SENATE SPECIAL COMMITTEE ON THE OREGON HEALTH PLAN

 

May 19, 2003                                                                                                          Hearing Room C

3:00 P.M.                                                                                                                          Tapes 3 - 4

 

MEMBERS PRESENT:         Sen. Peter Courtney, Co-Chair

Sen. Jackie Winters, Co-Chair

Sen. Margaret Carter

Sen. Bill Fisher

Sen. Lenn Hannon

Sen. John Minnis

Sen. Bill Morrisette

 

MEMBER EXCUSED:          Sen. Kate Brown

 

STAFF PRESENT:                 Marjorie Taylor, Committee Administrator

Megan Jensen, Committee Assistant

 

ISSUES HEARD:                   Informational Meeting

                                                    Overview of Population

    Possible Prioritization Scenarios

 

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 3, A

004

Co-Chair Winters

Calls meeting to order at 3:05 p.m. Opens informational meeting on the Oregon Health Plan (OHP).

INFORMATIONAL MEETING

     Overview of Population

022

Dr. Bruce Goldberg

Office of Health Policy and Research Administrator. Provides information concerning coverage under the OHP (EXHIBIT A). Discusses health care coverage for children and pregnant women and the related consequences to those without coverage.

100

Goldberg

Overviews adult coverage under the OHP and discusses:

·         Benefits of health coverage

·         Consequences without coverage

·         Cost shift and societal implications

195

Goldberg

Discusses cost shift estimates:

·         200 additional neonatal care unit stays will cost $4.8 million

·         Loss of coverage for OHP standard diabetics will result in at least 1,500 hospitalizations costing $5 million

·         60,000 primary care visits cost $4.5 million in the primary care office versus $18 million in the emergency department

·         Chemical dependency treatment for 9,000 adults will cost $16.2 million resulting in $90.7 million in societal savings.

228

Co-Chair Winters

Asks about the $90.7 million figure.

231

Goldberg

Explains that the figure comes from a study done in Oregon and offers to provide copies of the study.

237

Sen. Hannon

Asks about the $18 million in emergency room care causing an increase in premiums for regular health insurance coverage.

246

Goldberg

Offers to research the issue. Elaborates on emergency room health care.

270

Sen. Hannon

Inquires about the societal cost of using emergency rooms for health care.

273

Goldberg

Clarifies that the societal costs are all yearly costs.

275

Sen. Hannon

Clarifies the cost shift per biennium.

278

Goldberg

Responds regarding the offset. Speaks on costs including chemical dependency treatment.

295

Sen. Hannon

Asks about the ten percent of the OHP population having mental health or chemical dependency problems.

305

Goldberg

Responds that there are higher rates of a variety of illness among the population of the OHP compared to society in general. Explains that those with serious illness are often unable to work and fall below the poverty level.

321

Sen. Hannon

Asks about problems such as obesity, smoking, poor lifestyle choices, and  negative habits in the OHP population.

330

Goldberg

Replies that lifestyle-related health care costs are one of the greatest burdens to the health care system, and adds it is a burden not solely limited to the population of the OHP.

346

Sen. Hannon

Speaks on the issue being a problem for society.

354

Co-Chair Courtney

Inquires about the term ‘standard diabetic’.

359

Goldberg

Affirms.

363

Co-Chair Courtney

Clarifies the term.

367

Goldberg

Answers regarding the needs of diabetics and complications of the disease.

370

Co-Chair Courtney

Inquires that by fulfilling the need for insulin, the hospitalizations listed could be prevented.

378

Goldberg

Responds that by controlling blood sugar, hospitalizations can be avoided.

388

Co-Chair Courtney

Requests what chemical dependency treatment entails.

391

Goldberg

Explains that chemical dependency treatments cover a large number of alcoholics and smaller groups with other drug problems such as narcotic abusers.

398

Co-Chair Courtney

Asks how those with chemical dependencies are treated.

401

Goldberg

Explains methods for treating chemical dependency problems.

410

Co-Chair Winters

Speaks on diabetic strips and the ability to monitor blood sugar.

415

Goldberg

Explains the diabetic monitoring strips.


 

420

Sen. Morrisette

Poses question regarding chemical dependency coverage.

442

Goldberg

Explains there are at least 4,400 adults above the mandatory population. Notes the total figure is around 9,000 people.  

456

Sen. Morrisette

Asks how many people are not currently covered in the chemical dependency program.

458

Goldberg

Responds that approximately 4,400 people are not covered in the chemical dependency program.

TAPE 4, A

003

Goldberg

Defines the Medically Needy program which encompasses individuals living above the poverty level but who have large medical expenditures for chronic diseases and need assistance (EXHIBIT A, page 6).

041

Co-Chair Winters

Poses question regarding Medicare part B. 

046

Goldberg

Affirms.

048

Co-Chair Winters

Clarifies that the medically needy have hospital care under Medicare but do not have prescription drugs benefits.

050

Sen. Carter

Asks for the total number of people in OHP in 2001 and in 2003.

054

Goldberg

Explains that there has been a steady increase in the growth of OHP through 2002. Adds it has decreased during the more recent budget cuts.

062

Sen. Carter

Asks where those people are now, if they have no coverage.

066

Goldberg

Believes that the amount of uncompensated care is increasing. Elaborates on uninsured individuals.

084

Sen. Morrisette

Requests further information on the Medically Needy program and pharmaceutical benefits.

092

Goldberg

Believes more people are accessing the drug assistance programs of pharmaceutical companies since the state drug benefits have been cut. Explains that the drug assistance programs are beneficial but provide administrative overhead to the physician.

118

Sen. Morrisette

Asks about serving the medically needy since the state drug assistance program has ended.

122

Goldberg

Does not know how many people are being served.

135

Co-Chair Winters

Inquires about the status of the enrollment for prescription drug assistance for seniors for a small fee.

137

Katie King

Intergovernmental Relations, Department of Human Services (DHS). States the enrollment fee is $50 per person to be eligible for benefits and that they are trying to advertise this benefit to the public

144

Sen. Carter

Asks about claims that the drug assistance programs only work for a limited time and require a certain financial investment.

162

Goldberg

Explains a senior discount program for prescription drugs. Notes the program that provides prescription drug coverage is a different program.

180

King

Explains that one-third of Oregon pharmacies participate voluntarily.

188

Co-Chair Winters

Asks if DHS advertises its participation in the program.

190

King

Speaks on the marketing of the program.

204

Goldberg

Continues discussing the Medically Needy Program:

·         Benefits of health coverage

·         Consequences without coverage

·         Cost shift and societal implications

234

Sen. Morrisette

Says it is an important matching program with federal funds.

239

Goldberg

Affirms that when the programs are cut, federal funds are also lost.

245

Co-Chair Winters

Requests differentiation of populations within the Medically Needy program.

253

Goldberg

Offers to provide that information.

290

Mike Bonetto

Policy Analyst, Senate Republican Office. Presents information on population prioritization (EXHIBIT B). Discusses the Population Prioritization Worksheet.

340

Sen. Morrisette

Poses question regarding a separate program.

344

Bonetto

Responds regarding the program and the categories the new information focuses on.

350

Connie Seeley

Chief of Staff, Office of the Senate President. Discusses the Population Prioritization Scenario #1.

358

Sen. Carter

Asks about the standard population represented in the graphs.

361

Seeley

Responds regarding representation.

370

Bonetto

Replies that there is no standard for prioritizing populations. Continues discussion of the Population Prioritization Scenario #2. Lists order of  coverage being pregnant women and children, adults, couples and families, and then the medically needy.

412

Sen. Carter

Asks if the scenarios have been priced.

415

Bonetto

Replies that benefit package information must first be obtained.

TAPE 3, B

013

Seeley

Discusses Population Prioritization Scenario #3. Speaks on policy decisions and funding programs.

034

Sen. Hannon

Requests an explanation of the chart categories.

037

Seeley

Provides clarification.

049

Bonetto

Discusses Population Prioritization Scenario #4. Explains how the charts are created and the philosophy behind them. Speaks on flexibility.

076

Co-Chair Winters

States that the goal of the task force is to discuss where the priorities should be before going to the benefit package and the cost issues.

088

Sen. Morrisette

Discusses how to read the charts.

093

Bonetto

Explains each page is a specific scenario and each page of the populations vary. 

101

Sen. Hannon

Asks where potential for federally matched funds lies within the prioritization.

104

Bonetto

Explains where a higher match options.

108

Sen. Hannon

Requests further information on the federal funds matched in each scenario.

115

Bonetto

Offers to provide that information.

118

Sen. Minnis

Requests clarification of the categories of Scenario #4.

120

Bonetto

Responds regarding priorities and informs the committee of the key.

130

Sen. Winters

Clarifies the letters used relating to the categories.

140

Sen. Morrisette

Clarifies prioritization.

153

Goldberg

Discusses how to prioritize among the different populations for health care.

185

Sen. Morrisette

Questions how accurate the number of individuals in the populations are.

190

Bonetto

Replies that the numbers were received today and are very current.

195

Sen. Carter

Asks what CAWEM stands for.

201

Bonetto

Explains that CAWEM is the Citizen Alien Waiver Emergency Medical program. Explains the program. 

223

Sen. Carter

Asks if it is a mandatory program

225

Bonetto

Affirms and elaborates. Offers to provide any additional information desired by the committee members.

240

Co-Chair Winters

Requests the information be received prior to the next meeting.

251

Sen. Minnis

Inquires if HB 3624 is separate from the information provided currently.

260

Bonetto

Explains that HB 3624 focuses on the delivery system of the health care.

263

Sen. Minnis

Poses question regarding benefits.

265

Bonetto

Affirms and adds it provides more flexibility.

268

Sen. Minnis

Requests clarification on cost estimates.

274

Seeley

Explains how the cost estimates can be achieved.

282

Bonetto

Explains costing prioritization population packages.

290

Co-Chair Winters

Speaks on work to be done on the OHP with regard to prioritization and policy choices. Reiterates her request for information.

324

Sen. Minnis

Inquires who establishes the priorities set out in Scenario #4.

330

Seeley

Explains her suggestions for the scenarios. Speaks on the representation as an example.

359

Co-Chair Winters

Believes there is flexibility in the examples to allow for committee decision-making. Closes informational meeting. Adjourns the meeting at 4:27 p.m.

 

EXHIBIT SUMMARY

 

A – Oregon Health Plan, written testimony, Dr. Bruce Goldberg, 8 pp.

B – Oregon Health Plan, written testimony, Mike Bonetto, 5 pp.