Lawmakers Go Down To Wire On Health Care

The Oregon Legislature ended its session on Sunday after a marathon weekend in which it passed several health care bills, including one that went down to the wire.

The tobacco tax bill, which squeaked through on a party-line vote on Sunday evening, is one of Democratic Gov. Kate Brown’s sandbags to fill a $950 million two-year funding gap for Medicaid, which serves nearly 1 million Oregonians.

In a press conference on Monday, Brown said, “Oregon has long been a leader in health care access” but that “to continue to improve access across the state we needed a longer term, more sustainable funding source.”

Part of her solution is House Bill 2270, which squeaked through an hour before the session ended, on an 18 to 8 vote, with Republicans opposed. The Oregon Constitution requires a three-fifths vote - in the Senate that’s 18 votes - to approve new taxes.

The bill includes an increase in the tax on cigarettes from $1.33 to $2 a pack and the creation of an e-cigarette tax. Backers predict it will raise $340 million between 2019 and 2021. It comes with a caveat, however. The bill had stalled for months and looked like it was dead until it was revived in mid-June with the addition of a mandate that it goes before voters in the next general election -- which will be in November 2020. 

Still, Brown thanked lawmakers for its passage. 

“We have made the progress we needed to prevent families from living in fear that their health care will be ripped from them,” Brown said.

In addition to the state tax, there’s a federal tax of $1.01 per pack. The Oregon tax hike will boost the average cost of a pack to about $6.36.

Another pillar of Brown’s Medicaid funding plan, House Bill 2010, breezed through the Legislature in February. It authorizes a six-year tax on hospitals and insurance premiums and is expected to raise about $430 million.  

But lawmakers rejected Brown’s other funding proposal in May. House Bill 2269 would have required large employers who don’t pay for health care for their staff to start contributing either by paying for medical services directly or by contributing to a health care fund. It was expected to raise $120 million.

Nevertheless, Rep. Andrea Salinas, D-Lake Oswego and chair of the House health care committee, said the session ended with lawmakers closer to their goal of ensuring stable Medicaid funding.

“The biggest challenge for us was making sure that we were able to fund Medicaid,” Salinas said. “We are part of the way there.” 

Besides the tobacco tax, lawmakers approved two other key health care bills on Sunday. Senate Bill 770 will set up a task force to study universal health care, and House Bill 2005, which Brown called “icing on the cake” of this year’s session, creates paid family and medical leave. 

Senate Bill 770, which includes study of a Medicaid buy-in proposal from Salinas, passed the Senate with an 18-9 vote and then cleared the House with a vote of 37 to 18.  The bill authorizes a task force to hold statewide hearings on universal health care. The group will have until February 2021 to come up with recommendations for the state.

It will be up to the Legislature to decide the key elements of a universal health care system, including funding and how to treat the commercial health insurance market that covers private-sector employees and individuals.

House Bill 2005 sets up a program of 12 weeks of paid leave for parents of newborns or for a child placed through adoption or foster care. The bill also provides for paid time off for a personal or family member’s serious illness or allow an employee time to recover from a trauma like a sexual assault. The program will be financed by employer and employee contributions into a state-managed insurance fund. Companies with less than 25 employees will be exempt from participating.

On Saturday, the Legislature passed the Oregon Health Authority Budget, Senate Bill 5525, with a  25 to 2 vote in the Senate and then a 41 to 10 vote in the House. The $23.1 billion budget for the 2019 to 2021 biennium includes $31.6 million for behavioral health care, with $10 million of that dedicated to counseling and suicide prevention in schools. Earlier in the session, the Legislature passed three bills to curtail student suicides. Senate Bill 52, also known as Adi’s Act, requires each school district to create a suicide prevention plan; Senate Bill 707 creates a state advisory committee to study reducing suicides of young Oregonians; and Senate Bill 918 directs local mental health officials to alert educators, juvenile authorities, drug and alcohol treatment providers and others about a suicide in hopes they can help prevent other young people from following suit.

The budget also includes $10 million for public health modernization and $2.9 million for nurse visits to the homes of newborns or parents of newly adopted children. Senate Bill 526, which passed Thursday, aims to help new parents navigate the basics, including breastfeeding and sleep issues.

Rep. Andrea Salinas
Lawmakers passed another health care bill on Saturday -- House Bill 3273, which cleared the Senate with a unanimous vote. The bill will force prescription drug makers to fund take-back kiosks in every city in the state. In introducing the bill, Sen. Elizabeth Steiner Hayward, D-Beaverton, said: “It will help take prescription and nonprescription drugs that not being used out of the hands of children and keep them out of the water and soil.”

Though leading Democrats hailed the session, Salinas acknowledged that they failed to achieve some ambitious objectives on the health care front, including cutting the cost of prescription drugs to consumers by purchasing drugs from Canada. 

“This idea is not dead,” Salinas said. “We want to provide more relief to consumers at the pharmaceutical counter.”

You can reach Lynne Terry at [email protected].

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