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Oregon House Passes Cover Oregon Reforms on 56-2 Vote

Update: This article has been updated to reflect the passage of HB 4122 and SB 1582, as well as decisions from the federal government regarding changes in health insurance policy. Rep. Betty Komp, a Woodburn Democrat and the House Speaker Pro Tempore, added a personal touch as she explained the need to make Cover Oregon work.
March 5, 2014

Update: This article has been updated to reflect the passage of HB 4122 and SB 1582, as well as decisions from the federal government regarding changes in health insurance policy.

Rep. Betty Komp, a Woodburn Democrat and the House Speaker Pro Tempore, added a personal touch as she explained the need to make Cover Oregon work.

She said she grew up poor, and went without health insurance for 40 years. She put herself through college rather than have surgery to remove a lump from her breast -- which, thankfully, was non-cancerous.

“People who live in poverty, they don’t have healthcare. … Those are the decisions they have to make,” Komp told her colleagues.

“Has Cover Oregon been a debacle? Inequivocally,” Komp said. “We can’t give up on this because technology has not been our friend. Our policies were well-intended.”

Komp urged her colleagues to support House Bill 4154 drafted by Rep. Shemia Fagan, D-Clackamas, which directs the executive branch to seek federal waivers to extend the open enrollment for Cover Oregon through April, seeks federal subsidies for qualified consumers and small businesses who shopped outside the exchange; gives whistleblower protections to Cover Oregon employees; and allows Democratic Gov. John Kitzhaber to wipe clean the board members of the exchange.

HB 4154 heads to the Senate after passing out of the lower chamber on a 56-2 vote Tuesday afternoon. Kitzhaber praised its House passage in a written statement: “The roll-out of the Cover Oregon website has not met our expectations, but it hasn’t shaken our belief that everyone across the state deserves quality health care at an affordable price.”

Last week, the federal government allowed consumers to retroactively receive tax subsidies if they purchased qualified health plans from outside insurance exchanges like Cover Oregon. The other implements of HB 4154 will still need a waiver from the U.S. Health & Human Services Department.

The section extending the open enrollment period through April appears to be moot after the federal goverment announced Wednesday that it will not extend the March 31 deadline, according to Kaiser Health News.

A separate measure, which funded the extension of the high-risk pool for people who were refused insurance coverage because of pre-existing conditions, will be funded through a different bill, Senate Bill 1582.

The Senate passed SB 1582 on Wednesday with a 24-6 vote, funding the high-risk pool through the end of March. That bill had an amendment that would encouarge the Insurance Division to let people keep their substandard, pre-Obamacare plans for up to four more years, if the Obama administration approves. On Wednesday, White House officials said they would extend such plans through 2016.

Most Republicans supported SB 1582, but it did not escape charged comments from Sen. Tim Knopp, R-Bend, who said many of the people left in the high-risk pool were "illegal people," who didn't qualify for other insurance because of their immigration status. "We need to repeal and replace Obamacare with a market-driven system," Knopp said.

Despite all the problems of Cover Oregon, Knopp and Komp’s remarks cast sharp light on what may have happened had Kitzhaber not been elected governor in 2010.

Because Kitzhaber embraced the Affordable Care Act, poor women in her former situation can now receive Medicaid. If Republicans had been in power, Oregon could easily have rejected the federal dollars that have expanded the Oregon Health Plan to those whose earnings fall below 138 percent of the federal poverty line.

In other states, even some with progressive traditions, like Wisconsin and Maine, right-wing governors have refused federal money that would expand Medicaid to their poorest residents. Republican Gov. Scott Walker not only turned down billions in federal Medicaid dollars out of partisan spite, he has worked to dismantle BadgerCare, which provided a public healthcare option to Wisconsin’s working poor above the poverty line.

Meanwhile, in Oregon, at little to no extra cost to the state, 223,000 new people have been added to the rolls of Medicaid and are now part of the state’s 16 coordinated care organizations. The billions in federal investments that come from the Medicaid expansion will pump enough money into the state economy that the state is expected to actually save $79 million through increased tax revenue, according to an economist at Oregon Health & Science University.

An additional 39,000 people have signed up for subsidized private insurance through the crippled Oregon exchange. The state is punching slightly above its weight nationally in Affordable Care Act enrollment numbers.

The vast majority of Oregon House Republicans, including U.S. Senate candidate Rep. Jason Conger of Bend, supported HB 4154 as a way to fix critical errors, even as they excoriated the state’s bumbling rollout of the private insurance portion of Obamacare and Kitzhaber’s steps to correct its course.

“We are left shooting in the dark,” Conger said. “We’re left without information that we need such as what’s already been requested.”

Kitzhaber’s spokeswoman, Nkenge Harmon Johnson, told The Lund Report that the governor had already asked the Obama administration to extend the open enrollment period for Cover Oregon an additional month, to April 30.

Rep. Julie Parrish of West Linn was one of two Republicans to oppose HB 4154. She protested two key reforms that were left out. She wanted to give authority to Secretary of State Kate Brown to conduct her own audit of Cover Oregon, and was against expanding Kitzhaber’s authority to fire the entire Cover Oregon board.

“I don’t think the executive branch needs that authority,” Parrish said. “The executive branch failed to execute Cover Oregon.”

House Republicans saved their stand to oppose House Bill 4122, which mandates a new set of safeguards for future large state information technology projects, including widely distributed reports from a third-party oversight contractor. 

Rep. Paul Holvey and Rep. Nancy Nathanson, both Eugene Democrats, made a number of changes to an earlier version of HB 4122, specifying that state agencies are subject to third-party review of information technology projects, not just private contractors like Oracle.

Their additional work was in response to earlier Republican protests that HB 4122 was inadequate, resulting in a 40-18 vote last month. The vote was largely unchanged, at 41-16, although Rep. Dennis Richardson, R-Central Point, a candidate for governor, supported the final version of HB 4122 after leading the previous opposition.

Christopher David Gray can be reached at [email protected].

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