Before a Republican walkout halted the Oregon Senate’s ability to pass legislation, lawmakers passed roughly two dozen health care-related bills intended to remove red tape for patients seeking care, change pharmacy practices and achieve other goals.
While major pieces of health care legislation have been caught up in the impasse over what Republicans call a failure to compromise, many health care bills that didn’t carry a price tag or attract controversy quietly sailed through the Legislature with bipartisan support to the governor’s desk.
These bills flew under the radar during a session that was dominated by talk about hospital staffing, workforce challenges, rising opioid use and behavioral health. The approved bills bring state law in line with federal regulations or make other technical adjustments. They also allow hospitals to send unwanted drugs to incinerators.
Their success comes in contrast to other health care-related legislation that piled up in the budget-writing committee while awaiting the state’s revenue forecast. Those bills and others may falter after a group of Senate Republicans and Independents announced last week they’ll deny the chamber a quorum until the session’s last day to protest majority Democrats’ legislation on abortion, transgender health care and guns.
Though Republicans have offered that day to pass bipartisan legislation, Senate President Rob Wagner, D-Lake Oswego, has said he won’t allow the other party to effectively veto bills despite lacking the votes to stop them in a floor vote.
Making commercial insurers pay
Among the surviving legislation lawmakers passed and Gov. Tina Kotek signed are bills that seek to prevent private insurers from blocking patients from accessing medical treatments, services and devices.
Senate Bill 232 updates state law to allow out-of-state physicians or physician assistants to care for Oregon patients. The bill passed both chambers overwhelmingly and updates Oregon law to reflect the rise of telemedicine during the pandemic.
Senate Bill 628 mandates insurers cover a treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. The legislation follows years of advocacy from parents of children with rare conditions the medical establishment has been slow to recognize.
Known by their acronyms “PANDAS” and “PANS,” the conditions are marked by children who display obsessive-compulsive behavior or sensory problems after streptococcal infections.
The bill requires commercial insurers to cover three months of intravenous immunoglobulin therapy after less-intensive treatments weren’t effective. Insurers can require children to be reevaluated afterward.
“We must do our part to dismantle health inequities, especially those affecting children and their right to needed health care,” state Rep. Dacia Grayber, D-Tigard, said in a floor speech earlier this month.
She recalled how the family of a child with the disorder told her they paid $60,000 out-of-pocket after their insurer denied the treatment. She noted how over 4,000 children are estimated to suffer from the condition in Oregon and how the Medicaid-funded Oregon Health Plan approved coverage of the treatment last year.
The Legislature overwhelmingly passed Senate Bill 463, its latest attempt to stop insurers from requiring prior approval for proton beam therapy, a costly and controversial cancer treatment that’s grown in popularity.
Oregon patients with amputated limbs will have easier access to prosthetic and orthotic devices with the passage of Senate Bill 797. The bill requires insurers to cover devices that providers have deemed medically necessary to support patients’ routine activities.
Pharmaceuticals and psilocybin
Expanding training for Oregon’s pandemic-depleted health care workforce has been one of the most broadly supported goals of the legislative session. Multiple bills intended to streamline the training of nurses, dental assistants, behavioral health workers and others drew support early on but now face uncertainty.
Before the Senate ground to a halt, it passed Senate Bill 410. The bill changes how the Oregon Board of Pharmacy provides temporary licenses to pharmacy technicians who haven’t obtained their national certifications. It allows the board to issue only one temporary license to a pharmacy technician before they acquire their national certification.
The United Food and Commercial Workers Local 555, Oregon’s largest private sector labor union, backed the bill, arguing it will incentivize pharmacies to invest in more training for pharmacy technicians and lead to better-paying jobs.
Madison Walters, the union’s political liaison, told the Senate Health Care Committee in written testimony that the board allowed pharmacy technicians to keep renewing their temporary licenses because of staffing shortages.
She said that arrangement “disincentivizes workers and their employers from investing in training programs and pathways to certification, instead placing the burden on current employees to train and prepare the new workforce.”
“The lack of training has also increased safety concerns and led to a lower standard of care for many patients,” she said.
The Senate standoff has thrown into limbo three bills intended to tighten regulations around pharmacy benefit managers, companies that negotiate drug prices on behalf of insurers and critics say are hurting pharmacies and patients.
Brian Mayo, executive director of the Oregon State Pharmacy Association, told The Lund Report the three bills are critical to keeping what he calls Oregon’s dwindling pharmacies open.
However, the Legislature passed Senate Bill 608, which Mayo called a related but less impactful bill. The bill directs the health authority to survey retail pharmacies every three years on the costs of dispensing drugs.
Backers of the bill, which has passed both chambers, argue it will spotlight the high price pharmacies have to pay for prescription drugs.
The Legislature also passed Senate Bill 303, a controversial measure that’ll collect demographic data on the use of Oregon’s landmark law allowing adults to use psilocybin in supervised settings.
The bill requires psilocybin service centers to file quarterly reports with the health authority on race, gender, age, income, disability status and other sensitive client information.
Accessing Oregon’s psilocybin law is expected to cost thousands of dollars. Supporters say the bill will highlight whether whiter and more affluent clients are primarily accessing the new law. Opponents say it will add to the administrative burden that’s driving costs and will turn off clients concerned about the data collection.