This bill directs Oregon Health Authority, in collaboration with Department of Consumer and Business Services, to create implementation plan for public health plan to be made available to individuals and families in individual health insurance market and to small employers. Requires authority and department to conduct analyses of specified subjects regarding public health plan. Requires authority and department to report to Legislative Assembly by January 1, 2022, on implementation plan, results of analyses and recommendations for structure, design and other elements of public health plan.
Personal Choice and Responsibility
Allows OHA to create and implement a state-supported public health plan. The plan has opposing goals: affordability and adding new coverage options for specific populations prioritizing health equity, but it calls for additional subsidies to help with affordability – meaning taxpayer are on the hook to provide social medicine. The goal seems to be universal health care for all Oregonians.
OHA anticipates costs of up to $400,000 General Fund in consulting fees to assist with all aspects of the study to be conducted under this measure. This includes analysis of plan design options, reimbursement rates, federal approval, and policy issues, among other work required under this measure. That doesn’t cover the outreach infrastructure and investments that would support educating people, particularly communities of color and populations with above-average uninsured rates, about available options for subsidized coverage and newly available options under the American Rescue Plan Act of 2021 (P.L. 117-2). It also doesn’t include the increased cost to subsidize the coverage.
A state has flexibility in designing a Medicaid buy-in proposal, with key program features such as provider networks, reimbursement rates, and the role of public and private plans, to create a program that resembles a Medicaid benefit, a Marketplace product, or a hybrid of the two. States may choose to pursue federal waivers (e.g., Section 1332 Innovation waiver). Washington is the first state to enact legislation and implement a public option (Cascade Care). In 2019, Senate Bill 770 passed directing the Oregon Health Authority to engage in an analysis to help policymakers develop a public option to improve affordability and increase access to health care. In December 2020, the Oregon Health Authority released a report prepared by Manatt Health that evaluated three models and offered a list of considerations to create a public option: (1) coordinated care organization-led, (2) carrier-led, and (3) state-led partnership with a third-party administrator. House Bill 2010A directs OHA to collaborate with DCBS to create and implement a plan for a public health plan to offer more affordable coverage to individuals and small businesses. Reporting to legislature by January 1, 2022, seems like an impossibly big task.