SENATE COMMITTEE ON HEALTH POLICY
June 12, 2003 Hearing
Room B
1:00 P.M. Tapes
72 -74
MEMBERS PRESENT: Sen. Bill Morrisette, Chair
Sen. Bill Fisher, Vice-Chair
Sen. John Minnis
Sen. Frank Shields
Sen. Charles Starr
Sen. Vicki Walker
STAFF PRESENT: Marjorie Taylor, Committee Administrator
Heather Gravelle, Committee Assistant
MEASURE/ISSUES HEARD: SB 875 – Public hearing and Work
Session
HB 2987 A – Public
Hearing and Work Session
HB 3431 A – Public
Hearing and Work Session
HB 2828 A – Public Hearing and Work Session
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 72, A |
||
|
005 |
Chair Morrisette |
Calls the meeting to order at 1:00 p.m. and opens a
public hearing on SB 875. |
|
SB 875
– PUBLIC HEARING |
||
|
010 |
Marjorie Taylor |
Committee Administrator. Provides a brief overview
of SB 875 and explains the SB 875-8 amendments that replace the original
measure (EXHIBIT A). |
|
024 |
Rep. Mitch Greenlick |
District 33. Testifies in support of SB 875.
Introduces the SB 875-8 amendments (EXHIBIT
A). States most of his colleagues who have worked on the bill, have
concluded if implemented it would provide a start but is far from an ideal
solution. |
|
035 |
Rep. Greenlick |
Comments on support for the amendments. Explains that the SB 875-8 amendments
include the potential for building a bulk purchasing program for the
population 55 years of age and older, have not had coverage over the last six
months and are under 185 percent of the poverty level. |
|
065 |
Sen. Walker |
Asks what happens to residents who are 54 years and
younger. |
|
|
Rep. Greenlick |
Explains that the decision to choose 55 was a
compromise. Comments on negotiations. |
|
080 |
Sen. Minnis |
Comments that the population was modeled after the
senior prescription package from the 2001 legislative session. |
|
|
|
|
|
105 |
Sen. Walker |
States the bill is an intersection of ideas. It is a
start of what could be in the future. There will be a report prepared for the
next legislative assembly on the program.
|
|
110 |
Rep. Greenlick |
States that Senator Walker is correct and the next
session may want to continue it for another two years or change it based on
the experience. |
|
115 |
Dr. Bruce Goldberg |
Administrator, Office for Health Policy and Research.
States they began this discussion a couple of months ago. Explains there are about 450,000 people in
the state who are not insured, and another 400,000 who are underinsured or
have no access to prescription drugs. As a result of those discussions they began a process as to how
to work together through group purchasing power and to help provide the
discounted prescription drugs and make them more accessible and affordable. |
|
140 |
Dr. Goldberg |
Comments on the complexity of the pharmaceutical
market. Believes this is a first
step in setting up a model that will be successful. States that another reason to look at the age group above 54 is
because it is the population with the highest prescription need. |
|
150 |
Chair Morrisette |
Recesses the public hearing on SB 875 and opens a
public hearing on HB 2987 A. |
|
HB 2987
A – PUBLIC HEARING |
||
|
182 |
Marjorie Taylor |
Provides an overview of HB 2987 A and advises
members that they have received the HB 2987-A6 amendments (EXHIBIT B). |
|
175 |
Leonard Hagen |
Manager, Legislative Affairs, Regence BlueCross
BlueShield of Oregon. Introduces John
Powell, Lobbyist, and Sue Cole, Manager of individual and small group
underwriting. Submits graphics and
explains their concerns about declining enrollment (EXHIIBT C). |
|
256 |
Hagen |
Explains effects of SB 2987-A6 amendments on waivers
(EXHIBIT C, pages 6 and 7). |
|
312 |
Chair Morrisette |
Asks if high blood pressure could be considered in a
waiver, and if the person would be excluded from coverage. |
|
|
Hagen |
Responds he believes it would be a consideration. |
|
319 |
Chair Morrisette |
Comments he doesn’t know if the cause of a stroke
can be pinpointed entirely. |
|
310 |
Hagen |
Responds that part of the problem was anytime there
is a secondary condition it is sometimes difficult to medically determine a
cause. The bill says “only the
condition” and nothing else, whether it is related or not related. Adds that the secondary condition would
not need to be determined because it could not be excluded. |
|
342 |
Sen. Fisher |
Asks if blood pressure medication would not be paid
for if high blood pressure had been waived out and the person had a stroke
due to high blood pressure. |
|
361 |
Hagen |
Answers yes. |
|
326 |
Sen. Fisher |
Ask if a concussion from a fall would be covered if
blood pressure had been waived out. |
|
340 |
Hagen |
Responds affirmatively. Continues presentation on waivers up to 24 months (EXHIBIT C, page 6). |
|
|
Sen. Minnis |
Asks if they are trying to craft a methodology by
which insurance can be provided for more people who are now uninsured. |
|
396 |
Hagan |
Responds affirmative. States this would not apply to those currently insured. |
|
360 |
Sen. Minnis |
Comments on the population increase since 1993 and
states the same 400,000 people are still insured. Questions where the 400,000 figures comes from. |
|
407 |
Hagen |
Agrees it has been a problem. Continues presentation
on waivers (EXHIBIT C, page 7). |
|
430 |
Hagen |
Continues presentation on rate bands (EXHIBIT C, pages 7 and 8). |
|
TAPE 73, A |
||
|
016 |
Hagan |
Continues presentation on rate bands (EXHIBIT C, page 8). |
|
024 |
Chair Morrisette |
Comments that the rational is that the rate will go
down because they will attract younger employees. Asks if the Insurance Division will check the rates. |
|
032 |
Hagen |
Responds that he Insurance Division does keep track
of their rates. Comments on
requirements on changing rates. |
|
040 |
Chair Morrisette |
Asks if each adjustment will be based on the rate
for the average submitted to the Insurance Division. |
|
042 |
Hagen |
Responds that Sen. Morrisette is correct. |
|
048 |
Hagen |
Comments on Senate vote on HB 2987 A with a 4:1 rate
band and after that they continued to work with the Department of Consumer
and Business Services (DCBS) because there was a concern that a 4-1 rate band
pushed it too far on the upper end and that an employer with an older mix
would be hurt. In working with DCBS
they have arrived at a ratio of 2.5:1.
States that if it is too low, they will not be able to make this
attractive for the younger populations. |
|
058 |
Sen. Minnis |
Asks if they use credit scoring. |
|
055 |
Hagen |
Responds negatively. Continues presentation on rate bands (EXHIBIT C, page 9). |
|
075 |
Hagan |
Continues presentation, reviewing slide 18 on
participation credit (EXHIBIT C, page
9). |
|
087 |
John Powell |
Regence BlueCross BlueShield of Oregon. Comments on the uninsured population (EXHIBIT C, page 5). Explains that the data is from the
Office of Health Policy and is the last available data and is from 1998. States the targeted group of this bill is
the 18-40 year old person who is working with a group like themselves. This bill with the rate bands will allow
insurance companies to offer policies at a premium that will be lower than if
this bill does not pass. |
|
132 |
Peggy Anet |
Health Insurance Association of America. Testifies in support of HB 2987-A6
amendments (EXHIBIT D). |
|
|
|
|
|
190 |
Joel Ario |
Administrator, Insurance Division, Department of
Consumer and Business Services (DCBS). Summarizes written testimony (EXHIBIT E). |
|
254 |
Ario |
States they are not here to support or oppose the
bill but simply to explain the tradeoffs.
States if the bill is to move forward, they would like have the
ability to collect data. He believes
there is a trend toward reductions but whether those numbers are precise,
they cannot tell. Adds they would
also like to see a four-year sunset so that once they collect the data they
can come back and report to the legislature on whether the tradeoffs are
working. |
|
278 |
Chair Morrisette |
Asks if the data collection provision is in the
amendments. |
|
|
Ario |
Responds that the provision is in the HB 2987-A6
amendments (EXHIBIT B). |
|
265 |
Steve Doty |
Vice President, Northwest Employee Benefits,
Inc. Testifies in support of HB 2987 (EXHIBIT F). |
|
333 |
Lisa Trussell |
Associated Oregon Industries. Testifies in support of HB 2987 A and the HB
2987-A6 amendments, particularly as it relates to the rate banding and the
discount for 100 percent participation.
|
|
320 |
Lynn-Marie Crider |
Research Director, Oregon AFL-CIO. Testifies in opposition to HB 2987 A. States that they raised concerns about the
bill on the House side and she was not aware of the amendments or that the
bill was being heard until a few minutes ago. States they raised concerns
because the purpose of insurance is to spread the risk. That includes the risk between those who
are older and younger and the employers who employ people who are older and
younger. One simply cannot lower
costs for employers of young workers without raising the cost to employers
who have an older work force. Their
concern is the effort to expand coverage among employers of older workers,
which will end up making health insurance unaffordable for another group of
employers. |
|
373 |
Crider |
States they believe the HB 2987-A6 amendments are a
vast improvement. The 4:1 rate bank was
frightening and the 2.5 and the sunset are improvements, and believe the
study is important. States they would
have recommended that Section 4 be eliminated and consideration be given to
allowing low rates for employers employing young workers but maintained the
cap on the rates at the high end. |
|
401 |
Sen. Walker |
Asks if Crider has seen the information provided the
committee by Regence BlueCross BlueShield (EXHIBIT C). |
|
375 |
Crider |
States she does not know if she has seen it; she did
see some of the material they provided on the House side and they also met to
look at the material. |
|
385 |
Sen. Walker |
Comments that the information shows the impact of
the wider rate band (EXHIBIT C, page
9). States she believes the rate
band is appropriate because she believes younger workers have been
subsidizing older workers. |
|
427 |
Crider |
Respond there is some cross subsidy right now of employers
with younger work forces and thinks that is appropriate. |
|
|
Chair Morrisette |
Closes the public hearing and opens a work session on
HB 2987 A. |
|
TAPE
72, B |
||
|
HB 2987
A – WORK SESSION |
||
|
011 |
Sen.
Minnis |
MOTION: Moves to ADOPT HB 2987-A6 amendments dated
6/10/03. |
|
|
|
VOTE:
5-0-1 AYE: In a roll call vote, all members present vote Aye. EXCUSED: 1 - Sen. Shields |
|
|
Chair Morrisette |
The motion CARRIES. |
|
019 |
Sen.
Minnis |
MOTION: Moves HB 2987 A to the floor with a DO
PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and
Means by prior reference. |
|
024 |
Sen. Walker |
Thanks witnesses for their presentations and speaks
in favor of this bill rather than another bill that will be coming from the
House. Comments on the number of
uninsured people and paying the health insurance premium for her 25-year old
son. |
|
043 |
Sen. Minnis |
Asks why the bill has a referral to Ways and Means. |
|
045 |
Marjorie Taylor |
Responds she is not aware of the reason for the
referral to Ways and Means. Notes the
Fiscal Impact Statement (EXHIBIT G). |
|
056 |
SEN.
MINNIS |
WITHDRAWS
HIS MOTION. |
|
058 |
Sen.
Minnis |
MOTION: Moves HB 2987 A to the floor with a DO
PASS AS AMENDED recommendation and the SUBSEQUENT REFERRAL to the committee on
WAYS AND MEANS BE RESCINDED. |
|
060 |
Sen. Minnis |
Explains his motion would allow the measure to go to
the floor if there is no need for it to go to Ways and Means. |
|
075 |
|
VOTE:
5-0-1 AYE: In a roll call vote, all members present vote Aye. EXCUSED: 1 - Sen. Shields |
|
|
Chair Morrisette |
The motion CARRIES. SEN. FISHER will lead discussion on
the floor. |
|
083 |
Chair Morrisette |
Closes the work session on HB 2987 A and opens a
public hearing on HB 3431 A. |
|
HB 3431
A – PUBLIC HEARING |
||
|
087 |
Marjorie Taylor |
Administrator.
Reviews the provisions of HB 3431-A.
Advises that members have been provided copies of the HB 3431-A3 (EXHIBIT H) and the HB 3431-A4 (EXHIBIT I) amendments. |
|
085 |
Doug Barber |
Oregon Association of Health Underwriters. Testifies in support of HB 3431 A. States that the bill only applies to the
individual insurance market.
Introduces Steve Doty and states he will talk later about the
amendments. |
|
090 |
Steve Doty |
Vice President, Northwest Employee Benefits, Inc. Testifies
in support of HB 3431 A (EXHIBIT J).
|
|
100 |
Barber |
States the goal is to keep as many out of the high
risk pool as possible. Comments on choices of plans by people. The carriers under the current rules are
denying applications and sending people to high risk pools. This bill will allow them to underwrite
the plan the people are applying for.
The bill will allow more people to get private insurance coverage. |
|
141 |
Barber |
Explains that the two amendments come from the
Insurance Division. The HB 3431-A3
amendments (EXHIBIT H) are the
reporting requirements. It is the
exact same language as in HB 2987 A. The
HB 3431-A4 amendments (EXHIBIT I)
is the sunset, the same as in HB 2987 A. |
|
145 |
Sen. Walker |
Asks if an insurance company is obligated to tell
the applicant why their application for a policy with a low deductible is
turned down, why they are offering a plan with a higher deductible, and
whether this bill impacts that. |
|
155 |
Barber |
Responds that the insured is entitled to know why
they have been turned down; the agents are out of that loop now. The applicant could petition the carrier
to find the reasons why they were turned down. |
|
160 |
Sen. Walker |
Comments her concern is people being pushed into
higher deductibles. Asks if the
person could appeal to the Insurance Division. |
|
165 |
Barber |
Responds he believes the only option for the person
would be to appeal to the Insurance Division. Believes the decision is up to the company and there are no
strict guidelines as to why they have the ability to reject an application. |
|
175 |
Doty |
States it is his understanding that the insurance
company would reject, whereas under this bill the insurance company could ask
if the applicant would be interested in a higher deductible. States if the applicant is not interested,
they still have the option of going into the high risk pool. |
|
202 |
Joel Ario |
Administrator, Insurance Division, Department of
Consumer and Business Services (DCBS).
Testifies in support of HB 3431 A (EXHIBIT
K) with the HB 3431-A3 (EXHIBIT H)
and HB 3431-A4 amendments (EXHIBIT I).
|
|
|
Sen. Minnis |
Asks if the Insurance Division has the capacity to
crunch the numbers. |
|
241 |
Ario |
Responds they believe the data is relatively
straight forward. There is not a
large fiscal (EXHIBIT L) and do
not think it will take a lot of work. |
|
|
Lori Long |
Health Net Health Plan of Oregon, Inc. Submits a prepared statement in support of
HB 3431 but does not testify (EXHIBIT M) |
|
261 |
Chair Morrisette |
Closes the public hearing and opens a work session
on HB 3431 A. |
|
HB 3431
A – WORK SESSION |
||
|
260 |
Sen.
Fisher |
MOTION: Moves to ADOPT HB 3431-A3 amendments dated
6/9/03. |
|
262 |
|
VOTE:
5-0-1 AYE: In a roll call vote, all members present vote Aye. EXCUSED: 1 - Sen. Shields |
|
|
Chair Morrisette |
The motion CARRIES. |
|
268 |
Sen.
Fisher |
MOTION: Moves to ADOPT HB 3431-A4 amendments dated
6/12/03. |
|
270 |
|
VOTE:
5-0-1 AYE: In a roll call vote, all members present vote Aye. EXCUSED: 1 - Sen. Shields |
|
|
Chair Morrisette |
The motion CARRIES. |
|
284 |
Sen. Walker |
States she is concerned that consumers might be
bumped into higher deductible plans and is curious to look at the data and
make sure the bill is being used as intended. |
|
288 |
Chair Morrisette |
Asks that Ario send a copy of the data to Sen.
Walker as soon as it is available. |
|
290 |
Sen. Fisher |
MOTION:
Moves HB 3431 to the floor with a DO PASS AS AMENDED recommendation. |
|
294 |
|
VOTE:
5-0-1 AYE: In a roll call vote, all members present vote Aye. EXCUSED: 1 - Sen. Shields |
|
|
Chair Morrisette |
The motion CARRIES. SEN. WALKER will lead discussion on
the floor. |
|
299 |
Chair Morrisette |
Closes the work session on HB 3431 A and reopens the
public hearing on SB 875. |
|
SB 875
– PUBLIC HEARING |
||
|
|
Tom Hoer |
Executive Director, Oregon State Pharmacists
Association. Testifies in support of
SB 875. States that the SB 875-8
amendments (EXHIBIT A) are a very
delicate compromise. States that no
state has been able to execute a bulk purchasing program. They will find out if this works. |
|
328 |
Jim Gardner |
Attorney, Gardner and Gardner law firm representing
the Pharmaceutical Research and Manufacturers of America (PHARMA). States
that during his 16 year tenure as representative for PHARMA he has seen four
or five bulk purchase proposals. They
fell of their own weight because they were for one reason or another over
reaching and simply unworkable. This
proposal has the merit of being a modest effort to see if the concept will
work. Commends Chair Morrisette for
his tenacity in pursuing this objective.
|
|
330 |
Sen. Starr |
Asks if Gardner was referring to the SB 875-8
amendments. |
|
335 |
Gardner |
Responds affirmatively. |
|
360 |
Lynn Marie Crider |
Research Director, Oregon AFL-CIO. Testifies in opposition to SB 875 (EXHIBIT N) and the SB 875-8
amendments (EXHIBIT A), and asks
that the committee adopt the bill with the SB 875-1 amendments (SEE EXHIBIT C OF COMMITTEE MINUTES DATED
APRIL 15, 2003). |
|
TAPE 73, B |
||
|
001 |
Maribeth Healey |
Executive Director, Oregonians for Health Security.
Testifies in support of SB 875 with the SB 875-8 amendments (EXHIBIT O). |
|
|
Healey |
Submits chart comparing eligibility criteria (EXHIBIT P). |
|
067 |
Rep. Greenlick |
Comments he agrees with everything that Healey said,
and an ideal solution would be wonderful, but in 2001 six bills were
introduced and only one had a 15-minute hearing. States that the SB 875-8 amendments (EXHIBIT A) have support.
Believes this gives Oregon a chance to get moving. The success of this endeavor in the first
two to four years allows groups to be formed. The more groups in the pool, the more market share they can
move and have more bargaining power.
Encourages adoption of the SB 875-8 amendments. |
|
099 |
Sen. Shields |
Asks if the SB 875-1 amendments would kill the bill
and the choice is the SB 875-8 amendments or nothing. |
|
102 |
Rep. Greenlick |
Responds he thinks we have the opportunity to move
this because he believes there is enthusiastic support by some of the people
who would otherwise be opposed. |
|
100 |
Sen. Minnis |
Comments on testimony presented to the committee and
states this is a mechanism that helps develop the process by which one can
get to where the AFL-CIO and other organizations would like to go. States that he appreciates the work Rep.
Greenlick has done. |
|
135 |
Sen. Walker |
Asks if Rep. Greenlick has looked at the Washington
state program. |
|
|
Rep. Greenlick |
Responds that they did not look at it formally but
he is familiar with it and by they time they looked at it they were too far
down the path. |
|
145 |
Chair Morrisette |
Comments this has been a long process. States this
would allow groups who currently have insurance to come under this program;
they may go self-insured for the medical part and be in the bulk purchasing
program. |
|
161 |
Chair Morrisette |
Closes the public hearing and opens a work session
on SB 875. |
|
SB 875
– WORK SESSION |
||
|
164 |
Sen. C.
Starr |
MOTION: Moves to ADOPT SB 875-8 amendments dated
6/12/03. |
|
167 |
|
VOTE:
6-0-0 AYE: In a roll call vote, all members present vote Aye. |
|
|
Chair Morrisette |
The motion CARRIES. |
|
174 |
Sen.
Minnis |
MOTION: Moves SB 875 to the floor with a DO PASS
AS AMENDED recommendation. |
|
178 |
Sen. Walker |
Thanks those who worked on this proposal. |
|
|
Chair Morrisette |
States a group of people deserve credit for their
work. |
|
188 |
|
VOTE:
6-0-0 AYE: In a roll call vote, all members present vote Aye. |
|
|
Chair Morrisette |
The motion CARRIES. SEN. MINNIS will lead discussion on
the floor. |
|
199 |
Chair Morrisette |
Closes the work session on SB 875 and opens a public
hearing on HB 2828 A. |
|
HB 2828
A. – PUBLIC HEARING |
||
|
200 |
Marjorie Taylor |
Administrator.
Reviews provisions of HB 2828 A.
Advises members that the HB 2828-A5 amendments proposed by the
Management Labor Advisory Committee (MLAC), have been provided to them (EXHIBIT Q). |
|
205 |
Brian DeLashmutt |
Oregon Nurses Association. Testifies in support of HB 2828 A. Provides background
information on the issue of nurse practitioners functioning as providers in
workers’ compensation. HB 2828 as
introduced put nurse practitioners back into the status of being able to
provide compensable care to workers, but in many cases they are the primary
provider in many areas. |
|
251 |
DeLashmutt |
Explains HB 2828 A includes a compromise that was
reached on the current status of 90 days of treatment instead of 30 days of
treatment and 90 days for authorization of time loss. However, the 90 days did not stand up
under the review of MLAC. The House
did move forward and the bill passed 56-1.
|
|
235 |
DeLashmutt |
States they support the HB 2828-A7 amendments that
will be offered by Marshall Coba to fix a drafting error (EXHIBIT R). |
|
296 |
J. L Wilson |
State Director, National Federation of Independent
Businesses (NFIB). States he is
testifying as the co-chair of MLAC. Testifies
in support of HB 2828-A5 amendments (EXHIBIT
Q). |
|
315 |
Wilson |
Explains the HB 2828-A5 amendments (EXHIBIT Q). States that the issue for MLAC is management and over
sight. Submits letter from the
Medical Advisory Committee, Workers’ Compensation Division (EXHIBIT S). Notes comments in second paragraph and states that is why
they are adamant about the HB 2828-A5 amendments. Also submits letter from Governor Kulongoski in support of MLAC
(EXHIBIT T). States that MLAC unanimously endorsed the HB 2828-A5
amendments this morning. |
|
348 |
Chair Morrisette |
How asks how many members are on MLAC. |
|
349 |
Wilson |
Explains that MLAC is a 10 member committee, half
labor and half management. Labor
supported HB 2828 and management did not. |
|
369 |
Sen. Morrisettee |
Comments he knows it takes a majority of each side
to agree. |
|
3705 |
Wilson |
Comments that MLAC disapproved of two bills this
session. |
|
310 |
Sen. Walker |
Asks if MLAC is an advisory committee. |
|
315 |
Wilson |
Responds affirmatively and advises that the members
are appointed by the Governor and confirmed by the Senate. |
|
384 |
Sen. Walker |
Comments that MLAC does not make policy; they give
advice. |
|
325 |
Wilson |
Responds affirmatively, and clarifies further. It is
an informal agreement. |
|
392 |
Sen. Walker |
Asks if the legislature makes policies. |
|
|
Wilson |
Responds affirmatively. |
|
360 |
Sen. Walker |
States she would like to remind MLAC they are an
advisory committee and do not make policy. |
|
400 |
Sen. Fisher |
Asks if DeLashmutt can you live with the HB 2828-A5
amendments. |
|
411 |
DeLashmutt |
Responds, no.
Explains they have continued to work with the Workers’ Compensation
Division, and the Governor’s office. States he has no indication the Governor
will veto this. States he prefers the
bill with the HB 2828-A7 amendments. |
|
430 |
Marshall Coba |
Oregon Society of Physician Assistants. States he supports the HB 2828-A7
amendments. Physician assistants
currently provide health care services to several thousand patients
daily. It is important that physician
assistants do not lose any authority, especially in rural Oregon. |
|
461 |
Chair Morrisette |
Closes the public hearing and opens a work session
on HB 2828 A. |
|
HB 2828
A – WORK SESSION |
||
|
466 |
Marjorie Taylor |
Administrator.
Explains that the HB 2828-A7 amendments are included in the HB 2828-A5
amendments. |
|
472 |
Sen.
Walker |
MOTION: Moves to ADOPT HB 2828-A7 amendments dated
6/12/03. |
|
|
|
VOTE:
3-3-0 AYE: 3 - Shields, Walker, Morrisette NAY: 3 - Fisher, Minnis, Starr C. |
|
|
Chair Morrisette |
The motion FAILS. |
|
TAPE 74, A |
||
|
034 |
Sen.
Minnis |
MOTION: Moves to ADOPT HB 2828-A5 amendments dated
6/5/03. |
|
037 |
Sen. Walker |
Comments that she will not support the HB 2828-A5
amendments because MLAC is an advisory committee only. |
|
041 |
Sen. Minnis |
Explains why he is moving the HB 2828-A5 amendments.
|
|
049 |
Sen. Shields |
Asks what the dynamic was in the House, whether the
House looked at the MLAC recommendation, and why the measure passed the House
so overwhelmingly. |
|
0062 |
Wilson |
Explains that MLAC did not approve of HB 2828. The HB 2828-A5 amendments represent what
MLAC will accept with regard to nurse practitioners. |
|
060 |
DeLashmutt |
States they explained their case to the House committee,
MLAC, and the House floor and the vote was 56-1. The one no vote was because MLAC did not approve of the bill—it
was a process question. States that given that, he is stunned by the
discussion on this side. The problem
they have with the HB 2828-A5 amendment is it sets a double standard between
urban and rural. To have two
different standards of treatment under a workers’ compensation system is not
acceptable. |
|
|
DeLashmutt |
States they floated an amendment that was very close
to the HB 2828-A5 amendments through the department and the MLAC members and
it was rejected. The amendment was 90
days anywhere in the state and a managed care organization come along, as was
MLAC’s proposal, which was if a client is a patient of a managed care
organization, the nurse practitioner could provide care under the rules of
the managed care organization and have a come along. MLAC has since come up with the HB 2828-A5
amendments. States if it would break
the deadlock, they would be willing to offer the HB 2828-A6 amendments that
were drafted at the request of Sen. Brown, as a compromise amendments. Explains that the component of the HB
2828-A5 amendments that is unacceptable to them is the difference between
urban practice and rural practice.
States that access to health care is not just geographical, it is also
an economic issue and that occurs in the urban areas. |
|
106 |
Sen. Minnis |
Comments that the authority to practice in the rural
areas was done in the 80s. Asks why a
nurse practitioner would want to practice in a rural area if they can
practice in a metro area with the bulk of the population. States this will cause the loss of nurse
practitioners in the rural areas. |
|
120 |
DeLashmutt |
States that nurse practitioners were full
participants in the workers’ compensation system prior to the Mahonia Hall
Group. There was no indication that
practitioners were moving from one area of the state to another because of
the workers’ compensation incentive or disincentive. |
|
115 |
Sen. Minnis |
Responds that preceding MLAC and the workers’
compensation discussion on expansion of authority of nurse practitioners the
issue was with access and whether we wanted to give incentives to nurse
practitioners to practice in rural areas. |
|
120 |
DeLashmutt |
States he was the lobbyist when the nurse
practitioners were given authority for prescription writing and third-party
reimbursement in 1979. One of the
discussions was about access to health care.
They also made the case that it was not just geographic access, it was
also economic access. They have never
said that nurse practitioners are only to function in those areas of the
state where no one else is willing to go.
|
|
140 |
Sen. Fisher |
Comments he did not support the HB 2828-A7
amendments because he wanted more discussion. States that as sponsor of the original bill he will go with his
instinct and if the HB 2828-A7 amendment comes back, he will support it, but
he will not support the HB 2828-A5 amendments. |
|
152 |
|
VOTE:
2-4-0 AYE: 2 - Minnis, Starr C. NAY: 4 - Fisher, Shields, Walker, Morrisette |
|
|
Chair Morrisette |
The motion FAILS. |
|
158 |
Sen.
Walker |
MOTION: Moves to RECONSIDER the vote by which the
motion to ADOPT HB 2828-A7 amendments dated 6/12/03. FAILED. |
|
164 |
|
VOTE:
4-2-0 AYE: 4 - Fisher, Shields, Walker, Morrisette NAY: 2 - Minnis, Starr C. |
|
|
Chair Morrisette |
The motion CARRIES. |
|
|
|
|
|
172 |
Sen.
Walker |
MOTION: Moves to ADOPT HB 2828-A7 amendments dated
6/12/03. |
|
176 |
|
VOTE:
6-0-0 AYE: In a roll call vote, all members present vote Aye. |
|
|
Chair Morrisette |
The motion CARRIES. |
|
184 |
Sen.
Walker |
MOTION: Moves HB 2828 A to the floor with a DO
PASS AS AMENDED recommendation. |
|
189 |
Sen. Minnis |
Comments he is reading the letter from the Governor (EXHIBIT T) regarding the issues and
perhaps this will be a good test to see if it has any meaning or value. |
|
|
|
|
|
192 |
|
VOTE:
6-0-0 AYE: In a roll call vote, all members present vote Aye. |
|
|
Chair Morrisette |
The motion CARRIES. SEN. MORRISETTE will lead discussion
on the floor. |
|
203 |
Sen. Fisher |
Explains why he supports the HB 2828-A7 amendments. |
|
228 |
Chair Morrisette |
Closes the work session on HB 2828 A and adjourns
meeting. |
EXHIBIT
SUMMARY
A
– SB 875, SB 875-8 amendments, Rep. Greenlick
B
– HB 2987, HB 2987-A6 amendments, Leonard Hagen
C
– HB 2987, graphics on insurance reform, Leonard Hagen and John Powell, 10 pp
D
– HB 2987, prepared statement, Peggy Anet, 4 pp
E
– HB 2987, prepared statement, Joel Ario, 2 pp
F
– HB 2987, prepared statement, Steven Doty, 1 p
G
– HB 2987, Legislative Fiscal Statement, staff, 1 p
H
– HB 3431, HB 3431-A3 amendments, Insurance Division, 1 p
I
– HB 3431, HB 3431-A4 amendments, 8 pp
J
– HB 3431, prepared statement, Steven Doty, 1 p
K
– HB 3431, prepared statement, Joel Ario, 2 pp
L
– HB 3431, Legislative Fiscal Statement, staff, 1 p
M
– HB 3431, prepared statement, Lori Long, 1 p
N
– SB 875, prepared statement, Lynn-Marie Crider, 1 p
O
– SB 875, prepared statement, Maribeth Healey, 2 pp
P
– SB 875, comparison charts, Maribeth Healey, 3 pp
Q
– HB 2828, HB 2828-A5 amendments, MLAC, 2 pp
R
– HB 2828, HB 2828-A7 amendments, Marshall Coba, 1 p
S
– HB 2828, prepared statement by Medical Advisory Committee, J. L. Wilson, 1 p
T
– HB 2828, letter from Governor Kulongoski, J. L. Wilson, 1 p