Oregon Public Broadcasting

Head Of Moda Health Worries About Obamacare Replacement

The head of one of Oregon’s largest health insurers, Moda Health, said the company will remain in the individual market for now.

But speaking on OPB’s Think Out Loud, Robert Gootee, said he’s worried about what will replace the Affordable Care Act, which Republicans have said is a priority under the Trump Administration.

“I think one of the things a Republican administration is going to have to do between now and April is to provide some certainly in the markets," Gootee said. "Which is what the original Obamacare and the ACA market did with risk abatement programs."

"You’re going to have to have something like that because you can’t pay for in essence, everything for everybody,” he said.

Gootee said it’s hard to set rates for next year when it’s not clear what the market’s going to look like.

He also said uncertainty has the effect of increasing rates.

One of President Donald Trump’s first executive actions was to sign an order urging his administration to fight the Affordable Care Act as much as possible.

That said, there are only limited places where the law gives the administration power to quickly change course.

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Oregon Budget Proposal: Program Cuts, No New Taxes

The chief budget-writers for the Oregon Legislature have released a spending proposal that includes cuts to state programs.

The proposal issued Thursday outlines how lawmakers might bridge an expected budget gap.

Revenues continue to grow in Oregon, but the cost of providing services is growing faster, adding up to a $1.8 billion shortfall for the two-year budget cycle that starts in July, according to the co-chairs of the Legislature's budget-writing committee.

The proposal would mean cuts to state-funded programs like education, health care and public safety. Democratic Rep. Nancy Nathanson, who helped craft the plan, said those cuts probably won't sit well with Oregonians.

"I believe we'll start to hear from them once we start to have our public hearings that this is not adequate. It's moving backward," said Nathanson.

She and her senate colleague Richard Devlin drew up their plan without proposing any new revenue sources. They said those conversations are ongoing and a bipartisan agreement on tax increases is far from a sure thing.

Republicans, who serve in the minority in both chambers, offered some praise for the proposal. Senate GOP leader Ted Ferrioli called it a "budget based in reality."

Republicans have been cool to the idea of raising revenue to fill the budget gap.

"The only way Oregon will get through the current budget crunch is by setting better spending priorities and demonstrating budget discipline," said Ferrioli.

The Ways & Means co-chairs said their budget proposal would fund K-12 education at roughly $200 million less than the cost to continue services at existing levels.

Some education advocacy groups say the gap is even larger than that.

"We recognize that the co-chairs are in a tough spot," said Oregon School Boards Association director Jim Green. "But the budget proposals we are seeing signals a terrible cycle of future cuts for our schools."

The legislative proposal wouldn't mean as many cuts to higher education as a spending plan released by Gov. Kate Brown last month. But the co-chairs said it could still lead to higher tuition and staff reductions.

Another difference between the governor's budget proposal and the legislative budget framework is that the lawmakers' version does not recommend the closure of a new psychiatric hospital in Junction City.

Instead, the co-chairs would save money by reducing the number of patients being served in both Junction City and the state's main mental hospital in Salem. Like the governor's budget, the co-chairs' proposal does recommend shuttering an Oregon Youth Authority facility near Astoria.

Lawmakers convene Feb. 1 for a five-month session. Most budget decisions won't be finalized until after two more revenue forecasts — in February and May — give lawmakers a clearer picture of the revenue that will be on the table.

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OHSU Research Suggests New Way Of Treating Chronic Pain With Cannabis

Almost 30 percent of Americans will experience chronic pain in their lifetime. And the opioids used to reduce that pain have proved highly addictive for many.

Now, a study out of Oregon Health And Science University suggests a new way of treating chronic pain with marijuana.

Working on rodents, senior author Susan Ingram looked at cannabis and the ability of the body’s own cannabinoid system to control pain.

“We found that CB1 receptors — the receptor that is associated with addictive properties of the drug — are decreased. But that CB2 receptor activity is increased. Cannabis actually activates both CB1 and CB2 receptors equally. But it’s know that CB2 receptors can decrease pain," she said.

"So this study provides the basis to develop new synthetic pharmaceuticals that provide pain relief while minimizing addiction," said Ingram.

The hope is to find a drug that provides effective pain relief that doesn’t have any addictive qualities.

The OHSU study was funded by grants from the National Institutes of Health and American Heart Association. It was published in the Journal of Neuroscience.

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OHSU Stops New Hires Ahead Of Potential Obamacare Cuts

The president of Oregon Health And Science University isn’t waiting to see what Republicans do with the Affordable Care Act. In anticipation of deep cuts, he’s stopping the hiring of most new staff.

As a large, urban teaching hospital, OHSU gets a disproportionate share of Medicaid patients. For example, OHSU is responsible for close to 20 percent of all the money spent on hospitalizing them in Oregon.

With the federal government poised the repeal the Affordable Care Act — and the state facing a $1.7 billion budget hole — OHSU president Joe Robertson said the time to start reducing costs is now.

“We don’t know exactly what the future will be," he said. 

Congressional Republicans have said they would like to repeal, and possibly replace, the Affordable Care Act this year, but they have not released details of that plan yet.

"When you have a high degree of confidence that the ultimate impact will be in the many tens of millions of dollars over a multiple period of years," Robertson said, "one has the obligation to act proactively, rather than wait and react.”  On average, OHSU hires about 500 people a year.

Robertson said short of finding people for programs like the Knight Cancer Institute, those hires will be stopped.

He hopes that by not hiring new staff, OHSU can avoid cuts to existing staff.

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Kitzhaber Calls For Bipartisan Revamp Of Affordable Care Act

Speaking at a forum Friday, former Oregon Gov. John Kitzhaber said the Trump administration represents a chance to re-frame the debate on health care.

The Portland City Club forum was entitled "Blue States And Health Care Under President Trump."

But Kitzhaber, a Democrat who resigned amid scandal two years ago, said it would be a mistake to segment into red and blue states.

He said both the Affordable Care Act and one of the main Republican replacement ideas are flawed because they don’t address the underlying reason health care is so expensive.

“Democrats are planning to dig in and protect the ACA at all costs. The Republicans are going to do the opposite," he said. "The opportunity here is to re-frame the debate and say hey, there are real problems with the commercial insurance industry, but the fact of the matter is, unless we reduce the cost of medical inflation, you’re never going to solve the problem."

In a series of three tweets Thursday, President-elect Trump called Obamacare a failure, blamed Democrats and said it’s time Republicans and Democrats work together on a better plan.

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Oregon Supreme Court Ruling Prompts Families To Try To Recoup Medicaid Payments

When a couple grows old, one spouse often gets sick and needs long-term care — like a nursing home. That can cost $6,000 a month.

To qualify for Medicaid, couples often transfer the title for an asset, like a home, to the other spouse.

In 2008, the state tightened the rule governing asset ownership in an effort to recover more money. Now the Oregon Supreme Court has found that exceeded the state’s authority.

Attorney Tim Nay said they’re looking for families to come forward.

“We think it’s time for the state to give back the money they received illegally from Medicaid families in the past,” he said.

The rule brought in an estimated $10 million a year for Oregon.

By law, the state has to recover Medicaid expenses from an estate once both people are dead.

The Oregon Department of Health And Human Services declined to comment for this story.

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