Issues and actions in Oregon health today

March 24, 2017

In this issue ...

• Report details drastic impact of congressional health care plan on Oregon
• The road ahead for rural health
• State releases draft framework for new health-based air toxics standards
• Legislative update

Report details drastic impact of congressional health care plan on Oregon

Last week Governor Kate Brown released a report that detailed the impact to Oregon of the American Health Care Act (AHCA), which is being considered in Congress. Earlier this month the Governor called on the Oregon Health Authority (OHA) and the Department of Consumer and Business Services (DCBS) to analyze the impact the legislation would have on the lives of Oregonians.   The report's findings demonstrate the ways the AHCA would fundamentally change health care in Oregon and affect the health care reforms implemented through the ACA and through the innovative Oregon Health Plan (OHP) since 1994. After analyzing data to determine the impact on Oregon, OHA and DCBS found that this legislation will: Reduce coverage: As many as 465,000 Oregonians will lose health coverage, including approximately 80,000 in 2018. Oregon’s uninsured rate will triple from 5 percent to more than 15 percent. Reduce federal funding: To maintain Medicaid enrollment, we estimate the AHCA would shift $190 million in costs to Oregon starting in 2020, approaching $1 billion in 2023. The cumulative cost shift would be $2.6 billion over the next six years. Reduce economic activity: The AHCA risks the loss of more than 23,300 health care jobs that were created in Oregon after the ACA was implemented.

Additionally, the report demonstrates the ways the AHCA will reshape the lives of Oregonians in 10 areas:

1. Low-income working Oregonians and families struggling to make ends meet
2. Oregonians with individual insurance plans
3. Older adults and people with serious chronic illness
4. Women's health and family planning
5. Oregonians with disabilities
6. Rural Oregon
7. Oregon’s health systems
8. Oregon’s insurance market
9. Oregon taxpayers and the state budget
10. Economic impacts

A full copy of the report can be found at 95PercentOregon.com.

The road ahead for rural health

As health care continues to play an increasingly important role in the everyday lives of Oregonians, the Oregon Health Authority has debuted a new multimedia feature series diving into the impact of health care in every corner of Oregon. The first installment is focused on rural Oregon and the unique challenges and opportunities that exist outside Oregon’s metropolitan areas. Below is a short excerpt from this new series and the full story is here.

On a cold morning in January, a man with a wind-burnt face sits in front of large window at the Embers Grill in Joseph, Oregon. He wears muddy boots and a wool coat over a flannel shirt. Out the window, snow drifts reflect the sun and Wallowa Mountains. Above him a homemade flier reading “Save our Healthcare!” is taped to the wall announcing a local community meeting.

Asked to remain anonymous, he said that he works three jobs and sells firewood on the side to make ends meet. Noting that many of his neighbors work more than one job as well––calling it the “rural Oregon hustle”–– he lowers his head when he mentions that without the Oregon Health Plan, he and his neighbors would be without options for affordable healthcare if they were to get into an accident. Looking up at the healthcare flier, he said:

“This isn’t about politics or handouts. It’s about people working hard for a little peace of mind, knowing that an accident or the unexpected isn’t going to leave us homeless."

State releases draft framework for new health-based air toxics standards

Agencies seek public input on Cleaner Air Oregon program to protect public health, environment

State officials this week released a set of proposed options, or framework, for revamping industrial air toxics regulations in Oregon. The draft framework outlines key decisions that will shape the state’s proposed rules for Cleaner Air Oregon––a program designed to protect the health of neighbors living near industrial facilities.

Washington, California and numerous other states already have adopted regulations for air emissions from industrial facilities that consider local health risk.

The draft framework was developed with extensive public input at four regional forums held across the state and discussions with technical experts and environmental, business, community and public health leaders.

Following review and revisions from the Cleaner Air Oregon Rules Advisory Committee, the proposed framework will be used to draft new regulations, which will be released for public comment later this summer.

The proposed Cleaner Air Oregon framework:

• Applies to new, modified and existing facilities: As in most other states, the Cleaner Air Oregon regulations would apply to new and existing facilities, and any modifications current facilities may make.
• Sets a limit on the allowable overall level of health risk from toxic industrial air emissions from a facility. The framework proposes to set an acceptable risk level for entire industrial facilities and their equipment. This proposal is similar to rules in Washington, California, New Jersey and other states.
• Sets limits on the total levels of health risk in areas where people are exposed to emissions from many nearby facilities. These limits are intended to protect the most vulnerable––children, pregnant women, seniors and those with chronic illness––and communities with high rates of exposure in the past, including people with low income and communities of color. The proposed cumulative risk limits would put Oregon ahead of most other states.

Legislative update

Thursday the Oregon Senate passed SB 754, making it an offense to sell tobacco to anyone under 21. In a 19-8 vote, the bill now goes to the House floor (read the story here). HB 2307 and HB 2309, both related to evaluating the mental fitness and insanity of criminal defendants, also moved to the House floor earlier this week.

Last week the Legislature held a hearing about the requirements for coordinated care organizations (CCOs) in the future. OHA will continue to watch the development of legislation affecting the CCOs.

In federal news, House leaders postponed a vote on the American Health Care Act––with an expectation that a vote could happen as early as today.