bipartisan credit for Oregon, we meet routinely and have routine after-hour phone calls and communication between Republicans and Democrats in that space. And we might look pretty vocal in our opposition in a testimony, and then go talk about, “well let’s make this better, let’s make that better and let’s do this or do that.” So there’s a lot of communication between us.
However, having said that, at the end of the day I’m just one seat on that canoe. And whether I paddle or not, the canoe is still going in the same direction. Right? I don’t have any say, you know, the committee is seven Democrats to four Republicans, so we can’t stop anything or we can’t advance any policy [on our own]. We can offer concepts that we think that will improve it, and so our job is to show them a better path forward to accomplish the goal and maybe be more efficient.