Health Bills That Died in the Legislature's Second Half

A handful of important healthcare bills, including insurance rate review, didn’t pass the Legislature, but many will be back in February
The Lund Report

June 14, 2011—Insurance rate review, allowing psychologists to have prescribing privileges and expanding scope of practice all met a fateful ending when the Legislature adjourned recently. But most of these bills are expected to resurface when lawmakers reconvene next February. 

Because of the $3.5 billion budget gap, many bills that had a financial impact died, regardless of their policy merit.

Insurance Rate Review  

Sen. Chip Shields (D-Portland) introduced three bills (Senate Bills 717, 718, 719) to make the insurance rate review process more transparent and open to the public, particularly for small businesses and individuals.

Throughout the session, Shields argued that increased insurance rates strangled small businesses, which had to choose between providing coverage to their employees and losing profits.

“They need bigger scrutiny,” Shields said of the rate review process.

All three bills had “staunch opposition from the health insurance lobby,” he added, which contended that the Insurance Division would no longer be able to have candid conversations about rate increases with insurance companies. During public testimony, Theresa Miller, administrator of the Insurance Division, also said the bills would pose logistical challenges for the Division.

Shields, who intends to reintroduce the legislation next February, said a work group has been put together to reach consensus. 

Psychologist Prescribing Bill

For the fifth session, psychologists sought the ability to prescribe drugs to treat anxiety, depression, attention deficit disorder and other mental and emotional illnesses, but not narcotics.

If House Bill 3523 had passed, Oregon would have become the third state, after New Mexico and Louisiana, to give psychologists this privilege. A psychologist would have been required to have a master’s degree in clinical psychopharmacology, clinical training in physical assessments, pathophysiology, psychopharmacology and clinical management, and at least one year of experience in a mental health setting.

The bill had a $290,000 fiscal impact, and came under fierce opposition from the Oregon Pediatric Society, the Oregon Psychiatric Association and the Oregon Medical Association.

Questioning whether psychologists had the proper scientific training in the practice of medicine, and subsequent concerns about patient safety became the main points of opposition.

John McCulley, the lobbyist for the Oregon Psychiatric Association, said those concerns won the day. “There were a number of legislators who were concerned about the measure,” he said. “The bill didn’t have enough votes to move forward.”

It’s unknown whether the Oregon Psychological Association will reintroduce this measure next February since they did not return a call for comment.

ZoomCare Bill Didn’t Pass

Scope of practice bills received a fair amount of contentious debate this session (one scope of practice bill relating to dental hygienists, in particular).

Senate Bill 952 was one such bill that didn’t make it out of the Ways and Means Committee. It would have allowed supervising physicians to petition to the Oregon Medical Board to let their assistants dispense medications. It also would have removed a provision requiring the Oregon State Board of Nursing to grant dispensing authority to nurse practitioners only in circumstances where there’s a lack of pharmacy services.

ZoomCare, which operates eight health clinics in the Portland metropolitan area, was the major proponent. Dr. David Sanders, its CEO, believed the legislation would make it easier for patients to receive medications, including antibiotics, ear drops and muscle relaxants rather than have to stop by a pharmacy.

“We were under the impression up to the day before the end of the session that it was going to move,” said Len Bergstein, ZoomCare’s lobbyist.

Bergstein had expected the bill to pass with broad bipartisan support, but was stopped by Rep. Jim Thompson (R-Dallas), who a former executive director of the Oregon Pharmacists Association.  

The bill will be back in February. “Sometimes, a good idea takes to sessions,” Bergstein said.

Drug Purchasing Consolidation Fails

Senate Bill 962 would have required all state agencies to purchase prescription coverage through the Oregon Prescription Drug Program unless they could purchase them at a cheaper price elsewhere.

The Oregon Prescription Drug Program (OPDP), created in 2003, consolidates the purchasing power of the Oregon Educators Benefit Board, SAIF, and Oregon Health & Science University, serving more than 350,000 people.

Such a program has resulted in cost savings, according to Tom Burns, director of pharmaceutical programs for the Oregon Health Authority. “We think there’ll be savings for many agencies around the state that buy drugs,” he told the Senate Health Care, Human Services and Rural Health Policy Committee.

The bill was expected to have a fiscal impact, but such a statement was never prepared because the Ways and Means Committee never gave the bill a hearing.

No Expansion of Autism Coverage

Senate Bill 555 sought to make significant changes to coverage of screening for, diagnosis of, and treatment for autism spectrum disorders, which include a range of developmental disabilities affecting a person’s communicative, cognitive and physical capabilities.

Insurance companies would have been prohibiting from terminating a child’s health coverage solely because the child had been diagnosed with such a disorder. Additionally, health plans would have been required to cover a type of treatment called ‘applied behavioral analysis.’

“This is a huge step forward” in how autism is treated, said Sen. Alan Bates (D-Ashland) during a Senate hearing.

But with a $13.3 million fiscal impact, the bill never moved out of the Ways and Means Committee.

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Comments

Oregon was only one of seven states in which the American Psychological Association's national campaign for prescription privileges failed this year alone. In its 16 years, APA's campaign has seen 162 bills fail. There is a reason why 26 legislatures have said "NO" so many times. We psychologists who oppose this campaign for its low standards of training, low regard for safety and low opinion of the complexity of practicing medicine would like to urge the Oregon Psychological Association to assert its independence from APA and stop acting as its surrogate. APA has used state organizations as stand-ins to the detriment of the local organizations and the mental health systems of the states. APA pays for lobbyists through funding the state organizations, having them do their work for them and pretending to be a "grass roots" movement. APA wrote Oregon's bill in Washington, just as it has for all the other 25 states. It also wrote the curriculum for the inadequate training. APA created the "national test" graduates of their training take, and APA decided on the cutoff for passing the test. The training is sold by private schools administered by current and former APA officials working hand-in-glove with the APA. This bill and all the others are a wholly owned production of the American Psychological Association. It is APA that would benefit the most from such bills. Two thirds of APA's revenue is from publications, and drug companies purchase thousands of pages of expensive advertisements in medical journals. Drug companies sponsor activities and buy expensive booth space at conventions. It is time for OPA to think of what's best for Oregon's psychologists and its people, and not just dance to the tune played at APA's Washington DC headquarters. There are far safer and more effective alternatives to help Oregonians get good mental healthcare that includes medication. APA and its puppet organizations dare not consider those for fear it would undermine their campaign for more money and political power. It's time for OPA to cut the strings and do what's best for Oregonians.

there will be no health care reform until and only until the public sector has to pay half or more for their coverage and endure 20% + increases every year. fact