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