After a series of public forums the Oregon Health Authority is left with strong public engagement but little direct mandate
$righthorizontal$September 16, 2010 -- This time last year, a series of town hall meetings would have garnered far different reactions than the cordial tones state officials have encountered recently in a series of public forums around the state about healthcare reform.
The five public forums – one more tonight in Bend
– focused on a specific part of the Patient Protection and Affordable Care Act: forming a state-based health insurance exchange where consumers can shop for health plans and take advantage of subsidies.
Meetings to solicit public input in Baker City, Florence and Corvallis filled the rooms to capacity, as did the 300 people who showed up in Portland on Monday evening, Sept. 13.
“We’re getting really good feedback,” said Tina Edlund, deputy director for the Oregon Health Authority, which is leading the sessions and will ultimately make a policy recommendation to the 2011 Oregon Legislature. “The conversation has been civil and smart and engaging.”
Forming a state-based health insurance exchange – what amounts to an on-line marketplace for health insurance – was mandated by Congress. But many of the details are still left up to individual states.
The Department of Health and Human Services will determine the basic benefits package that insurers must follow to participate in the exchange, but major questions have been left to state officials such as whether insurers should be allowed to sell individual and small group plans outside the exchange or whether the exchange will delve into hospital and physician charges.
At Monday’s meeting participants were asked how many health plans people should reasonably be offered.
“I think people are glad there are still decisions to be made,” Edlund said. “The federal government left us with some options so we could craft something that was very state specific.”
Board members are hearing a wide array of comments that fit the complexity of the healthcare system and the many problems that abound. Affordability is, of course, a prime concern as well as making available information based on quality. Others are urging the board to require insurers to cover alternative medicine, while some prefer a more free-market approach.
Some, such as Ruppert Reinstadler, an insurance broker, doubt the insurance exchange will make much of a difference.
“Every agent out there has an exchange per se where you can go on-line and look at all the plan comparisons,” Reinstadler said. “So the idea that you are going to put together another bureaucracy in a time when we have so little money to spend anyway. This duplication issue drives me nuts.”
Reinstadler wisely pointed out that making health insurance affordable depends on lowering costs, which neither the federal law nor state reform efforts have sizably tackled.
“Basically everybody is paying for the same services from the same providers,” Reinstadler said. “So how can you take any cost out of that system until you get them to lower their cost.”
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