May 29, 2013 -- The Oregon House passed four bills that will move the state in compliance with the Affordable Care Act, which both opponents and champions have come to label informally as “Obamacare.”
As Republican-led states have fought attempts to expand their Medicaid population or implement insurance exchanges, there was little risk of that happening in Oregon. Gov. John Kitzhaber is both a Democrat and a medical doctor.
But Republicans, led by Rep. Tim Freeman of Roseburg, let their opposition be heard, by opposing two of the four crucial bills in large numbers — House Bill 2859, which aligns eligibility requirements for the Oregon Health Plan with the federal Medicaid changes and House Bill 2240, which enables the insurance exchange, Cover Oregon, to comply with federal insurance statutes.
“I just got pretty uncomfortable with the linkage with Obamacare,” Rep. Bill Kennemer, R-Oregon City, told The Lund Report after the vote yesterday. He had supported the bills on the Health Committee, but opposed the two of them on the floor. He said he wanted a more independent, Oregon-based approach, and was concerned about unpredictable price changes in the insurance market.
Kitzhaber’s unwavering support for the Affordable Care Act has allowed government functionaries in the Oregon Health Authority and the Department of Consumer & Business Services to work toward making the transition relatively seamless and less dramatic than other states.
One of the four bills, House Bill 3458 seeks to deal with the price concerns addressed by Kennemer by establishing a state medical reinsurance program, paid for through premium assessments. That program intends to help offset any potential sticker shock as high-needs health consumers enter the individual and small business insurance markets next year.
HB 3458 passed unanimously on Tuesday, although three Republicans — Rep. Sherrie Sprenger of Stayton, Rep. Kim Thatcher of Keizer and Rep. Gail Whitsett of Klamath Falls — initially opposed the reinsurance bill before switching their votes to give the bill consensus.
Although HB 3458 effectively adds a new, three-year surcharge to health insurance premiums, the assessment will be less than current premium surcharges, which help pay for the children’s health program and the high-risk pool, the Oregon Medical Insurance Program, intended for people denied coverage because of pre-existing conditions.
The high-risk pool disappears next year when those people have guaranteed issue through Cover Oregon and cannot be charged higher rates because of their health condition. The special children’s insurance program for lower-middle class families, Healthy Kids Connect, will also come to an end, with those children receiving coverage through the Oregon Health Plan.
Abolishing the Healthy Kids Connect private insurance option and putting them on the Oregon Health Plan will save the state $12 million while at the same time give these children more comprehensive medical coverage. This change was made possible by House Bill 2091, which passed Thursday, with just two Republican opponents — Thatcher and Rep. Wally Hicks of Grants Pass.
Three Republicans — Rep. Greg Smith of Heppner, Rep. Jim Thompson of Dallas and Rep. Jason Conger of Bend — supported all four Affordable Care Act bills.
Conger gave his support because HB 2859 incorporates an earlier measure that he sponsored, House Bill 2638, to promote individual responsibility in the Medicaid population.
“All of our healthcare transformation has focused on external factors that determine healthcare outcomes,” Conger said, despite statistics that show 40 percent of healthcare outcomes are due to lifestyle choices within the person’s control.
This section of HB 2859 directs the Oregon Health Authority to reward money to coordinated care organizations to set up community wellness programs and help people on Medicaid lead healthier lifestyles.
Christopher David Gray can be reached at [email protected].
Image for this story by M.O. Stevens (public domain) via Wikimedia Commons.
