HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

 

March 20, 2003   Hearing Room 50

3:00 PM Tapes  65 - 66

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Alan Bates

Rep. Jeff Kruse

Rep. Jeff Merkley

 

MEMBERS EXCUSED:            Rep. Susan Morgan, Vice-Chair

Rep. Randy Miller

 

GUEST MEMBERS:               Rep. Gordon Anderson

Rep. Mitch Greenlick

Rep. Carolyn Tomei

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Patricia Nielsen, Committee Assistant

 

ISSUES HEARD:                     Informational meeting

Committee Discussion on OHP Recommendations

Work Session

Adoption of Committee Recommendations

 

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 65, A

005

Chair Westlund

Calls meeting to order at 3:14 p.m.  Opens informational meeting.

INFORMATIONAL MEETING

020

Chair Westlund

Recesses the committee at 3:15 p.m.  Asks members to review the submitted draft recommendations, primary Medicaid cost-containment recommendations, and secondary Medicaid cost-containment recommendations (EXHIBITS A, B, C).

**************************

RECESS         **************************

025

Chair Westlund

Reconvenes the committee at 3:28 p.m.  Gives brief overview of proposals.

050

Rep. Merkley

Refers to EXHIBIT A and raises concerns:

·         Urges the committee to clarify it is responding to a directive to bring ideas, not endorsing establishment of a budget for Medicaid categoricals.

·         Asks to include language in the document that translates the fact of reduced coverage due to budget limitations into devastating impact on quality of life:

o        Additional medical complexities for those who cannot get preventative treatment

o        Personal suffering

o        Inability to live productive lives

095

Rep. Bates

Asks if more explicit language is needed, to describe the effect if only the basic plan is approved.

105

Rep. Merkley

Responds the report must communicate concerns over loss of quality of life for those without coverage.

115

Rep. Bates

Suggests inserting language into recommendation two.

120

Rep. Merkley

Asks the committee to clarify the report is presenting a health care package as instructed, not recommending the package.  Asks to express concerns about impact of the plan as presented.

130

Chair Westlund

Points out the instruction was to prepare a package within existing resources; also it is wise to actually keep the plan within existing resources.  Expresses satisfaction that it is established within resources as a baseline to build on.  Points out there is language to add services later if resources become available.

160

Rep. Merkley

Asks for the language to be stated in the actual document.  Suggests modified wording.

170

Chair Westlund

Comments the first page says “as a base plan.”

 

 

Committee discussion of where to add language.

220

Rep. Merkley

Suggests language and location.

225

Rep. Bates

Suggests the problem is the location of the language.  Suggests putting the disclaimer language right at the beginning.

250

Rep. Merkley

Acknowledges it is the best plan within existing resources, but notes reservations and concerns about the effect on people.

260

Chair Westlund

Suggests recognizing economic consequences and cost shifts, and inability to predict all effects.

285

Rep. Merkley

Suggests we can predict the consequences, and should acknowledge we do know what severe consequences there will be.

300

Rep. March

Asks for specific suggested language.  Agrees it is a good proposal but it is the minimum which should be done.  Points out this is not the Oregon Health Plan (OHP); it is a Medicaid-based plan to which items can be added later.

385

Rep. Bates

Comments on the structure of the plan

·         Maintains care organizations which have evolved from the OHP

·         Significant change from other Medicaid plans because it has a defined list of benefits

Recommends the report go forward to Ways and Means.

405

Chair Westlund

Closes informational meeting.  Opens work session to consider committee recommendations.


 

TAPE 66, A

WORK SESSION

005

Rep. Bates

MOTION:  Moves the Committee Recommendations report to the Joint Ways and Means Committee, Subcommittee on Human Resources, with a DO ADOPT recommendation.

010

Rep. Greenlick

Suggests a cover memo to clarify the concerns of the committee outside the language of the report.

015

Chair Westlund

Reiterates the report was not intended to document all consequences.  Agrees with the memo idea.

035

Rep. Merkley

Suggests mentioning cost shifts and human impacts as well.  Proposes specific language:

The committee presents below the best possible plan it could design based on the premise of operating within available resources.  The committee notes, however that the base plan in this document would eliminate health coverage for 150,000 Oregonians, and that such loss of coverage would have significant human consequences.  The loss of insurance will translate into less preventative care, diseases that progress to higher disease states and impacts upon individuals’ families and productivity and community.

050

Chair Westlund

Asks for Rep. Merkley and committee staff to work on language.  Invites members to write personal letters to accompany the report.

065

Rep. Bates

Comments sometimes specific words are important, and in fact the committee is recommending a plan, with the caveat offered by Rep. Merkley.  Suggests protecting the report from further alterations.

075

Chair Westlund

Advises tougher times may be ahead, and the committee may look back and see it was a good plan, which is a base and a place to fall back to.  Points out it is possible revenue forecasts will continue to deteriorate, and this covers 350,000 Oregonians with a benefits package significantly greater than federal Medicaid coverage.

095

Rep. Kruse

Suggests the document go forward as is, and members with concerns prepare a supplemental document or letter expressing concerns.  Reminds members the Ways and Means Subcommittee will consider this later, and things may change as additional information becomes available.

115

Rep. Anderson

Commends committee on work accomplished.  Agrees this is a framework and things can be added later.  Expresses concern over member disagreements about details.  Suggests a positive statement is needed about what can be done at this time.

130

Chair Westlund

Acknowledges this represents work of many, and many concessions.  Opines this is more comprehensive than federal Medicaid minimum.

155

Rep. Merkley

Agrees the difference is in presentation.

205

Chair Westlund

Suggests adding a sentence or two explaining recommendations, which is not part of the recommendations themselves.

230

Vice-chair March

Recommends voting.  Recesses the committee at 4:12 p.m.

**************************

RECESS         **************************

250

Chair Westlund

Reconvenes at 4:19 p.m.

255

Rep. Bates

Withdraws his previous motion.

257

Rep. Bates

MOTION:  Moves the committee vote out to the Joint Ways and Means Committee, Subcommittee on Human Resources, the recommendations of the report with a BE ADOPTED recommendation, and that committee staff with appropriate members add a preamble to encompass the information above the recommendation, as well as the additional language requested by Rep. Merkley.

270

Chair Westlund

Clarifies the motion includes the primary and secondary Medicaid cost containment recommendations (EXHIBITS B, C).

275

Rep. Bates

Affirms.

280

Chair Westlund

Clarifies the preamble would go out in letter form which individual members can sign if desired.

282

Rep. Bates

Affirms.

285

Chair Westlund

Restates and discusses the motion to move the recommendations to the full Ways and Means Committee.

290

Rep. March

Clarifies the primary and secondary cost containment recommendations are part of the report.

295

Chair Westlund

Confirms. Continues reviewing language.

300

Rep. Merkley

Agrees.

330

Chair Westlund

Summarizes.

350

 

VOTE:  5-0-2

EXCUSED:  2 - Miller, Morgan

 

Chair Westlund

Hearing no objection, declares the motion CARRIED.

395

Rep. Greenlick

Asks whether long term care is part of the committee’s recommendation.

400

Chair Westlund

Discusses mandate for various areas to be considered.

420

Chair Westlund

Closes work session.  Adjourns the committee at 4:27 p.m.

 

EXHIBIT SUMMARY

 

A – Informational OHP, draft recommendations, staff, 8 pp

B – Informational OHP, primary medicaid cost-containment, staff, 7 pp

C – Informational OHP, secondary medicaid cost-containment, staff, 3 pp