Wheeler Scolds Congress for Threat to Behavioral Healthcare Funds

The Portland mayor inherited a city grappling with a severe homeless problem, as people with mental health and drug and alcohol issues have been forced onto the streets. The Medicaid expansion has provided resources for local CCOs to help these people, but their funding would be decimated under a Republican proposal in Congress.

An animated Portland Mayor Ted Wheeler added his voice to the chorus of Oregon Democrats who are appalled by the Congressional Republican healthcare plan, arguing that attempts to slash funding for Medicaid would devastate local organizations that use federal funding to provide behavioral health services for the city’s large homeless population.

“I’m very concerned that the resources that our non-profit organizations depend on are going to dry up,” Wheeler told reporters.

The question about imperiled Medicaid funding and the work of the state’s coordinated care organizations came during a discussion of Portland Metro mayors on their attempts to reduce the problem of homelessness -- a problem they said had already been dumped on them by federal and state governments.

“Local government in America is the dumping ground for all of society’s problems,” Wheeler said. “We have an opiate epidemic that we have not got a grip on. We have a heroin epidemic that we have not got a grip on. Our safety net is an embarrassment.”

Wheeler said the health bill would exacerbate problems like the opioid and heroin epidemics that have already left cities and local law enforcement overwhelmed, by cutting off the source of funding for rehabilitation.

“You’re going to hear us be more aggressive on this point,” Wheeler said angrily, bracing the lectern.

Wheeler said the federal government had slashed the U.S. Department of Housing and Urban Development’s affordable housing budget in the 1980s, funding that has never recovered, nearly 30 years after President Reagan left office.

But President Obama did help secure one source of funding to help low-income people -- the Medicaid expansion, which has allowed Oregon’s coordinated care organizations to link homeless people with free mental health services as well as drug and alcohol rehabilitation.

But now, House Republicans are pushing the American Health Care Act, which will end the Medicaid expansion in 2020. One proposal in the bill would slash Medicaid funding for expansion members, while another would prevent new people from getting coverage while also blocking coverage for people who lapsed in coverage.

“As written, it’s quite draconian for healthcare for the Medicaid population,” said Jeff Heatherington, the CEO of FamilyCare, talking with The Lund Report after Wheeler’s press conference. FamilyCare provides Medicaid services for 130,000 low-income and disabled Oregonians in the Portland metro area.

The U.S. House Ways & Means Committee approved the bill before 4 a.m. on Thursday, without an independent analysis from the Congressional Budget Office.

Heatherington said that, at his organization alone, the Medicaid population has risen from 47,000 to 130,000 people. Statewide, Medicaid membership has risen over million, with 350,000 coming in from the expansion. The expansion allowed FamilyCare to raise rates to behavioral health providers, which has allowed these organizations to expand the number of low-income people they can serve.

The CCO also has care coordinators, or community health workers, that interact with homeless people with the Oregon Health Plan, to assist them with care needs.

Wheeler said the city had managed to get 4,500 people off the streets in 2016, but the numbers of homeless grew anyway.

Gresham Mayor Shane Bemis, a Republican, said his city had hired a social worker for the first time to connect homeless people with the available resources, as skyrocketing Portland housing prices have pushed poor people east of the city and the opioid epidemic has become more visible.

“There’s a large drug problem on our streets,” Bemis said.

Reach Chris Gray at chris@thelundreport.org.