Two Democrats vote 'no' signaling shaky road to House
April 25, 2011 -- The Oregon Senate passed legislation today to create a health insurance exchange without the vote of two Democrats and three Republicans. The bill heads next to an equally divided House.
Senate Bill 99 passed the Senate Monday with 24 votes in favor and one excused. Sen. Suzanne Bonamici (D-NW Portland/ Beaverton), who voted ‘no’ said she strongly supported forming a health insurance exchange, but she had misgivings about certain portions of the bill.
“Small business and individuals will be paying the premiums, but unfortunately it’s lost the support of many of them,” Bonamici said on the floor. “They want it to do something very reasonable, which is negotiate for lower cost.”
Bonamici said the bill prohibits the exchange board from bargaining for lower premiums.
“I hope this comes back from the House in a form that we can all support,” she said.
Sen. Jackie Dingfelder (D-Portland) was the other 'no' vote from a Democrat.
Sen. Chip Shields (D-North Portland) voted ‘yes’ but said he too was unhappy with a provision he characterized as “tying the hands of the board” to negotiate for lower premiums.
Sen. Alan Bates (D-Ashland) defended the bill as a bipartisan compromise. He said the state already has a mechanism for negotiating with insurers through rate review under the Department of Consumer and Business Services.
“The bill doesn’t say the exchange can’t negotiate. It says each company must be treated equally and fairly,” Bates said. “I believe in competition, but when we have more than 100 plans, how they can start negotiating with them is something beyond the scope of the exchange.”
Bates said the exchange won’t be a panacea to what ails the healthcare system, but it could potentially lower premiums by 10 to 15 percent due to current cost shifting that could reportedly be eliminated with an exchange.
Bates also addressed the inclusion of insurance broker commissions that would be paid through the exchange as a substantial reform of the current system of compensating agents. But it wasn’t a detail that drew much support from consumer advocates that wanted brokers left out.
“I’ve got all my friends unhappy with me and all my enemies are unhappy with me,” Bates said. “The bill is probably just about right.”
If Oregon doesn’t pass a bill to create its own exchange, the federal government will impose one.
“My biggest worry is this goes to the House and dies and we are stuck 18 months from now with a federal exchange we can’t make work in this state,” Bates said.
Rep. Mitch Greenlick (D-Portland) who heads the House Health Care Committee had made overtures toward strengthening the exchange bill, but indicated to The Lund Report last week
, he will probably back off.
Beginning in 2014, individuals and small businesses with less 50 employees will be able to purchase health plans through the exchange. It will determine eligibility for federal and state subsidies while serving as the single point of entry for multiple government programs. Starting in 2016, businesses with up to 100 employees will be able to buy coverage through the exchange.
The goal is to create a uniform playing field to compare insurance coverage equally on the basis of cost and performance, offer greater freedom of choice, as well as share risk across the entire market. The bill also calls for an advisory panel and an oversight board made up of legislators.
The legislature must sign off on a final business plan for the public corporation that will administer the exchange at its legislative session in February. Sen. Frank Morse (R-Albany) called this a feedback loop.
“This bill ensures a level of accountability not realized in any past major legislation to come before this body,” Morse said.
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