Sen. Alan Bates, D-Medford, died suddenly last Friday, putting state leaders and healthcare advocates in a state of shock as they remembered one of the fathers of the Oregon Health Plan, who was a champion to the end for better healthcare for all Oregonians, both as a legislator and an osteopathic physician.
He died of a heart attack after a sunny day spent at his most beloved pastime, fly-fishing on the Rogue River with his son. Bates was 71.
“You don’t replace somebody like Senator Bates,” said John Mullin of the Oregon Law Center, who noted that Oregon health policy has already been adrift after the sudden resignation of Gov. John Kitzhaber in February 2015. “We have a real challenge ahead of us in 2017.”
But the steps to replace him in the Senate have already come. The Jackson County Democratic Party will name an interim replacement to fill the seat until Dec. 31, and an all-parties election for the seat will occur Nov. 8 for the last two years of his term. Candidates must file by Aug. 30 to appear on the ballot.
Bates served two terms in the Oregon House from Ashland before moving to the Senate, where he represented an ideologically diverse group of constituents in Ashland and Medford for nearly 12 years.
He was well aware of the need to serve both Republican and Democratic constituents, winning hard-fought re-election contests in 2010 and 2014 and developing a reputation of honesty and reasonableness that endeared him both to his own party and the Republican opposition.
The most striking condolences came from two Republicans: his longtime partner on the Human Services Budget Subcommittee, Sen. Jackie Winters of Salem; and Canby Sen. Alan Olsen, who credited Bates with saving his life.
Bates carried a black medical bag with him to the Capitol, which was put to quick use when Olsen suffered a heart attack.
“He was a friend, a colleague, a fellow veteran, and the man who saved my life. I will miss his calm demeanor and hearty smile,” Olsen recalled. “He will be in my heart forever.”
“My heart is heavy and my soul hurts with the news of the sudden passing of our dear colleague Doc Bates,” said Winters. “I cannot imagine sitting in committee without him by my side. Oregon has lost a wonderful human being who put all of us before himself. He will be sorely missed, and the hole he leaves is so very big.”
Winters sat beside Bates for years, and has had to play a similarly careful political balance on issues, serving as a moderate Republican from across the aisle.
Bates got so fed up with the leftward projection of his party in the 2015 session that he helped defeat a measure he sponsored, providing state funding for an academic study of healthcare financing, including a single-payer health system. He reversed his decision the following Monday, telling his colleagues he’d been brought to yes over the weekend with “two broken arms.”
Doctor and Legislator
His commitment to actively serving people with primary care was legend, with Bates working the weekends during the legislative session at his medical practice in Medford even after long days in the Capitol. And when the minority Democrats played hooky from the Capitol in the mid-’00s to prevent a quorum, Bates volunteered his time at a Woodburn clinic, treating migrant farm workers.
A Seattle native, Bates received his bachelor’s degree from Central Washington University and his osteopathic medicine degree from the Kansas City University of Medicine and Biosciences.
Bates made the pivot from medical practice to public policy by chairing the Health Services Commission, and working with the Center for Evidence-Based Medicine to hash out the state’s prioritized list for the Oregon Health Plan, which uses science to determine which medical procedures are covered and which are not. The commission is now known as the Health Evidence Review Commission. “He did a great job of making it go. It’s his leadership that made it work,” said Rep. Mitch Greenlick, D-Portland.
“Al has been a friend of more than 35 years ever since he went into practice. It’s a loss both personally and professionally,” said Jeff Heatherington, CEO and president of FamilyCare. “He was the main champion for the Oregon Health Plan. He had the history. He was on the original task force that put it together in the early ‘90s, not as a legislator, but as a physician.”
Heatherington and FamilyCare may be put into a particularly vulnerable spot politically, as Bates was seen as the biggest ally of the old managed care organizations like FamilyCare to serve Medicaid patients through the enhanced coordinated care model, and pushed back upon the Oregon Health Authority’s deference to hospital management.
Longtime healthcare lobbyist Ellen Lowe recalled that Bates was instrumental in getting the Oregon Health Plan to cover reproductive services, including abortion, as well as comfort and hospice care for ailing seniors, even as the federal government refused to cover the cost.
“It saved money to cover these things,” Lowe said. “He was always interested in serving all Oregonians, which came from his experience as a family physician, foster parent and school board member.”
Bates to the Rescue
In 2003, then-Rep. Alan Bates teamed up with Rep. Jeff Kruse, R-Roseburg, and Rep. Ben Westlund, R-Bend, to devise the hospital assessment tax to fund the Oregon Health Plan after an economic recession left the general fund unable to pick up the state’s share for the state’s neediest citizens.
“They called themselves the ‘Tres Amigos,’” Greenlick said. “They saved the Oregon Health Plan. Alan was such an amazing force.”
“Now two of my great heroes are gone,” lamented Greenlick, the chairman of the House Health Committee. Kruse is currently the vice-chairman of the Senate Health Committee while Westlund, who later became state treasurer, died in 2010.
The hospital assessment imposes a tax on Oregon’s hospitals to draw down federal funding, which is then used to repay the hospitals when they provide care. The involvement of the Oregon Association of Hospitals and Health Systems in devising the assessment process helped pave the way for its participation in the coordinated care system.
In one of his final policy accomplishments, Bates won approval for a new insurance program that will serve impoverished Pacific Islanders who are residents of Oregon but citizens of the island nations included in the Compact for Free Association, and for years had been shut out of Medicaid because of their unique status.
“He was finding out how to get healthcare to everybody, and we’re chipping away at it,” said Shane Jackson, a lobbyist for the COFA islanders.
