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Improved Oregon revenue forecast could fund health care improvements

Behavioral health, coverage, workforce loom large on the laundry list of unmet requests facing state lawmakers. A legislative impasse could keep them from going anywhere despite the availability of new funds.
The Capitol Building in Salem. | JAKE THOMAS/THE LUND REPORT
May 18, 2023

This article has been updated with  additional comment from lawmakers.

A new revenue forecast means Oregon lawmakers will have more money available to fill gaps in the state’s underdeveloped behavioral health system, maintain insurance for low-income Oregonians and widen the health care workforce training pipeline, among other competing requests..

State economists on Wednesday wrote in their updated revenue forecast that “available resources are expected to be up sharply” compared to their set of predictions issued in March. 

Oregon tax revenues exceeded earlier projections by $1.9 billion for the current two-year budget cycle, according to the forecast. The stronger than expected tax revenue will mean Oregon’s upcoming 2023-2025 budget will end with $2.9 billion in reserves. Those reserves “are larger than Oregon has been able to accumulate in past cycles, and should help stabilize the budget when the next recession hits,” reads the forecast.

If legislative leaders can resolve the impasse in the Oregon Senate, that money could change the fate of some bills and programs.

The Legislature’s health care committees have approved a series of ambitious bills that seek to train more medical workers, expand community behavioral treatment settings, clear admissions logjams at hospitals and others. 

But many of those bills have price tags and have remained parked in the Joint Ways and Means Committee, the Legislature’s key budget-writing panel. With the new forecast in hand, lawmakers will determine which funding requests to include in the state’s new two-year budget they’re expected to finalize before adjourning late next month. 

State Sen. Deb Patterson, a Salem Democrat who chairs the Senate Health Care Committee, told The Lund Report that the forecast was “certainly encouraging.”

“I’m hopeful that most, if not all of those bills, will be able to be funded, at least to some degree,” she said. “I know some of the asks are large, but they’re really critical.”

Some of those larger asks include: 

  • $81 million for behavioral health worker training. 
  • An estimated $271 million is needed for nearly 600 residential beds to treat Oregonians with substance use or mental health disorders.
  • $74 million for behavioral health programs and others. 
  • $40 to train more nurses and other health care workers. 
  • $20 million to train more dental hygienists and assistants. 

State Reps. Hai Pham and Cyrus Javadi, dentists who sponsored the dental workforce training, told The Lund Report
reacted cautiously to the forecast. 

In a joint statement to The Lund Report, the bi-partisan lawmakers wrote that "it’s still too early to speculate about specific budget decisions, but we plan to keep advocating for this and other oral health priorities." 

"As practicing dentists who have had similar experiences, in different parts of the state, with our oral health workforce shortage, it is critical that we prioritize oral health this session so we can provide much-needed support to our hardworking dental professionals and ensure Oregonians get the oral healthcare they so desperately need," they said in the statement. 

The budget-writing committee is also considering relatively smaller requests. Those include nearly $2 million in the current and upcoming budget to fund a bill that would set up peer-run groups that would reach out to people in the mental health system, informing them of their rights and available benefits, and $3.8 million for a community health pilot program working with low-income families. 

Those smaller requests also include Senate Bill 1079, one of Patterson’s priorities. Hospitals across the state are struggling with capacity issues because of the lack of facilities to discharge patients who’ve been treated but still require lower-levels of care. The situation is straining hospital finances while causing more patients to “boarding” in emergency departments. 

“It’s really gumming up the whole works on everything,” said Patterson. 

The bill would set up a 22-member task force to look at hospitals’ barriers to discharging patients and requests $800,000 from the state’s discretionary general fund. 

The Oregon Health Authority also has costly requests in its proposed $4.2 billion budget.

The Lund Report reported recently that state lawyers had expressed concern that funding could kill an expansion of behavioral health clinics that would ease the capacity crisis at the Oregon State Hospital.

State Rep. Rob Nosse, a Portland Democrat who chairs a key health care panel, told The Lund Report in a text that the budget forecast means the state will be able to fund health insurance programs for low-income Oregonians. 

The agency is asking for $397 million to help with federally approved changes that would allow the Medicaid-funded Oregon Health Plan to pay for healthy food and affordable housing for low-income Oregonians. It’s also asking for $268 million to keep Oregon Health Plan members insured as the state redetermines who is eligible for the program after a pause during the pandemic. 

But both Nosse and Patterson said that none of these bills can pass until the Senate Republicans end a walkout that’s stalled the chamber’s business. Republican senators launched the walkout as a protest over abortion rights and gun control legislation.