Some legislators might be taking an extended holiday this summer after finishing work in the 2017 marathon session on July 7, but not Republican Rep. Julie Parrish of West Linn and Tualatin.
Parrish has been hard at work assembling signatures to put a funding package for the Oregon Health Plan and an insurance exchange stabilization program before the voters.
“People who are paying their own freight for healthcare are extremely concerned that these dollars will be swept away for things unrelated to their direct healthcare and that the mismanagement of the OHA needs to be a first priority for the Legislature,” Parrish told The Lund Report on Tuesday, as she drove to the post office to mail stacks of blank signatures across the state.
Volunteers as well as paid signature gatherers have been out in full force pleading with registered voters to “stop a sales tax on healthcare” -- alluding to the $5 a month assessment on plans in the group health insurance markets. “It’s going to be a Herculean effort,” she said. “But people are frustrated with the governor, they are frustrated with the Legislature.”
After Democrats and their allies made public their funding package, Parrish countered with a proposal raising cigarette taxes and other taxes to fund just one year of the Oregon Health Plan, which she believes would allow the Legislature to restore accountability to the Oregon Health Authority, which because of technology failures, was unable to certify eligibility in real time.
Parrish’s proposal was never fully debated and the Democratic leaders steered House Bill 2391 with the support of a handful of Republicans to keep the Oregon Health Plan Medicaid expansion fully funded through June 30, 2019. HB 2391 reinstated a 1.5 percent assessment for reinsurance stabilization on insurance plans for 2018 and 2019 that had expired at the end of 2016, and it also raised the hospital assessment, a portion of which hospitals will not be able to fully recoup.
In addition to the Medicaid funding, HB 2391 establishes a reinsurance program -- an insurance program for insurers -- that taxes all plans up front and then allows the insurers to tap into a state fund to offset the cost of the sickest consumers in the individual market. The Department of Consumer & Business Services anticipates requesting permission from the federal government to enact such a program as early as this week.
The market has seen double-digit increases year-after-year since the enactment of the Affordable Care Act, as the new customers -- who had been denied coverage previously -- turned out to be much sicker than insurers anticipated, according to DCBS spokesman Jake Sunderland. Congressional Republicans also killed the funding for a risk corridor program, forcing Oregon’s two co-operative health insurance start-ups out of business and forcing Moda Health to turn to Oregon Health & Science University for a $50 million handout.
Parrish has until Oct. 5 to turn in 59,000 valid signatures to put HB 2391 on the ballot and it’ll be a race to the finish to force the issue before the voters on Jan. 23, 2018.
Anticipating a successful drive, a legislative ballot title committee has already been formed, with four Democrats and two Republicans, including one on each side of the issue. Rep. Greg Smith of Heppner opposed HB 2391 while Sen. Jackie Winters of Salem supported it, as did the hospital industry, Medicaid health plans and all major Oregon insurers except Regence BlueCross BlueShield.
But while the taxes in HB 2391 do raise group health insurance premiums by $5 a month, state insurance regulators have already used the reinsurance program to lower individual health premiums $25 a month. It’s unclear whether a successful referendum would cause individual market consumers to swallow a $25 price hike if the reinsurance program loses its primary funding stream.
Two political groups have organized to place the measure on the ballot in January -- Stop Healthcare Taxes and Oregonians Against More Healthcare Taxes, and the two groups are trading funding. Parrish has received over $1,300 to reimburse expenses in her work on the ballot referendum as a political consultant, collating and turning in petitions to the Secretary of State.
Parrish and her petition co-leader, Rep. Cedric Hayden, R-Cottage Grove, have each diverted more than $4,000 from their political campaign funds into these groups. Dr. Patty Buehler also donated $2,500 to the tax opponents in June, before the referendum campaign was launched. She is the wife of Rep. Knute Buehler, R-Bend, who is seeking the Republican gubernatorial nomination for next year’s election against Democratic Gov. Kate Brown.
Rep. Buehler has asked the governor to call a special session this fall to find a different funding mechanism for the Oregon Health Plan. The Republicans have been less sympathetic to stabilizing the Obamacare private insurance market.
In their comments to the state, Parrish and Hayden said that the reinsurance program merely throws good money at a failing program without getting at some of the underlying problems, such as the small size of the pool. Parrish has previously proposed moving the Oregon Educators Benefit Board onto the exchange, which would increase the individual market pool from 210,000 people to 363,000 covered lives, decreasing volatility.
Parrish is a top critic of OEBB and the Public Employees Benefit Board in general, and has tried to kill these generous plans and move government employees either onto the exchange or the Medicaid coordinated care organizations. The exchange plans have very limited networks as well as high deductibles and copayments compared to PEBB and OEBB plans. The Medicaid plans also have narrower networks because they pay providers less than commercial insurance. The Oregon Education Association, SEIU and AFSCME have all strongly opposed Parrish’s proposals.
Hayden and Parrish also called the reinsurance program a bait-and-switch, since the program outlined in the federal waiver goes through 2027, while the 1.5 percent insurance assessment expires in 2019 -- requiring the state Legislature to approve the tax again in two years or else run afoul of the federal waiver.
Sunderland conceded this point, but said the decision to continue to the program would be in the hands of the 2019 Legislature.
Chris can be reached at [email protected].
Correction: Parrish is being paid by the petition campaign only for expense reimbursements.