03/24/2017 Legislative Update March 27
Senate Democrats elect new leader
Oregon State Senator Ginny Burdick was elected Senate Majority Leader, replacing Sen. Diane Rosenbaum. Sen. Rosenbaum will replace Sen. Burdick as Senate president pro tempore. Rosenbaum will continue to serve as the chair of the Senate Rules Committee. Burdick was first elected to the state senate in 1997 and co-chaired the Joint Measure 91 committee, which was charged with oversight and regulation of recreational marijuana.
Burdick’s election marks a major shift in leadership for Senate Democrats. The majority leader is responsible for the development and implementation of the caucus agenda.
Interim Legislative Days
The Oregon Legislature convened September 28-30 for interim legislative days. The primary focus for the House and Senate Health Care Committees was the rate-setting process for Coordinated Care Organizations (CCOs). At stake was the viability of Oregon’s health transformation system, which is predicated on preventing illness and coordinating mental, physical, behavioral and oral health care, rather than the former fee-for-service ‘sick’ care system. The new system is funded by a global budget — on a per-member, per-month, basis, which gives health organizations a high incentive to keep patients healthy.
OHA Director Lynne Saxton, senior leadership for the Oregon Health Authority, and their actuarial consultant appeared before the House and Senate Health Care Committees to discuss and defend the controversial rate-setting process. In response to a letter of corrective action from the Centers of Medicare and Medicaid Services, OHA officials revised the 2015 rates mid-year, making the rates retroactive to January 1.
The budget hit for some CCOs is significant. Six of the 16 CCOs will be subject to a ‘claw-back’ of almost $100 million with Family Care, a Portland based CCO, subject to a $55 million penalty. Family Care has initiated a lawsuit, charging the process goes against negotiated agreements and lacks transparency. Some of their Freedom of Information requests have been denied.
Lawmakers, especially those who had helped negotiate the original health transformation legislation in 2009, were sympathetic to CCO concerns. Current Oregon law requires the per-member per-month CCO rates to be set prospectively, not retroactively. However, the implementation of the Affordable Care Act and the resulting Medicaid expansion, has meant increased federal investment (they cover 100 percent of the funding for the new Medicaid population until 2016 when the amount will decline) and influence in the process. CMS approval is needed for rates or federal dollars are at risk.
The OHA has expressed a commitment to the global budget to transform healthcare. They contend they had to redevelop the rates in order to bring sustainability to the system. Legislators have asked the OHA to appeal to CMS so that the initial rates for 2015 can be used for the first six months. This issue will be scheduled for the next interim Legislative Day committees.
Other committee business
Sen. Laurie Monnes Anderson, the Senate Health Care Committee Chair, canceled the scheduled hearing on the ‘Cadillac tax’ on high-end health plans, to allow more time to discuss the CCO rate-setting process. This topic is expected to come up again in November and it has a possible impact on health care coverage for state employees.
The House Health Care Committee received a report from the Department of Consumer and Business Services on the health insurance exchange. DCBS Director Pat Allen didn’t present because he was appearing before a Congressional Investigatory Committee in regard to Cover Oregon, the independent agency which was dissolved last session. The news for the government-regulated exchange is good: they’ve made it through the transition to stand up a new marketplace and are prepared for open enrollment which begins November. 1. To date, 83,000 Oregonians are receiving subsidies from the health insurance marketplace. Oregon’s uninsured rate has dropped from 15 percent to about 8 percent.
Recreational Marijuana Sales Begin October 1
Recreational marijuana is now legal in Oregon. Adults 21 and older can legally possess and use recreational marijuana, but there are limits. As of July 1, 2015, Oregonians are allowed to grow up to four plants on their property, possess up to eight ounces of usable marijuana in their homes and up to one ounce on their person. Recreational marijuana cannot be sold or smoked in public.The Oregon Health Authority has regulatory oversight of recreational marijuana sales. For more information go to: www.whatslegaloregon.com.
The Oregon Health Authority is drafting temporary rules regarding marijuana labeling, concentration and testing. Of special concern is youth access and child safety around edibles in particular. Washington State’s poison center is reporting double the number of calls for marijuana edible intoxication in the first half of 2015 compared with 2014; one third occurred in youth and a substantial fraction (15%) in those under age 6 http://www.seattletimes.com/seattle-news/reports-of-pot-edible-exposure-to-poison-center-spike/
Legislators will convene for the next Legislative Days November 16-18 and legislators are expected to hold informational hearing on possible issues to surface in the February 2016 session. The deadline to request legislative drafts is November 24.
Two physicians have announced plans to run for Governor next year to finish the remainder of Gov. John Kitzhaber’s term. Dr. Bud Pierce, a Salem oncologist and former president of the Oregon Medical Association, is running for the Republican nomination. Dr. Julian Bell, an Ashland physician, runs the intensive care unit at Providence Medford Medical Center and is seeking the Democratic Party nomination. Gov. Kate Brown is expected to file her bid shortly.
Former House majority leader Val Hoyle has officially entered the race for Secretary of State. Senator Richard Devlin, the co-chair of the joint Ways and Means budget-writing committee, announced earlier in September along with Labor Commissioner Brad Avakian.
For more information about the legislative process, please contact Katy King.