June 2007

Major reform ahead for insurers

Health insurers put on a happy face as they ushered in what the Oregon Insurance Division called the first major market reform in more than a decade. Three bills recently signed by the governor increase health insurance regulation and transparency. Despite previously coming out against the bills, the health insurance industry accepted the new laws in the end.

A few months ago, Regence BlueCross BlueShield lobbyist John Powell strongly opposed a bill that would close a loophole in the state’s ability to regulate medium-size groups, those with between 26 and 50 employees, which currently fall under federal regulation. House Bill 2002 combines the small and medium group markets under the state’s purview, while expanding the rate bands (the allowable maximum price difference between any two health plans). At the time it was introduced, Powell warned lawmakers that such a policy could increase rates for younger groups and medium-size groups. Other insurers agreed.

OHP Standard could re-open

The Oregon Health Plan Standard may open its doors for the first time in two years, but don’t expect anything drastic.

“We’re at the point where if the funding continues at its current level, or by some miracle it increases, we can be thinking about new patients coming into the program,” said Jim Edge, administrator of the Division of Medical Assistance Programs.

Major EMR project stalled

A project to create a shared network of electronic medical records within the Portland area has been sidelined after project members failed to agree on who would fund ongoing initiatives.

Health plans have increased pressure on hospitals to pony up their share. But hospitals argue that it’s the health plans that have the most to gain in terms of cost savings if an exchange system were realized.

On the Record with sam Adams

As Portland’s public utilities commissioner, Sam Adams has a lot on his plate. An issue that’s not on his professional radar, however, may be closest to his heart.

As a young campaign worker, Adams was struck with appendicitis. The tragedy caught him off guard, and without health insurance.

Adams eventually filed bankruptcy and spent the next 15 years climbing out of debt.
Although he no longer has to cash his checks at the Plaid Pantry, he hasn’t forgotten those formative years.

Editor-in-Chief Tim Stumm recently caught up with the on-the-go lawmaker to ask how that early setback influenced his political career, and which job he will be campaigning for next fall.

OHN: You seem like an intelligent guy, why didn’t you have health insurance?

SA: I was a campaign worker, and political campaigns don’t pay a lot of money. I was having trouble making ends meet, and I used the stipend they gave me for health insurance to try to pay my bills. I was a 24-year-old and had always been healthy.
Then I had appendicitis and I had lots of medical bills for which I had no resources to pay.

It took me 15 years to pay all the original debtors back. But it was very humbling and humiliating to go through that bankruptcy.

Health care reform bills barrel towards passage

The freight train to universal health care in Oregon is motoring down the track.

Sen. Ben Westlund (D–Tumalo), chief co-sponsor of Senate Bill 329, along with Sen. Alan Bates (D–Ashland), said their legislation has enough votes to pass both houses.

Meanwhile, Rep. Mitch Greenlick’s (D–Portland) referral to the voters to make health care a Constitutionally protected “fundamental human right” moved toward passage. House Joint Resolution 18 also declares health care “an essential safeguard of human life and dignity.”

Also in this issue...

• Former OMA president ousted from health professionals board
  
• Lawmakers don’t always follow law on mandates
  
• Debate over health records gets personal
  
• EMS reform put on hold
  

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