House Votes to Give Homeless a Path to Free Birth Certificates

The House passed a bill that will allow the state records division to stop charging homeless people for their birth certificates. Three other bills go to Gov. Brown, protecting patients from surprise billing, putting DCO members on CCO boards and banning whip-its for minors.

The Oregon House voted for a measure that will allow Oregon-born homeless people to get free birth certificates, a critical starting point to receiving government assistance, earning a GED and getting ahead in life.

House Bill 2402 sets up a $50,000 fund in the Oregon Health Authority that the Center for Health Statistics can tap when social service organizations request a birth certificate on behalf of a homeless person. It now must be passed by the Oregon Senate before becoming law.

The fund will allow the records division to waive the fee for these groups and individuals.

“A lot of our homeless community members want to better their lives, and to do that they need their ID,” said Rep. Teresa Alonso Leon, D-Woodburn, a freshman legislator who has worked as a GED instructor. She sponsored the bill along with Rep. Cedric Hayden, R-Cottage Grove, Rep. John Lively, D-Springfield, and four other House Democrats.

Though it perhaps should not have been so hard for legislators to tell their own government to stop charging indigent people for the right to prove who they are, passing HB 2402 proved a convoluted road.

The Oregon Health Authority wanted to cover administrative costs for means-testing the applicants and the Center for Health Statistics has used profits from selling birth certificates at $25 a pop to fund its work, since it receives no support from the general fund.

Sen. Jackie Winters, R-Salem, said another hitch was outsourcing much of this work to a private vendor, which wouldn’t just print off more copies the way a state subsidiary might.

In the end, the deal allows for the free copies without making the Center for Health Statistics forfeit any of its funding. Nonprofit and local government groups will have to apply on behalf of the homeless individuals, and the state may decide to charge them a nominal fee.

HB 3030

In other business, the House gave final passage to a number of other health-related bills, banning whip-its for minors, requiring coordinated care organizations to have a member of a dental care organization on their governing boards and passing a balance-billing law that will stop providers from billing patients when they unwittingly go outside their insurance network to get care. These bills now go to the governor.

The whip-it bill was brought forward by a group of Cottage Grove high school students and sponsored by their legislator, Republican Rep. Cedric Hayden. Whip-its are canisters of nitrous oxide which are intended to be used for spreading whipped cream or filling up balloons, but are instead readily abused by youth to get high. “It can cause brain damage,” Hayden said.

House Bill 3030 first passed the House with a bar on whip-it sales set at age 21 and a steep maximum penalty of $6,250 and a year in jail for anyone caught selling to underage people. But the Senate moderated the bill, lowering the age to 18, allowing only a fine of $2,000 and eliminating the possibility of jail for convictions.

HB 2882

The dental law, House Bill 2882, was also from Hayden, and backed by Advantage Dental. It had passed the House unanimously earlier this session but Moda Health,CareOregon and the Coalition for a Healthy Oregon sprang on the bill in the Senate, trying to avoid sharing power with the dentists.

Their efforts were largely brushed aside, but a minor compromise eliminates a nominating process for the DCOs, giving the CCOs the full authority to pick whomever they like from any DCOs providing care to their members. The final compromise passed both chambers unanimously.

Advantage Dental CEO Mike Shirtcliff, who had fought for years to get proper dental representation on the quasi-public governing boards for the state Medicaid plans, said he was pleased with the final bill.

HB 2339

The House also passed, 47-10, the final version of House Bill 2339, which ends the practice of “surprise billing,” in which hospitals and physicians seek an often-inflated payment from patients when the insurance company doesn’t pay, because unbeknownst to the patient, some of the providers do not have a contract for the right health plan.

The first version of HB 2339, which passed the House in April on a mostly party-line vote, set a prescriptive payment for these providers, pegged to Medicare prices, but physicians successfully fought this recourse off in the Senate, arguing that it would discourage health insurers from giving them fair contracts.

The compromise forces insurers and uncontracted medical providers to work out a payment on an ad-hoc basis and sets up a work group to suggest legislative solutions for 2018 that might reach a more certain outcome of these disputes. If no bill passes next year, the ad-hoc situation will continue -- but billing the patient will still have to stop.

“All of us agree we need to take the balanced billing out of the hands of the patient,” said Sen. Tim Knopp, R-Bend, when the final version of the bill was announced in May. “I’m fine having the insurers and providers fight out the rate.”

The Oregon State Public Interest Research Group lauded the Legislature for coming through with a law that Gov. Brown can sign that protects patients, even if it leaves a dispute between physicians and insurers:

“We believe that consumers who do everything that can reasonably be expected of them should not be left on the hook for inadvertent and often unavoidable out-of-network charges,” said policy director Jesse O’Brien, in a blog post. “Consumers should be held harmless in these situations and should not be required to pay more than the in-network rate. HB 2339 will provide that necessary protection for Oregon consumers.

“Today, without these protections, Oregonians who do everything right often have no recourse when they receive a giant bill they could do nothing to avoid. This status quo is unjust and unacceptable.”

Reach Chris Gray at [email protected].

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