HB2116 Sent to Ways and Means Committee; HB2009 Work Session Today

HB 2116, which would generate revenue needed to pull down matching federal funds for expanding coverage to uninsured children and low income adults, was passed out of Oregon's House Revenue Committee on Thursday and sent to the Joint Ways and Means Committee with a do-pass recommendation.

A work session on HB2009 carries over from yesterday to today's Human Services Subcommittee of the Joint Ways and Means Committee which meets at 1:00 pm.

Below are highlights of a summary written by a colleague, Laura Etherton of OSPIRG, yesterday:

The Health and Human Services subcommittee of Ways and Means is currently considering House Bill 2009, the main health care cost containment bill this session, and is expected to adopt proposed amendments to the bill (-81B) as soon as Friday May, 29. If HB 2009 is passed by the subcommittee, it will next go to the full Ways and Means Committee. 
The bill was developed to put in place many of the cost containment elements of the health reform plan proposed by the Governor-appointed Oregon Health Fund Board (OHFB). 
The Oregon Legislature's consideration of the legislation comes at a key time. Soaring costs and an economic recession have catapulted health reform efforts to the top of the agenda in Washington D.C., as well as at the state level.
In some areas, the resulting bill would take important steps toward lowering health care costs and improving quality. For example, it would promote the use of best practices in medicine and cutting administrative waste. In other areas, the bill would fall short of establishing the industry accountability measures needed to rein in the rising health insurance costs facing families and businesses.

Details:

In its favor, HB 2009 includes sensible strategies to begin identifying and cutting waste in the health system in ways that improve care. Steps forward include provisions to:

• Cut red tape by replacing the myriad versions of claims and billing forms with one common electronic form, and encouraging adoption of effective health information technology. 
• Use the best practices in medicine,making sure that doctors and patients know of the latest, most effective therapies for their conditions. 
• Improve health care cost transparency through an all-payer, all-claims database. 
• Establish the Oregon Health Authority with the duty to contain costs, improve quality and expand access. 
• Direct the Authority to develop a health insurance exchange, including the potential for the choice of a public plan.

On the other hand, HB 2009 falls short when it comes to standing up to insurers' and hospitals' high prices squeezing families and businesses trying to hang on to coverage. The bill includes weak language that: 

• Allows the Director of Consumer and Business Services more discretion on whether or not to approve rate hikes, making a challenge to a rate approval or denial more difficult. 
• Fails to require a robust review of factors, such as the insurer's financial position and the number of people expected to drop coverage if the rate is approved, to help determine whether a rate is excessive. 
• Does not limit the growth in insurer administrative costs, which are currently rising many times faster than the rate of inflation.

After years of double digit health insurance rate hikes, including Regence BlueCross BlueShield's 26% rate hike last year, it would have been reasonable for the Legislature to require more rigorous review of rates in order to protect the public interest.

But holding commercial insurance companies accountable on rising costs has proved difficult during a session when hospital and insurer taxes to fund health coverage expansion were under negotiation. HB 3145, a bill to strengthen rate review, sponsored by Rep. Shields and passed by Rep. Holvey's Consumer Protection Committee, was traded away as part of efforts to gain insurers' support for the tax. Similarly, a bill modeled after Maryland's successful program regulating hospital rates died in committee. 

If we assume that these bills, or some revised version of them will pass this session, we have a lot of work before us to assure transparency during the interim, and discussion of legislation in preparation for the 2011 session. Passage of these bills is a step, but alone will not reach our objective of improved health, which includes access to affordable, quality health care for all who live in Oregon and eventually all who live in this nation. There is a lot of work ahead of us.