The drive toward a Basic Health Plan for working-class Oregonians leaped over its first hurdle, as House Bill 4109 passed out of the House Health Committee 7-1 on the first day of the 2014 session.
HB 4109 calls for the Oregon Health Authority to study the option of a “Basic Health Plan” for Oregonians who earn less than 200 percent of the federal poverty level but don’t qualify for the state’s Medicaid program, the Oregon Health Plan.
The Basic Health Plan is an optional provision for states under the Affordable Care Act, and it’s modeled after a program in Washington state. The health plan would be paid for with the subsidies that would otherwise go to this population in Cover Oregon.
“This is simply a study bill. We have no preconceived notion that it’ll be the right tool for Oregon,” said John Mullin of the Oregon Law Center, who is leading a coalition of groups that advocate for low-income Oregonians and immigrants.
Advocates have pushed for the concept because many low-income Oregonians who buy plans on Cover Oregon are often faced with a health plan that has either a high monthly premium or high deductible, even with the subsidies. A state-run plan, possibly administered through coordinated care organizations, may be able to provide a simple health plan for the same amount of money and at less cost to the consumer.
Rep. Brian Clem, D-Salem, said he hoped the plan could show a way that the working poor could pay $50 or less a month in premiums. The income ranges to qualify for the plan would be $16,000 to $23,000 for single people and $33,000 to $48,000 for a family of four.
The Basic Health Plan would also cover all legal residents up to twice the poverty line, including recent immigrants barred from receiving the Oregon Health Plan.
HB 4109 was opposed by Rep. Jason Conger of Bend, who is campaigning for the Republican nomination for the U.S. Senate. He said he opposed the study because he disliked the idea of locking this population into one plan instead of giving them multiple options on Cover Oregon.
“Health insurance market is in a place of transition and disarray,” Conger said. “I’m completely unconvinced that the Basic Health Plan is a good solution in the long run.”
His concerns echoed the remarks of lobbyist Doug Barber, who spoke for the Oregon Association of Health Underwriters, which is comprised of health insurance agents. He noted that when the state Family Health Insurance Assistance Program gave parents the option of receiving free health coverage through the Oregon Health Plan or paying a premium for subsidized private insurance, they chose to pay.
Nobody could be forced to sign up for the Basic Health Plan, but people would likely no longer qualify for Cover Oregon subsidies to purchase a private insurance plan.
The other Republicans on the committee supported the study bill, including Rep. Jim Thompson, R-Dallas: “We don’t know what the right course is,” he said. “It’s not something we’re funding eternally.”
“I find this information is useful,” said Rep. Mitch Greenlick, D-Portland, one of the leading supporters of the study. But he said he was concerned about what effect the Basic Health Plan’s implementation might have on Cover Oregon: “I fear that the Basic Health Plan would destabilize the exchange. It may affect the financial viability of the exchange.”
HB 4109 now heads to the Joint Committee on Ways & Means, which must come up with $60,000 to enact the law and study the Basic Health Plan, according to an estimate from the health authority. The cost of the bill will likely be vetted by the Human Services Subcommittee, chaired by Sen. Alan Bates, D-Medford.
“OHA is doing pretty well with their budget. We may have the money for it,” Bates told The Lund Report, but he admitted he knew little about the bill or the Basic Health Plan on the first day of the session.
He said the Basic Health Plan sounded like an idea he would support, if the administration of the plan could be turned over to the coordinated care organizations, who operate the Oregon Health Plan on a local level.
“The CCOs have to be in control, otherwise we have no cost controls,” Bates said. “I’m not interested in running an insurance plan.”
Christopher David Gray can be reached at [email protected].