Greenlick Concedes Lawmakers Punted Tough Questions

Leading reformist gets praise yet disappointment for what legislature left out of critical reform
By: 
David Rosenfeld

July 23, 2009 -- Oregon's Legislature "avoided all of the hard questions" when it dealt with healthcare reform, according to Rep. Mitch Greenlick (D-Portland), who spoke to a group of health reform advocates earlier in the week. 

The legislature's biggest accomplishment was creating a funding stream to insure nearly every child and expand the Oregon Health Plan through a tax on insurers and hospitals. 

Greenlick, who chaired the House Health Care Committee, earned praise for that. But several reform advocates among more than 100 people in attendance raised frustrations and disappointments with what lawmakers didn't  accomplish. For the most part, Greenlick agreed.
 
“Those very difficult contentious issues were avoided,” he told those gathered at a free event organized by Oregon Health Action Campaign.
 
It came down to whether lawmakers could get the votes. In most cases, the answer was ‘no’ even though Democrats controlled both chambers. 
 
Greenlick agreed that the state couldn't afford to wait much longer to deal with the dire situation in Oregon where nearly one in four who apply for individual health insurance are rejected for pre-existing conditions.
 
The Oregon Medical Insurance Pool, where insurance is guaranteed but the cost is higher, may not survive for another two years, he said. Insurers currently pay roughly $90 million per year to help subsidize those plans.
 
“OMIP really worked in the first decade and a half of its existence,” Greenlick said. “Right now OMIP is unstable. I’m not sure it will survive after 2011.”
 
Asked about pronouncements by insurers who've said they'll increase premiums to cover the 1 percent provider tax to cover the uninsured, Greenlick said he expected that would happen. “If we use the hospital and insurance tax as soon as possible, we’ll be able to reduce insurance costs."
 
Teresa Miller, administrator of the Oregon Insurance Division, told TheLundReport that it will be hard to measure when the tax begins to have its intended effect. “That’s something we’re going to have to work on. The goal of the tax is to increase the number of insured lives and decrease uncompensated care.” 
 
As far as covering undocumented immigrants, Greenlick said, “If we included healthcare for illegal immigrants it could not have passed. We made the political expedient position to put that question off.” His own opinion on the matter is clear. “We can’t let anyone be excluded for any reason."
 
Other issues the legislature left on the table, which Congress may decide, include the following:
  • How to create a public health plan that everyone can buy into,
  • How to create an insurance market exchange with standard benefits,
  • How to fully deal with minority health disparities,
  • Whether to require insurers to cover everyone regardless of pre-existing conditions,
  • Whether to enact an individual and/or employer mandate,
  • Whether to raise a general tax to pay for subsidizing insurance coverage,
  • And how to streamline the state’s purchasing power.

This won’t be the first time the legislature punted tough healthcare reform questions to an outside body, only to ignore or postpone what it recommended.

In 2007, when Democrats controlled the legislature for the first time in more than a decade, it largely ignored recomendations from the Oregon Health Policy Commission. Instead, it created the Oregon Health Fund Board and continued deliberations. 

This time around the legislature created the Oregon Health Authority and the Oregon Health Policy Board. Together they are charged -- along with solving the above questions -- with carrying out an expanded Medicaid program and streamlining state government, which includes splitting the Department of Human Services. Both boards are currently seeking members.

Take Action

Apply for the new health policy boards or nominate someone else by reading a call for members here.

To be included in future meetings such as these contact the Oregon Health Action Campaign.

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