Basic Health Plan Discussion Focused on Policy Paper by December

House Bill 2934 has been downsized from a directive to the federal government to a work group discussion that will flesh out the policy and further inform the debate for the Legislature in 2016. Advocates say the move will not delay the potential implementation of a health plan for immigrants and working-class Oregonians in 2017.

The state took a baby step towards implementing a Basic Health Plan, which would provide healthcare for thousands of legal immigrants left uninsured by Obamacare and tens of thousands of low-income people who currently qualify for subsidized health insurance on the exchange.

The House Health Committee passed HB 2934 on Monday by a 7-1 vote with just Rep. Knute Buehler, R-Bend, opposed. The bill heads for the House floor next week.

The bill is pared back from its original version, which tasked the Oregon Health Authority with submitting a blueprint to the Centers for Medicare and Medicaid regarding the state’s plans to implement the new health program, which would cover people up to 200 percent of the federal poverty line who are not already receiving care through Medicaid or the Children’s Health Insurance Program, as well as women who receive Medicaid because they’re pregnant.

The modified HB 2934 directs the Oregon Health Authority to call together stakeholders, including legislators, consumer and low-income advocates, healthcare providers and health insurers, and tasks them with shaping policy around the potential new health plan and reporting back to the interim health committees in December.

The downsized bill disappointed Rep. Alissa Keny-Guyer, D-Portland, who was ready to move forward with funding for a more detailed plan as intended, but Rep. Mitch Greenlick, D-Portland, said he was satisfied with the modified bill: “The hope is this process will get us answers to the questions we have in policy decisions.”

John Mullin of the Oregon Law Center, which advocates for low-income residents, told The Lund Report that he supported the amended version because it can be passed without a special budget appropriation and discussion between the state agency and the federal government would not likely be completed by the February 2016 legislative session. He said it would not delay Oregon adopting a Basic Health Plan.

A Basic Health Plan would likely be administered through an expansion of the scope of the coordinated care organizations that now serve Medicaid members on the Oregon Health Plan. The program would largely funded by transferring the money now given to insurance companies to subsidize private insurance, while providing richer coverage than what’s available on the exchange.

The plan would exclude eligible people from the exchange, drawing opposition from the Oregon Association of Health Underwriters, which represents insurance agents, who earn a commission when they assist consumers who purchase subsidized private insurance policies on the federal exchange.

Estimates from an Urban Institute and Wakely Consulting study estimated the state’s cost at  $25 million a year, although much of that could be made up through small premiums charged to consumers, or possibly money from the hospital provider tax.

The discussions generated by the work group could flesh out the policy around a Basic Health Plan and offer the Legislature a bill to consider in 2016, with the program getting underway on Jan. 1, 2017, said Joseph Santos-Lyons, the executive director of the Asian Pacific American Network of Oregon.

“We have been working for many years to get all of our community covered,” Santos-Lyons said. “We’ll have the information we need to implement a full basic health plan program.”

Justice for Islanders

Santos-Lyons represents a particularly aggrieved group of Oregonians -- islanders from the South Pacific, whose native countries have treaties with the United States giving them free immigration to the U.S. The treaties are a result of heavy U.S. military involvement and occupation during World War II, followed by the use of some islands as atomic testing sites.

Several islands, including Bikini Atoll, are among the most hazardous places on Earth, and no longer inhabitable. Oregon has the largest population of people from the affected islands in the United States, with several thousand living in the Salem area.

This group of people once qualified for Medicaid, but federal budget control acts passed in 1996 barred adult islanders from receiving ever receiving Medicaid. They are also restricted from the federal student loan program.

Santos-Lyons told The Lund Report that Rep. Brian Clem, D-Salem, was going to bat for this population with House Bill 2522. That bill, set for a vote in the House Health Committee on Friday, would create an Islander Health Coverage Assessment Gap Office at the Oregon Health Authority, but Clem is working to augment the bill with state funding to restore health benefits for islanders who would otherwise qualify for the Oregon Health Plan, which is capped at 138 percent of poverty. The Basic Health Plan would cover them to 200 percent of poverty, and could apply if funding is not found.

Editor's Note: The original article incorrectly stated the Medicaid eligiblity for natives of island nations that have signed the Compact of Free Association. Adults from these islands are never allowed to receive Medicaid with federal funding, but they could benefit from state funding or the Basic Health Plan.

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