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Earlier this week Republicans in the
U.S. House of Representatives unveiled their legislation to repeal and replace
the Affordable Care Act (ACA).
Today 95 percent of Oregonians have
health coverage and 98 percent of children are covered, in large part because
of the expansion of Medicaid. Expanding access to Medicaid has been central to
this effort, and has enabled Oregon’s successful implementation of our
patient-centered, coordinated care model for Medicaid. The Oregon Health
Authority and the Department of Consumer and Business Services are reviewing
the proposal that was released to analyze the impact to Oregon; however, we
know that Oregon has more than 375,000 Oregonians on Medicaid expansion and
there are serious concerns about proposals that would scale back funding and
leave those Medicaid expansion individuals without coverage.
 In reviewing the various proposals debated at
the federal level, Oregon has focused on five key priorities that are crucial
to any changes in health care at the federal level:
- Changes
to the Affordable Care Act (ACA) and Medicaid should maintain, not reverse,
levels of health care coverage in Oregon and other states.
- Oregon’s
coordinated care system is a model for federal Medicaid reform. Medicaid cost
savings should be achieved by changing health care delivery, not rolling back
eligibility, benefits, or funding levels. Oregon has shown that it’s possible
to improve quality for patients while also reducing costs.
- Federal
changes to the ACA should stabilize, not disrupt, Oregon’s insurance market.
Insurers need clarity about upcoming changes.
- Changes
to the ACA should preserve the state’s ability to serve and protect health
insurance policyholders.
- Maintain
funding to allow innovation and focus on prevention, including funding for core
public health services funded in the ACA
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Last week the Oregon Health Policy
Board (OHPB) sent a series of recommendations to the Governor and Legislature
regarding the future of coordinated care organizations in Oregon’s health care
system. These recommendations were developed through a qualitative and quantitative
analysis that involved numerous reports and presentations related to CCO
performance as well as six statewide listening sessions.
The intent of the listening sessions
was to hear directly from consumers, advocates, primary care providers and
other stakeholders about the current state of CCOs and health system
transformation, and to identify additional hopes and expectations for our
system as we move forward. The OHPB heard from roughly 600 individuals and
organizations in person in diverse communities and through email, written
letters and testimony at regular meetings.
The recommendations are intended to
inform the next phase of health system transformation as it pertains to the
coordinated care model. They act as policy guidance to the Oregon Health
Authority and as information for legislators as they prepare potential
legislation. They serve as OHPB's response to the Governor's request for specific
recommendations regarding health equity and the social determinants,
integration of physical behavior and oral health, accountability and
transparency, and community partnerships and engagement.
The recommendations from the OHPB fall
into four policy areas and directly address:
CCO governance, transparency and
accountability
- CCO priorities
- Fiscal transparency
- Accountability
- Community
collaboration and input
- Monitoring and
oversight
Health equity and social determinants of
health
- Health equity
accountability and transparency
- Social
determinants of health
- Workforce
diversity
Accelerated system integration
- Physical, oral
and behavioral health integration
- Primary care
Sustainable costs
- High-cost drugs
-
Pay for value
The full report about the OHPB’s
recommendations is available
on the OHPB website.
The Centers for
Medicare & Medicaid Services (CMS) approved Oregon’s Medicaid 1115
Demonstration waiver renewal on January 12, 2017. The Oregon Health Plan (OHP)
covers more than 1 million low-income Oregonians who are struggling to make
ends meet. This is the largest health plan in the state, covering one in four
Oregonians statewide and almost 40 percent in some rural communities.
This was a huge step
forward in Oregon’s health system transformation. It will allow the state to
continue its innovative model of health care for OHP members and providers. The
approval preserves more than two decades of work that have gone into building
and improving the Oregon Health Plan.
The waiver renewal, a
five-year contract with the federal government, is approved for the period from
January 12, 2017, through June 30, 2022. The Oregon Health Authority and CMS
worked through an expedited approval process to ensure that Oregon is able to
maintain the success achieved under health system transformation and continue
momentum to ensure all Oregonians have access to high-quality, affordable
health care.
To provide
stakeholders and the public with detailed information about the components of
the waiver and answer questions, the Oregon Health Authority will host a
webinar to provide an overview of the approved waiver. Details for the webinar
are below:
Legislative update
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The
OHA Ways
and Means Joint Subcommittee on Human Services
budget presentation finished Thursday, with
Lynne Saxton wrapping up the first round of OHA presentations.
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In
addition to the budget presentations from OHA, a number of tobacco tax bills were heard in
public hearings with the House Committee on Revenue. These bills include HB 2037,
HB
2056, HB 2062,
HB
2662, and HB 3178.
- Air quality
continues to be a top priority for both chambers, with informational hearings in both chambers; and
Thursday the Senate Committee on the Environment held a public hearing on SB 197––a
bill requiring that the Environmental Quality Committee adopt rules for
regulating air contaminant emissions from dairies.
- Finally, legislation focused on convening a workgroup
for the Health Care for All Oregon Children program––SB 558––
was heard by the Senate Committee on Health Care earlier this week.
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