February 23 rd , 2018 LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE UNIVERSAL ACCESS TO CARE WORK GROUP 2018
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE AGENDA 2:30-2:35 PM Welcome, Opening Remarks 2:35-3:30 PM RAND Study (2017) 3:30-3:30 PM Work Group Discussion 3:50-4:00 PM Public Comment Opportunity
F ina nc ing He a lth Ca re in Ore g o n: F o ur Po lic y Optio ns Ge tty/ o o yo o Cha pin White , Christine E ib ne r, Jo di L iu, Ca rte r Pric e , No ra L e ib o witz, Gre tc he n Mo rle y, Je a ne ne Smith, T ina E dlund, Ja c k Me ye r 3
Ore g o n is a mo ng the le a ding sta te s in pursuing he a lth c a re re fo rm 4
Ore g o n HB 3260 c a lle d fo r a na lysis o f fo ur po lic y o ptio ns 5
RAND a nd HMA use d q ua lita tive a nd q ua ntita tive me tho ds in the a na lysis 6
We e va lua te d e a c h o ptio n o n multiple c rite ria 7
Spe c ific a tio ns a nd K e y Re sults 8
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Pro po rtio n o f Ore g o nia ns c o ve re d wo uld va ry b y fina nc ing o ptio n Sing le Pa ye r Pro po rtio n o f Ore g o nia ns Co ve re d HCI P Pub lic Optio n (No ng ro up) Uninsure d Priva te No ng ro up Co ve ra g e Me dic a id E mplo ye r-spo nso re d Gro up Co ve ra g e Me dic a re , F E HB, VHA, I HS SI NGL E HCI P PUBL I C ST AT US PAYE R OPT I ON QUO 10
Po lic y o ptio ns c o mb ine diffe re nt fina nc ing so urc e s SI NGL E PAYE R HCI P PUBL I C OPT I ON F e de ra l funding Ne w sta te pa yro ll ta x I nc re a se in sta te inc o me ta x Re duc e pro vide r pa yme nt ra te s Ne w sta te sa le s ta x 11
Pe rc e nt o f Po pula tio n 100% 100% 96% 95% Co ve re d 12
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T he Bo tto m L ine 16
I mple me nting a ny o ptio n re q uire s ke e n a wa re ne ss o f b e ne fits a nd tra de -o ffs 17
Que stio ns? 18
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE WORK GROUP TASKS I dentify incremental state-level policy changes to make it easier for individuals a) to access and maintain coverage, whether through their employer or through existing or new publicly funded programs. b) Describe potential changes to employer-sponsored coverage and commercial plans, including the extent to which existing coverage mechanisms are compatible with a universal coverage system. Determine what mechanisms, if any, are needed to minimize disruption to the current health care system. c) Explore whether new governance models are needed to achieve universal access, including major components and functions of any such model. d) Explore long-term sustainable funding sources that can raise sufficient revenue to finance universal access, including local, state and federal funding availability. e) Investigate the federal waivers and permissions that would be required for Oregon to maximize federal funding for the provision of health care services.
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE January 9 th 2018 Meeting • History of House Bill 3260 (2013) • History of changes in health care delivery in Oregon • Cost trends in health care • Rate of insured, uninsured, and under insured • Current insurance coverage approaches: public and private including employer- sponsored coverage • Understanding of health care financing in other OECD counties • Affordability of health coverage and access to comprehensive health care services (public and privately funded health coverage) • Distinction between health insurance status and access to health care and • Long-term sustainable funding for universal health care coverage for all Oregon residents
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE ROADMAP 2018 Timeline January April June – August September 2018 February March May Alternative Finalize and submit Review RAND Health Care Health International Charter Financing & Financing report to Health Oregon Coverage Lessons for Delivery in Models Policy Committees Study Oregon post-ACA Oregon Federal ACA in Workgroup Proposals Cost Administrative Oregon from Other Feasibility Discussion Drivers and Complexities States Considerations and Related Barriers and Challenges Costs Governance Solicit Input Tools to and Member Models and Contain Consumer Orientation Health Care Choice Costs 21
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE MEMBER COMMENTS AND NEXT STEPS
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE NEXT STEPS At the Oregon Nurses Association Offices (18765 SW Boones Ferry Rd # 200, Tualatin, OR 97062): • Thursday, March 22 nd 8:00-11:00 am • Thursday, April 19 th , 8:00-11:00 am • Wednesday, May 23rd, 8:00-11:00 am • Thursday, June 21 st , 8:00-11:00 am • Thursday, July 19 th , 8:00-11:00 am • Thursday, August 23 rd , 8:00-11:00am
LPRO : L EGISLATIVE P OLICY AND R ESEARCH O FFICE PUBLIC COMMENT
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