HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM COMMITTEE

 

 

February 11, 2003   Hearing Room 50

3:00 PM Tapes  22 - 23

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Merkley

Rep. Jeff Kruse

Rep. Alan Bates

 

MEMBER EXCUSED:            Rep. Randy Miller

Rep. Susan Morgan, Vice Chair

 

GUEST MEMBERS:               Rep. Carolyn Tomei

                                                Rep. Billy Dalto

                                                Rep. Laurie Monnes Anderson

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

 

ISSUES HEARD:                     Informational Meeting – “The Public OHP Overview”

                                                Lynn Read, Acting Administrator for the Office of Medical

                                                          Assistance Programs, DHS

                                                Jim Edge, Acting Assistant Administrator for the Office of Medical

                                                Assistance Programs, DHS

 

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

Tape 22, A

001

Chair Westlund

Meeting called to order at 3:10pm, introduces invited guests Lynn Read and Jim Edge for the Office of Medical Assistance Programs, DHS and opens the informational meeting.

INFORMATIONAL MEETING

018

Lynn Read

Acting Administrator of Office of Medical Assistance Program with Jim Edge, Acting Assistant Administrator.  (EXHIBIT A)  Begins presentation talking about traditional Medicaid page 3.

105

Chair Westlund

Comments that if we had the general fund, we could push that higher than 200 percent.

111

Read

Agrees and continues.

118

Rep. Bates

Asks how do you disregard a third of someone’s income.

120

Read

Responds to how you disregard a third of someone’s income. Continues.

148

Rep. March

Asks if we have a waiver that releases us from caring for children under twenty one, what do we do, cut it off at eighteen.

150

Read

Responds to the waiver that makes us different than other states.

162

Rep. Dalto

Asks where are the nursing facilities for children under twenty one.

167

Read

Comments about that she will get back to us with that information.

170

Rep. Bates

Elaborates on his knowledge about these programs to clear up any misunderstanding.

182

Read

Continues presentation on page 6. .  (EXHIBIT A)

191

Berkobien

Asks in the absence of the prioritized list, we would have to use medical necessity definition, what would that cover if we went back to that definition.

198

Read

Comments that if we look at page 8 it would give some explanation. .  (EXHIBIT A)

215

Rep. Dalto

Asks if physicians have to accept Medicaid cards.

220

Read

Responds about physicians accept Medicaid cards.  And turns the presentation over to Jim Edge.

247

Kruse

Makes comments about excluded drugs on the list.

264

Read

Agrees with Rep. Kruse’s comments.

274

Edge

Begins his discussion on the Oregon Health Plan

343

Berkobien

Asks if any other states have a prioritized list like Oregon..

352

Edge

Not aware of any other states using a prioritized list.

361

Rep. Bates

Makes comments about the prioritized list and comments that the Federal government has blocked us using the list the way it should have been used and elaborates.

412

Read

Responds about the prioritized list.

TAPE 23, A

011

Rep. Merkley

Asks what is the source of flexibility or lack of flexibility in the Federal Government when it comes to this.

021

Read

Comments about the flexibility.

037

Rep. Merkley

Asks why something like this would go to the White House.

039

Read

Responds why this type of issue would go to the White House.

066

Rep. Merkley

Asks if this essentially got caught up in the politics around single payer insurance and Hilary Clinton’s group or is that what really drove the lack of flexibility.

072

Read

Expresses that she does not think that is correct and elaborates.

080

Chair Westlund

Comments that the operative word is reduce benefits and taking that money and matching that with Federal dollars and expanding eligibles, asks if that is a fair classification.

082

Read

Responds yes and no and explains.

095

Rep. Bates

Makes comments about the prioritized list and asks if the list have any value to define the value any more and should be keep using it or replace it with something else and elaborates.

113

Read

Does not have an answer for him on that subject.  Continues presentation.

134

Rep. Bates

Makes comments about the figures and asks if we still rank high as far as  expenditures per individuals and do you have any idea if the prioritized list has impacted that at all.

143

Read

Comments that we rank very low and continues presentation.

167

Chair Westlund

Asks how Colorado spends a $1000 more than the US average when they are below the US average in Medicaid expenditures.

171

Read

Comment about the state of Colorado.

178

Chair Westlund

Asks how Oregon compares to Colorado in size.

180

Read

Responds to what she thinks the population of Colorado is.

190

Rep. Bates

Asked if this includes long term care facilities.

196

Read

Responds yes.

189

Bates

Comments that we really need to cut that out as Medicaid payments for long term care facilities are probably half the budget.

192

Read

Responds that the portion of their agency that handles long term care their general fund is about the same as OMAP’s general fund.

195

Rep. Bates

Responds that the systems we use in Oregon is substantially different than any in the United States and that really sques these numbers, asks can you cut the numbers out to have OMAP only.

198

Read

Will look into doing that.

203

Chair Westlund

Agrees and elaborates.

216

Rep. Merkley

Is guessing that there is a large immigrant population that is eligible, but does not sign up for the program, so that would drive it to a very low level per eligible, asks if that is a factor and can we get the numbers per participant.

220

Read

Answers question that it is per participant.

233

Chair Westlund

Asks for clarification from Rep. Merkley about what he means.

240

Rep. Anderson

Comments about the huge difference across the nation in terms of amounts spent, asks if it is that totally political or can we by waiver ask for more.

247

Read

Responds about having a waiver and asking for more.

265

Rep. Bates

Makes comments about statistics in Oregon that may be driving these figures and elaborates.

289

Chair Westlund

Makes comments about western medicine.

304

Chair Westlund

Offers a compliment of how helpful this is and thanks Lynn Read for her detail.

312

Edge

Makes comments Federal Governments and about the program and how it is working.

327

Berkobien

Asks in Oregon how do these numbers break out in other states.

339

Read

Responds that they will look for information on Oregon to see how they compare to other states.

356

Edge

Continues his presentation.

TAPE 22, B

013

Rep. Merkley

Asks question about premium requirements.

015

Edge

Comments that we are talking about the expansion population.

018

Rep. Merkley

Asks what the monthly premium is for the expansion categories.

020

Edge

Suggests that the members look at page 50 of (EXHIBIT A) they have a list of those premiums.

025

Rep. Bates

Asks for the difference in OHP plus verses OHP standard benefit packages.

035

Edge

Comments about the OHP package differences.

065

Read

Makes additional comments about he differences in the packages.

068

Rep. Kruse

Makes comments.

082

Chair Westlund

Comments that whatever the committee comes up with could be extremely controversial also.

085

Rep. Bates

Comments on Rep. Kruse’s comment from above.

091

Read

Comments about work being done currently and gave list of names of delegates that would like to come back and be a part of this process.

113

Edge

Comments that they are aware of the controversial issue of the co payments and elaborates.

135

Chair Westlund

Comments further about co-payments.

138

Rep. Bates

Comments that he is not criticizing the health service commission, they did what they were suppose to do and he asks if we can go further.

140

Rep. Kruse

Questions the comments about the health service commission and elaborates his opinion.

145

Chair Westlund

Comments that we will get the opportunity to write that shift.

152

Rep. Merkley

Asks question of Rep. Kruse about the cost shift in regard to co payments.

158

Rep. Kruse

Responds to Rep. Merkley about co payments.

163

Rep. Merkley

Asks questions about being kicked out of the plan for non-payment of co-payments.

173

Read

Responds to the question.  Asks how Chair Westlund would like her to proceed.

180

Chair Westlund

Comments that he would just like her to continue though the presentation outline.

187

Read

Continues presentation.

216

Rep. Kruse

Asks if that is the Federal poverty level for TANF. (Temporary Assistance for Needy Families)

220

Read

Comments no, and elaborates.

224

Rep Kruse

Comments that we have had a surplus of TANF dollars to use to back fill into other things.

232

Rep. Tomei

Asks for definitions on the acronyms in the handout.

239

Rep. Merkley

Asks why there was a separate CHIP fund.

242

Read

Comments about the CHIP Fund and continues presentation.

280

Rep. Bates

Articulates his understanding of the program before.

284

Read

Answers and continues presentation.

346

Rep. Tomei

Asks why there are so many more males in the 29 age range in the chart we are looking at (EXHIBIT A)

350

Read

Answers questions on the charts in (EXHIBIT A).

375

Chair Westlund

Comments that the typical American family is a single family with a woman and elaborates.

412

Monnes Anderson

Asks questions about Medicaid expenditures.

413

Read

Explains about Medicaid expenditures.

429

Rep. Bates

Asks about new eligible single couples, what does it costs the Oregon Health Plan to insure these 50 thousand people.

TAPE 23 B

005

Read

Answers and continues presentation on page 28 of (EXHIBIT A)

014

Rep. March

Asks question about those that are at 0 percent.

018

Read

Comments about those at 0 percent.

024

Rep. Merkley

Asks why aren’t the people from 0 – 10 percent  under the category in the plus plan.

029

Read

Comments that they have an income that might qualify them they may not fall into the other categories and continues presentation.

037

Rep. Merkley

Comments that these are not single childless couples are they.

045

Read

Explains with more detail.

047

Chair Westlund

Elaborates his understanding.

050

Read

Comments that these adults and families their children have OHP plus.

053

Rep. Monnes Anderson

Asks what are some of the reasons some people do not want to be on SSI and ask if there are ombudsmen to assist with them.

073

Edge

Makes comments to about the question on SSI..

063

Read

Elaborates with more detail about the process.

097

Rep. Monnes Anderson

Asks if this is a systems problem getting them on SSI.

101

Read

Comments about SSI.

115

Rep. Bates

Makes comments about the time it takes after you get on SSI and then onto Medicare.

129

Read

Comments and continues presentation.

135

Chair Westlund

Asks what was the total amount of dollars we spend on this population.

140

Read

Does not have the answer.

149

Chair Westlund

Talks about percentage of eligibles on slide 29 on (EXHIBIT A)

164

Read

Answers and continues presentation.

177

Rep. March

Comments about the CHIP eligibles category.

180

Read

Answers about CHIP eligibles and suggest that we stop here and continue later.

185

Chair Westlund

Asks if she can you explain your understanding the Bush administrations proposed changes in Federal Medicaid and Health Care Policy.

190

Read

Comments that she has a staff member that could answer that question better than she, she will answer to the best of her knowledge.

225

Rep. Kruse

Makes comments about wanting to see this legislative package implemented and is it relevant to what we are doing now thinks we are needing a matrix of Medicaid money.

260

Read

Asks for clarification about what he is needing.

287

Rep. Kruse

Explains in more detail.

295

Rep. Bates

Will hold the rest of the questions until a later date.

 

Chair Westlund

Closes the informational meeting and adjourns 4:55pm

 

EXHIBIT SUMMARY

 

A – Informational – OHP, Oregon Health Plan Overview, Lynn Read, 108 pp