Rep. Richardson's April 14, 2007 Update

OHPC Health Care Recommendations in Rep. Greenlick’s HB 3368


On April 12th the House Health Care Committee heard representatives of the Oregon Health Policy Commission who presented Rep. Greenlick’s House Bill 3368, which embodies the OHPC’s recommendation for Oregon health care reform.

A detailed explanation of the OHPC’s recommendations is contained in the Oregon Health Policy commission "Road Map for Health Care Reform,” which can be found online.

A comparison of Senators Bates and Westlund’s S.B. 329 and former Governor Kitzhaber’s S.B. 27 with Rep. Greenlick and the OHPC’s H.B. 3368 as of March 21, 2007 is available on the Health Policy Commission website.

H.B. 3368 has many redeeming provisions. Unfortunately, one overshadowing provision is the high expense of its health care insurance policy subsidies. The estimated cost for H.B. 3368 is $1.1 billion per biennium.

The OHPC proposed subsidies embodied in H.B. 3368 Section 9 (1)* provide the State of Oregon (regardless of the availability of State funds or extent of the individual’s assets), “shall” provide public subsidies for all “uninsured low-income individuals.”

Section 9 (3) indicates cost-sharing (subsidized premium payments), shall continue for individuals earning more than 200% FPL, so long as the individual is encouraged for “…appropriate use of preventive care and avoidance of unnecessary services.”

Section 9 (4) indicates, “Cost-sharing shall be based on an individual’s ability to pay….”

Finally, Section 9 (5) provides health care insurance coverage for all children under age 19 in homes earning less than 200% FPL, and subsidization of insurance for those in homes earning between 200-300% FPL.

H.B. 3368:
SECTION 9. ORS 414.839 is amended to read:
{Italicized wording in brackets is deleted from current statute.}
414.839.
(1) [Subject to funds available,] The Department of Human Services [may] shall provide public subsidies for the purchase of health insurance coverage provided by public programs or private insurance, including but not limited to the Family Health Insurance Assistance Program, for currently uninsured low-income individuals [based on incomes up to 200 percent of the federal poverty level. The objective is to create a transition from dependence on public programs to privately financed health insurance].

(2) Public subsidies shall apply only to health benefit plans that meet or exceed the basic benchmark health benefit plan or plans established under ORS 735.733.

(3) Cost-sharing shall be permitted [and] for an individual with income above 200 percent of the federal poverty guidelines, provided it is structured in such a manner to encourage appropriate use of preventive care and avoidance of unnecessary services.

(4) Cost-sharing shall be based on an individual's ability to pay and may not exceed the cost of purchasing a plan.

(5) The state may pay a portion of the cost of the subsidy, based on the individual's income and other resources. For children under 19 years of age, there shall be:
(a) A full subsidy for children whose family income is at or below 200 percent of the federal poverty guidelines;
(b) A partial subsidy for children whose family income is above 200 percent and at or below 300 percent of the federal poverty guidelines;