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Legislative Report for April 21, 2017

 

The chamber of origin deadline marked the halfway point of our legislative session. On Tuesday, the official deadline, many bills were laid to rest in their committees after never receiving a “work session” or vote. There were more than 2,600 bills introduced in the legislature. Of those, approximately 400 were approved by policy committees. The volume of bills moving through the process is noticeably lower than in recent sessions, a possible signal of the tumultuous times ahead over the budget.

 

It may be halftime in the legislature, but there will be no break for lawmakers. Normally, the chamber of origin deadline is the big news of the week during regular session. We are by no means in a normal session because of the budget challenges. On Monday, the Co-Chairs of the Ways and Means Committee released their “working budget,” an itemized list of spending cuts to balance the multi-billion-dollar budget shortfall. Among the proposed cuts are a significant reduction of funding for public schools ($212 million), the elimination of Medicaid expansion under the Affordable Care Act ($256 million), significant cuts to health-related services for the state-managed Medicaid program ($131 million) and other reductions across state government, totaling $1.77 billion.

 

Ideas on immediate relief to the budget shortfall are running rampant around the building. On Thursday, Republicans called for a two-year hiring freeze for state agencies in an effort to reduce spending by $790 million, according to their estimates. Several hours later, Gov. Kate Brown announced her own hiring freeze of two-months to reduce new expenses while the legislature defines a path forward on the budget. Both plans are politicking at its worst. Republicans announced their proposal in advance of the governor’s announcement. The governor’s announcement, similarly, was an effort to appease the business community and budget hawks, suggesting the state would take spending reform seriously. Ultimately, the hiring freeze includes several exemptions for essential personnel and there is no evidence a hiring freeze could be implemented in the manner either party has suggested.

 

Moving forward, the budget discussion will dominate the legislature. Policy bills will become a second tier as lawmakers begin to understand the options and the ramifications of potential budget solutions. Legislative workgroups will begin releasing reform packages for containing the increasing costs of essential government services and new sources of revenue dedicated to specific programs, including a series of health care taxes and the possible return of a business gross receipts tax. In the end, spending and revenue reforms are expected to be limited as the clock to adjournment begins to count down.

 

We are now past the chamber of origin deadline and the basic framework for a transportation package has not been released. A joint legislative committee has spent a significant amount of time considering financing and investment options for a robust transportation package. The package was expected to be released this week, but backroom deliberations continue. The delay could prove to be a problem for transportation leaders as the larger budget deliberations become the primary focus. If leadership cannot get the timing right on a package, there will be an increasing probability the transportation package fails to move forward before adjournment and becomes part of a special session.

 

It is tempting to become hopeful given the high-stakes negotiations occurring in the legislature. These special committees and workgroups need time and collaboration to be fully fleshed out before they are released into the wild. The limited amount of time remaining in our legislative session will surely limit the volume of proposals allowed to move forward, especially given the budgeting challenges. As a result, the probability of a special session later this year is becoming increasingly likely.

 

OPSO bill passes unanimously off House floor

 

Early this week, the House unanimously passed HB 3363, which changes the way DOs are listed in Oregon Revised Statute (ORS).  In many cases, DOs are currently referred to as “osteopaths,” and the practice of osteopathic medicine is called “osteopathy.” This bill changes those references to “osteopathic physician”, or “doctor of osteopathic medicine.” The bill was sponsored and carried by Rep. Ron Noble (R-McMinnville), whose son recently graduated from COMP NW.

 

HB 3363 brings much needed consistency to Oregon statutes and is an important step in formally recognizing DOs’ expertise and training. Initial meetings with health care leadership on the Senate side show a willingness and excitement to pass the bill in both chambers.

 

Senate Health Care Committee moves bills to fulfill deadline requirements

 

In order to meet first chamber deadlines required to keep bills alive, the Senate Health Care Committee voted this week to move several bills to the Committees on Rules or Ways and Means, which are not tied to the same constitutional deadlines.

 

  • SB 233: This bill codifies definitions for community benefit, eligibility categories, flexible services, related party and social determinants of health. It also requires Oregon Health Authority (OHA) to publicly release financial and health care utilization data used to calculate global budgets for coordinated care organizations (CCOs), to use uniform standards when reporting data, publicly, and to use specified criteria when establishing a global budget. It also allows CCOs to appeal global budget with the Department of Consumer and Business Services (DCBS), and to dispute a global budget by seeking judicial review.

 

The committee voted to adopt the -2 amendments, which prohibit OHA from claiming financial and utilization data, among other data sources used by the agency to calculate global budgets as a trade secret. The amendment also allows DCBS to charge a fee to the non-prevailing party involved in an independent rate appeal process.

 

The committee then voted unanimously to move the bill as amended to Ways and Means.

 

  • SB 235: The committee adopted a “gut and stuff” amendment to SB 235, which amends the Indoor Clean Air Act, and allows for smoking on outdoor patios. The committee then voted to move the measure to Rules.

 

  • SB 934: This bill would require CCOs to spend a certain amount of their expenditures on primary care. The committee voted unanimously to move this bill to the floor with a do pass recommendation.

 

While some bills were moved to the floor, or sent to other committees to meet deadline requirements, Chair Laurie Monnes Anderson (D-Gresham) did opt to kill several bills:

 

  • SB 998: This bill would create a weak tobacco licensure program, and was met with opposition from provider groups, counties, and others. Chair Monnes Anderson held a public hearing on the bill, but opted not to move it forward in the process.

 

  • SB 997: This bill was brought forward by Sen. Elizabeth Steiner Hayward (D-Portland), and would tax employers of a certain size who do not offer health insurance to employees. In an odd turn of events, Chair Monnes Anderson opted not to move the bill in time to meet the first chamber deadline, effectively killing it.

 

House Health Care moves litany of bills on Monday

 

The House Health Care Committee adopted the -1 amendments to HB 2300. The original bill included 7-11 drugs in CCO budgets, but during the previous public hearing, the Oregon Health Authority (OHA) said they would like to amend the bill to create a mental health preferred drug list (PDL). NAMI told the committee that they would be open to creating a preferred drug list treatment algorithm, so they introduced the -1 amendments, which created a 12-member clinical advisory group in the OHA to make recommendations on the PDL algorithms. Under the -1s, the advisory council would be made up of several types of practitioners as well as mental health advocates. The -1s allow the algorithm to be recommended, but not mandatory. NAMI did draft -2 amendments that would have made this mandatory, but the amendments weren't written correctly, so Chair Mitch Greenlick (D-Portland) announced his hope that it would be fixed in the Senate. However, after the amendments were adopted unanimously, the bill was sent to the Ways and Means Committee.

 

HB 3261, which requires Oregon Health Policy Board (OHPB), in collaboration with the Office of Rural Health, to develop a uniform application for all health care provider financial incentive programs and continue to study the programs, was sent to the Ways and Means Committee.

 

To keep bills alive, mostly for political purposes, the House Health Care Committee sent HB 3428, which requires PEBB and OEBB members to be enrolled in CCOs, to the Committee on Rules without recommendation. HB 2015, the Speaker's effort to mandate doula reimbursement, was also sent to the Committee on Rules without recommendation.

 

HB 2310 modifies the public health system by creating better collaboration between counties and the OHA. The committee adopted the -1s and the -3s, which clarified funding and accountability mechanisms, and sent the bill to Ways and Means by unanimous vote. Chair Greenlick noted for the record his hope that they find magical money to fund the system.

 

Single Payer discussed in Senate Health Care

 

Yesterday afternoon, the Senate Health Care Committee held an informational public hearing on SB 1046. This bill would require the Oregon Health Authority to initiate and implement a single payer system in Oregon. Since the first chamber deadline had already passed prior to this bill’s initial hearing, the bill will not be moving forward this session.

 

Proponents of a single payer system testified that the proposed system would be simpler, more efficient, and more humane than the current system. Many of the supporters belonged to Health Care for All Oregon and filled the hearing room wearing red t-shirts.

 

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