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Oregon Models Effective Health Care Change, Rollout

In the year since Oregon passed sweeping state health care changes, now coupled with the new federal law of March 2010, the new Oregon Health Authority has started implementing vast changes to Oregon’s health care system aimed to control costs, improve delivery and quality, and ensure transparency and accountability.

While other states are scrambling to hire personnel and outline policy, Oregon’s health-related programs are actively providing more access, better care and lower costs for Oregonians, according to Tina Edlund, Deputy Director of the Oregon Health Authority. Oregon the state has been on the right track for years putting it in a good position to build on federal action, she said.

“We’re ready to go,” Edlund said. “When they actually handed down the rules, we were already pretty far down the road to make policy choices to enact them.”

Thinking Ahead

In 2007, Oregon recognized the need to address skyrocketing costs and fix its health care delivery system. The state passed Senate Bill 329, creating the seven-member Oregon Health Fund Board to guide what that change should look like. After extensive research and public input, the Board, including AARP Oregon’s Volunteer State President Ray Miao, developed recommendations that led to the 2009 legislation that got the ball rolling and established the Oregon Health Authority as the single agency for all health-related programs.

Now in action, the Oregon Health Authority represents coverage for 850,000 Oregonians and leverages purchasing power of approximately 25 percent of the overall insured market, according to Edlund. The nine-member, citizen-led Oregon Health Policy Board advises the Oregon Health Authority and helps oversee the implementation of national reform efforts.

Oregon is not only known for its proactive policy, such as portability and universal coverage, but also for its innovative methods. For example, the Healthy Kids program, now within the Oregon Health Authority, built an “aggressive and eye-catching” statewide outreach and marketing strategy to raise awareness and attract new enrollees and is being used as a national model, according to Cathy Kaufmann, Administrator for the Office of Healthy Kids.

What’s in Place

While changes have been taking place since March, many others took effect as of Sept. 23 or are underway.

These include:

  • Expansion of Healthy Kids to cover 80,000 more children and 35,000 more low-income adults by Jan. 2011. Kaufmann said as of October, Healthy Kids had added 61,000 kids, including thousands of middle class kids previously unaware of eligibility, now covering a total of 330,000 individuals. Call 877-314-5678 toll-free now to learn more and enroll your children or grandchildren today. Healthy KidsConnect is the private sector option in the Healthy Kids program for families with incomes that exceed 200 percent of the federal poverty level; it offers premiums subsidies  for families up to 300 percent of the federal poverty level.
  • Additionally, all children under 19 years old will now have access to coverage and young adults can stay on their parent’s health care plan until age 26.
  • A new high-risk pool called the Federal Medical Insurance Pool (FMIP) to provide another health insurance option for Oregonians with pre-existing medical conditions who’ve been denied coverage. This is in addition to the Oregon Medical Insurance Pool (OMIP), which has been enrolling high risk individuals since 1990. OMIP also offers a way to continue insurance coverage for those who exhaust COBRA benefits and have no portability options. There is a single application for both the state and federal pools.
  • The creation of the Health Insurance Exchange, which has been in development for five years. The exchange brings together an array of basic private insurance plans for those who are uninsured, self-employed or between jobs and should simplify the process of finding the right plan for more savvy consumers, according to Development Manager Nora Leibowitz.
  • Adding free preventative care to new health care plans, including many cancer screenings and vaccinations, mammograms and well-child visits.

What’s to Come

There is much discussion about what may happen to health care reform efforts at the national level with the recent shifts in Congress and Oregon’s 2011 legislative session starting in Feb. 1. According to Tom Jovick, Administrator of the Office of Private Health Partnerships which oversees the high risk pools and Healthy KidsConnect, “it’s more likely that opponents of the health reform bill will find ways to dilute the budget needed to fund it rather than repeal its provisions.”

With its estimated $3.2 billion deficit, Oregon is counting on financing from the federal government for reform program “startup funds” and tax credit subsidies in order to provide accessible, quality care that Oregonians can actually afford, Jovick added.

“If the state’s leaders use the same problem solving skills that made Oregon a forerunner in health care innovation, the budget crisis shouldn’t inhibit the continued, successful implementation of efforts to ensure health care accessibility and quality and cut costs,” said Rick Bennett, AARP Oregon Director of Government Relations. “In fact, it’s pretty clear that investing in health and tackling health care reform is one of the most promising solutions to creating a healthy Oregon and addressing and turning around the state’s economic woes, which have been fueled by high unemployment and soaring health costs hurting individuals, families and businesses alike.”

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