Government

Oregon adopts plan for universal health access

After months of debate, state lawmakers approved a bill calling for a strategy to cover all Oregonians.

By Doug Trapp — Posted Aug. 6, 2007

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Oregon will offer health insurance to all uninsured residents by 2010 if the state can carry out a recently adopted plan and if voters approve a cigarette tax.

In late June, Oregon Gov. Ted Kulongoski signed the Healthy Oregon Act, a 14-page road map for reforming the state's health care system and covering all of the state's roughly 615,000 uninsured residents -- about 17% of the population. The law calls for a health insurance pool for the uninsured and suggests an individual insurance mandate.

One of the measure's sponsors, Sen. Alan Bates, DO, compared the task at hand -- providing universal insurance access while improving health care quality and reducing costs -- to climbing Mount Everest. "We've just established base camp," said Dr. Bates, a family physician.

The measure creates the seven-member Oregon Health Fund Board to design a plan for the insurance pool and overall reforms. On July 9, Kulongoski appointed as the board's executive director Barney Speight, his deputy chief of staff and former deputy administrator for the Washington State Health Care Authority. The Oregon board will issue an interim report in February 2008 and final reform recommendations that October.

Democratic lawmakers also are asking voters to approve a constitutional amendment boosting the cigarette tax by 84.5 cents to provide health insurance for children up to age 19. The tax, part of Kulongoski's Healthy Kids Plan, would increase the cigarette levy to $2.025 and raise $152.7 million by 2009 to cover 117,000 uninsured kids. The vote split along party lines, so House Democrats didn't reach the 60% majority required for tax increase passage.

The Oregon Medical Assn. supports both efforts, said Scott Gallant, associate executive director.

It took months of discussions to pass the Healthy Oregon Act. It will take months or years more to see its recommendations through.

The drive to cover the uninsured began with a Senate commission Dr. Bates chaired in 2006.

After five months of committee hearings, the measure incorporated provisions from other reform ideas, such as a health insurance pool promoted by the Oregon Business Council, a group with more than 40 executives from large businesses in the state. The council supports the law, said Duncan Wise, council president.

The measure also incorporated parts of a plan from the Archimedes Movement, led by former Oregon Gov. John Kitzhaber, MD. That effort advocated an equitable, sustainable, inclusive health care system. Along those lines, the Health Fund Board is to suggest ways to refocus the health care system in Oregon to focus more on preventive and primary care.

Oregonians should expect a healthy debate over requiring people to have insurance. Nesbitt, who as the new health board's chair, will oversee the initial implementation of the act, said the law leaves the issue open. "I don't think the bill's language is prescriptive," he added.

Also open is how much it might cost to provide insurance to everyone. The medical association's Gallant said using Medicaid and other federal programs to cover everyone in Oregon at up to 300% of the federal poverty level would cost $684 million in the two years from 2007 to 2009, including $235 million from the state.

"For a state like Oregon, that's not pocket change," Gallant said.

Back to top


ADDITIONAL INFORMATION

Oregon's plan

The Healthy Oregon Act is a road map for offering health insurance to all state residents. The new law:

  • Calls for covering 615,000 uninsured residents by expanding Medicaid and the State Children's Health Insurance Program, and offering affordable health care coverage through an insurance pool.
  • Creates the seven-member Oregon Health Fund Board to develop a plan by Oct. 1, 2008, to cover the state's uninsured. The board is also to propose ways to contain health care costs and improve quality, with a focus on primary and preventive care.
  • Calls for the Health Fund Board to create a committee to examine Medicare policies that contribute to relatively low physician pay rates.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn