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Oregon legislative session’s early end closed curtain on significant health care bills

Bills concerning treatment centers, violence against hospital staff, school health and insurance mandates perished, but other impactful bills made it through
Oregon State Capitol in Salem. | JAKE THOMAS/THE LUND REPORT
March 12, 2024

When legislative leaders shut down Oregon’s 2024 session last week earlier than planned, it closed the curtains on significant health care legislation — including some that appeared to have a shot at passage.

An effort to streamline the siting of residential treatment facilities passed both houses, for instance, while a bill to increase the criminal penalty for assaulting a hospital worker had broad support and what appeared to be a compromise in place. 

But both died when the clock ran out on Thursday, three days before the session’s officially scheduled final day.

Other bills that didn’t make it to passage included a measure to boost access to school health services and a bill that would have helped lawmakers scrutinize proposed new insurance mandates.

Each of the bills were aimed at pressing issues, and support helped them clear legislative hurdles early on. But because of either their cost or controversy, they didn’t cross the finish line before the session ended.

“Things that have controversy can be difficult to land in five weeks,” state Rep. Rob Nosse, a Portland Democrat who chairs the House health committee, told The Lund Report. “And sometimes it takes just more time to get something through.”

That said, lawmakers successfully appropriated money for drug treatment and prevention programs and passed bills protecting patients affected by insurer tactics to lower their prescription drug costs. 

Session bell tolled early

The five-week session could have run through Sunday, March 10, but lawmakers and lobbyists expected it to run through Friday, March 8 instead.

Then, early Thursday afternoon, word spread through the Capitol that legislative leaders planned to shut things down by that evening.

Among the bills that appeared to have momentum until then was a bill that would have set up a fast-track for residential treatment facilities. A state-hired consultant earlier this year found that Oregon has a shortfall of residential treatment beds — an issue that lawmakers have been trying to address. 

The bill also sought to fix Oregon land-use laws that violate federal fair housing statutes. But after passing the House, the fast-tracking bill was amended in the Senate to make it easier for local governments to overcome objections from residents to setting up facilities in residential neighborhoods. 

It passed the Senate Thursday by a margin of 22-6. But lawmakers adjourned the session before the House could vote on the amended bill. 

House Speaker Julie Fahey told The Lund Report in a statement that legislative leaders did not believe there was enough time to discuss the changes the Senate made to the bill, which she said “ expanded the scope significantly.”

A similar effort died in the previous session as well. State Rep. Mark Gamba, D-Milwaukie, told The Lund Report he is worried the bill’s failure will complicate lawmakers’ efforts to expand behavioral health and addiction treatment services. 

“I think it’s going to make many of those ‘shovel-ready’ projects not be built,” he said.

Another bill that appeared close to passage was a bill intended to limit corporate and private equity influence over the delivery of health care (click here for full article).

Yet another outcome that surprised some observers concerned a renewed effort to increase criminal penalties against people who knowingly assault hospital care workers. Despite broad support from health care industry and workers,  the bill again ran into objections that the change would further criminalize mental illness. 

State Rep. Travis Nelson, a Portland Democrat who co-sponsored the bill, told The Lund Report that it included language to protect people with developmental disabilities or experiencing a mental health crisis from being charged from a hospital altercation. It also would have mandated more protections for workers and a grant program that would help hospitals purchase metal detectors and other safety devices. 

The bill had bipartisan support, and Nelson said he thought there were enough votes to overcome the opposition. The bill cleared the House Judiciary committee but remained stuck in the Legislature’s budget-writing committee. It didn’t receive a vote in either chamber. 

“I think there was broad agreement on everything else that was in the legislation,” Nelson said. “But the penalty and the potential impact were of concern to some lawmakers.”

State Sen. Sara Gelser Blouin, D-Corvallis, and other advocates for people with disabilities opposed the bill out of concerns that it would mean felony charges for vulnerable people. 

Other bills failed

A bill that would have directed over $19 million to expand school-based health centers also died while sitting in the budget-writing committee. Proponents argued that expanding the clinics to more school districts would bring needed behavioral health and preventive services to students. 

“I just think the closer we can put young people to access to health care, especially mental health care, the better that is for those young people,” state Rep. Lisa Reynolds, a Portland Democrat who sponsored the bill, told The Lund Report. 

Reynolds, a pediatrician, said the centers could help a student who might have trouble seeing a psychologist because they’d have to take time off from school and their family might have trouble finding one. 

But she said there were concerns that it would add an ongoing cost to the state budget. 

Another bill that met the same fate would have established a committee to review the cost of health insurance mandates proposed by lawmakers. Recent legislation has required insurers to cover treatments for proton beam therapy for cancer, neurological disorders in children and others. Proponents argue that such debates sometimes include little consideration of cost-effectiveness and competing needs. A similar bill also died in 2023. 

Bills on health care and behavioral health passed

Despite the setbacks, Reynolds and Nosse described the session as successful overall. 

Nosse successfully passed House Bill 4092, which requires the Oregon Health Authority to study if funding for community mental health programs is adequate for them to fulfill their functions under state law. The programs provide mental health services for low-income Oregonians. The bill also directs the health authority to study the administrative burden on community mental health programs and other providers. 

Additionally, lawmakers passed bills alerting health care providers if a patient overdoses, exempting the Oregon State Hospital from new staffing requirements, changing the title “physician assistant” to “physician associate” an creating an awareness day for hypertrophic cardiomyopathy — a condition where the heart has trouble pumping blood because of thickening muscles. 

While lawmakers rewrote Measure 110 withs House Bill 4002, which reinstates criminal penalties for possession of small amounts of drugs like fentanyl and meth, they also passed a companion bill that directs $211 million for childhood health, prevention and treatment services as well as for the criminal justice system. 

Reynolds described the funding for childhood health programs “phenomenal,” also calling it “very meaningful” that the bill ties it to addiction prevention. 

“That is kind of a rethinking of addiction,” she said. “There’s been a lot of discussion that we can’t treat ourselves out of this. We certainly can't criminalize ourselves out of this. We need to think about prevention strategies, and that means treating pregnant people who have substance use disorder, that means reducing childhood trauma.”

Nosse said one of the more notable bills to pass was House Bill 4149, which is another attempt to bring more oversight to companies that local pharmacies claim are putting them out of business.

Sponsored by state Rep. Nancy Nathanson, D-Eugene, and Christine Goodwin, R-Canyonville, the bill requires pharmacy benefit managers, intermediary companies that negotiate drug prices for insurers, to apply for licenses with the state. Pharmacies will have a clearer path to contest reimbursements paid by pharmacy benefit managers under the bill. 

Lawmakers also approved other bills related to prescription drug cost and access. One bill bans insurers from requiring that physician-administered drugs be purchased at specific pharmacies. Another requires insurers to count manufacturer discounts on prescription drugs toward patients’ out-of-pocket maximums. Insurers will also be prohibited from charging patients more than $35 for a month’s supply of insulin. 

Nathanson successfully sponsored another bill that’s in response to the closure of PeaceHealth University District hospital in Eugene. The bill directs $1.3 million to help Eugene Springfield Fire provide another ambulance for a year and $3.2 million for a pilot project for more efficient ways of responding to emergency calls. 

 You can reach Jake Thomas at [email protected] or via @jakethomas2009.