This year’s legislative session wrapped up with Oregon lawmakers passing a slew of bills affecting health care, including measures to help hospitals, benefit nurses and curtail corporations’ influence on medical care.
It also wrapped up with stacks of bills shelved or trimmed due to a $750 million budget gap. Still, as the session ground toward the final gavel late Friday, legislative leaders framed the session in a positive light.
“This session, we passed meaningful legislation that will make a difference in people’s lives,” said House Speaker Julie Fahey of Eugene, noting that the most bills passed among the 3,500 filed were approved with bipartisan support.
The bills passed included a reform of Oregon’s laws on civil commitment and approval of tens of millions of dollars to address the ongoing mental crisis. (See our separate story on mental health bills passed this session.)
Lawmakers expect patients and providers to benefit from a ban preventing corporate interests from controlling care at some private medical practices. It passed despite strong opposition from industry lobbyists representing Amazon and UnitedHealthcare, the nation’s biggest health insurer.
Legislators also approved a proposal to give the state a strategy to prevent addiction in young people where it often becomes an ailment for life. This bill was hailed by supporters who’ve been pushing for more emphasis on addiction prevention for years.
And they approved bills on drug discounts, proposals to help mothers and newborns, bills protecting health care workers and more.
Here’s a look at some key measures that passed.
Corporate influence on medicine
Rep. Ben Bowman of Tigard tried to get lawmakers last year to approve a bill to limit corporate meddling in clinical decisions. It almost crossed the wire but got stuck in the Senate and was shelved at the last minute.
Now the House Majority Leader, he brought it back this year with Sen. Deb. Patterson of Salem as Senate Bill 951. Signed by Kotek earlier this month, it will bar nonmedical entities or personnel from owning or controlling private medical clinics, including through hiring, setting work hours or determining compensation.
The law also bars most “noncompete” agreements that prevent physicians from treating local patients when they leave a practice. It excludes hospitals, which own many clinics.
In a related move,lawmakers on Tuesday approved House Bill 3410, which amends the corporate medicine bill. It strengthens the ban on physician noncompete agreements by making them retroactive. That voids current physician noncompete agreements.
Health care workers
Lawmakers also passed bills affecting health care workers, including the tens of thousands of nurses working in the state.
Senate Bill 537 addresses violence in the workplace, including in home health settings. It requires annual training, counseling and investigations of reported incidents.
The bill had strong support from the Oregon Nurses Association, which represents more than 24,000 nurses and other professionals. Paige Spence, a spokesperson for the association, said the bill aims to counter increasing violence in health care settings.
“There's been a real uptick in violence, particularly in emergency departments, labor and delivery and behavioral health units,” Spence said.
Patterson and Portland representative and registered nurse Travis Nelson, championed the bill, which will allow staff to “flag” violent patients on their medical record or room to alert staff about how best to approach them. That notice will also alert home health care staff.
Nelson and Patterson also championed a bill to loosen the rules on what providers are allowed to coordinate care for patients. Right now primary care providers, like doctors and nurse practitioners, are responsible for care coordination but House Bill 2789 will enable registered nurses to handle that responsibility.
The bill is a first in the nation, Nelson said: “This is huge in my opinion.”
Nelson said nurses are qualified to manage patients’ care but haven’t been allowed to do so on their own. He said the bill is likely to curb spending, even allowing nurses to form companies to coordinate the care of patients recently discharged from the hospital, for example.
The Oregon Nurses Association had prioritized passage of a bill to allow striking workers to collect unemployment benefits. Senate Bill 916, signed by Kotek last Tuesday, will provide benefits after the first two weeks of a strike and as much as 10 weeks after that. Its passage follows a six-week strike by nurses at several Providence hospitals in Oregon — one that left many nurses dissatisfied with the outcome.
“We'll really level the playing field to give our members some clarity of mind as they think about the options that are on the table to resolve a collective bargaining issue without worrying about paying their mortgage, paying medical bills, feeding their families in the meantime,” Spence said.
Kotek signed another bill in May to give more autonomy to nurses at public schools. House Bill 2948, or Hannah’s Law, blocks administrators from directing nurses’ provision of care in schools.
It is named after Hannah Ledson, a West Linn student with cerebral palsy who requires a feeding tube. Her mother, Lisa Ledson, a registered nurse, told lawmakers that decisions by administrators led to her daughter contracting a lung infection.
Another bill passed this month aims to protect nurses from an encroachment of virtual nursing programs, like those created by Hippocratic AI. It recently announced raising $140 million to develop virtual nurses to consult with patients.
House Bill 2748, also backed by Nelson, bans AI programs from posing as nurses. There are nearly 130,000 thousand people licensed by the Oregon Board of Nursing though not all of them practice in the state.
The bill, signed by Kotek last Tuesday, is a first in the nation, Nelson said. It will only allow humans to use licensed nursing titles like registered nurse, nurse practitioner, certified registered nurse anesthetist and certified nursing assistant.
The bill does not affect the use of the title “doctor” by AI programs. Also, the amended version of the bill that was passed does not ban the use of “nurse” by artificial intelligence programs.
“I still think we have a bill that goes a long way towards ensuring that nursing titles are protected,” Nelson said.
Patient care
The Legislature approved Senate Bill 1168 to improve the quality of home care for patients by barring health care professionals, including speech, physical and occupational therapists, from being paid on a per-visit basis. The nurses union said that provision aims to prevent professionals from rushing through visits because of pay concerns. The bill also prevents companies from cutting worker pay based on “productivity standards.”
Companies can still create standards but they cannot reduce pay based on meeting benchmarks or seeing enough patients.
“Part of the impetus here is the rise in private equity influence in Oregon's health system,” Spence said.
The association has its eye on a possible merger of Providence Health, Oregon’s biggest home health and hospice services provider, with Compassus Health, a private equity-backed company based in Tennessee. State officials are currently reviewing the plan.
Another proposal, which aimed to increase support for Indigenous language interpreters, failed. House Bill 2976 would have given $1.5 million to Pueblo Unido, which offers Indigenous language interpretation, to add three languages to its accreditation program. It passed in committee but did not make it past budget writers who had much less to work with this year.
Children and women
Sen. Lisa Reynolds, who charged into the session with a slate of bills to support pregnant people and mothers during the first year of their baby’s life, saw several of her priorities stuck in committee when the session ended.
“There’s a lot of disappointed people right now,” Reynolds, who represents Portland, told The Lund Report. “I've been working on this stuff for over a year. And always, at this time and session, I wonder what could we have done differently, how could we have fought differently, how we could have fought harder. And nothing comes to mind.”
Reynold’s ambitious package of seven bills for women and newborns faced an uphill battle this year over funding concerns.
Three survived, including Senate Bill 690, which will give low-income parents of young children some leeway when they miss rent payments and make them a priority for state housing help.
Senate Bill 692 for parents and newborns also passed. It will require commercial insurance to cover doula services, which include help with birthing and during the postpartum period. Oregon currently has about 470 doulas registered with the state.
The bill includes $1 million for training to increase the number of doulas in the state.
Another Reynolds proposal, Senate Bill 1039, which called for devoting $1.5 million to a perinatal initiative at Oregon Health & Science University, was folded into the Christmas tree bill of various spending proposals.
The bill devotes $500,000 to the Oregon Perinatal Collaborative for the next two-year budget cycle and enshrines the collaborative in law. It aims to help people before and after pregnancy and during birth. It is currently focused on bringing down hypertension and supporting pregnant people and mothers with addictions.
Reynolds plans to keep pushing for other support for young children. She said if the state put more money into the beginning of life it would have to spend less on adult addiction and mental health.
“We're putting a lot of money — as we need to — in secure residential treatment facilities for people with behavioral health issues, and I would argue, if we did better in 0 to 5 (years old), we wouldn't need those facilities in 15 years,” Reynolds said. “But we do need them now.”
Another bill will help women as they go through menopause. Championed by Republican Rep. Shelly Boshart Davis of Albany, House Bill 3064 requires coverage of FDA-approved treatments for perimenopause, menopause and postmenopause, including hormones, antidepressants and osteoporosis medications. The bill applies to commercial insurance and health plans for state employees and teachers.
Employer plans are exempt as are Medicare and Medicaid, which are regulated by the federal government.
Drugs
The Legislature passed a controversial bill this session intended to protect continued access to discounted drugs by safety net clinics, or federally qualified health centers, and hospitals serving a large number of low-income patients. The federal 340B program requires drug manufacturers that participate in Medicaid to sell discounted drugs to eligible entities. Drug companies have been trying to limit the program, saying that providers have been abusing it to bolster profits rather than help needy patients.
House Bill 2385 addresses those complaints by fining manufacturers up to $5,000 a day for interfering with the sale and delivery of 340B drugs.
Despite Republican and some Democratic opposition to the bill, it passed and was signed earlier this month by Kotek.
Nosse said the bill helps both patients and struggling clinics and hospitals.
“It preserves the ability to get your medications if you're getting them at a federally qualified health center or at a hospital where you choose,” Nosse said. “And hospitals and clinics get to use that discount to pay their staff to improve their computer system, to hire a behavioral health specialist that they couldn't hire before, to extend their hours of operation. That discount allows them to [put] money back into care.”
It was also welcomed by the Hospital Association of Oregon.
“Oregon is ranked second in the country for the fewest pharmacies per capita, making it difficult for Oregonians to get the medications they need,” the association’s president and CEO, Becky Hultberg, said in a statement earlier this month.
A bill sponsored by retail pharmacies to block corporate middlemen from adopting measures that limit access and reimbursements went nowhere — the third straight time that has happened.
Access and equity
A proposal intended to preserve coverage for low-income Oregonians, House Bill 2010, sailed through the Legislature and was signed by Kotek in March. The bill renews and expands the hospital tax that unlocks federal matching dollars to fund the Oregon Health Plan, the state’s version of Medicaid that provides free benefits for 1.4 million low-income people in the state.
The law could be affected by a Republican budget bill now being negotiated in Washington D.C. A recent amendment would cut the allowable provider tax rate below that set by Oregon, though it would delay the impact until 2028.
“If the Senate amendments to the ‘Big, Beautiful Bill’ pass, with those changes in the hospital provider taxes, we're in trouble,” Nosse said.
But a bill intended to help marginalized communities access health care went nowhere. SB 528 would have increased funding for regional health equity coalitions that work with state and local officials to identify long-term strategies to increase health equity for communities of color, tribal communities, immigrants, refugees, migrant or seasonal farmworkers, individuals and families with low income, people with disabilities and LGBTQ communities.
Hospitals
A bill long sought by hospitals to block lawsuits against them by patients injured by drugs or products produced elsewhere passed on the final day of the legislative session. Senate Bill 1173 appeared dead on multiple occasions, but ultimately won approval Friday afternoon.
One of the biggest problems facing Oregon hospitals was addressed in part this session. Senate Bill 296 aims to help people ready to be discharged from hospitals access longer-term care. Right now, hospitals end up keeping many patients longer than necessary because they have nowhere to go.
The bill requires the Oregon Health Authority to track and streamline the Medicaid approval process for longer-term services. And it asks the Department of Human Services to explore short-term options for patients while they’re waiting for an approval.
Patterson championed the bill.
“SB 296 is just one step in addressing this challenge, and I expect to be continuing this work in future sessions,” Patterson told The Lund Report in an email.
(Mike Francis, Joanne Zuhl and Nick Budnick contributed reporting)