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CHIEF SPONSORS: State Sens. Wlnsvey Campos (D-Aloha), Deb Patterson (D-Salem), and Lisa Reynolds (D-Portland), and Rep. Ben Bowman (D-Tigard)
WHAT IT WOULD DO: Senate Bill 609 would substantially increase reimbursement under the Oregon Health Plan (i.e., Medicaid) for primary care services provided by physicians, dentists, optometrists and mental health care professionals.
PROBLEM IT SEEKS TO SOLVE: OHP reimbursement for primary care services is currently half or less of the reimbursement that commercial health insurers pay. About one-third of Oregonians are on the Oregon Health Plan, so it’s a major part of the market. Advocates testified that the low reimbursement rates discourage providers from offering primary care, leading to long wait times and worse outcomes for patients.
WHO SUPPORTS IT: A host of primary care groups, including the Oregon Academy of Family Physicians, the Oregon Optometric Physicians Association, and the Osteopathic Physicians & Surgeons of Oregon. Proponents emphasized research that shows primary care saves far more than it costs—as much as $12 for every dollar spent, they said, because it prevents more serious complications.
“Primary care clinics across the state are closing due to an inability to cover their costs,” Dr. Brian Frank testified on behalf of the Oregon Academy of Family Physicians. “Nearly 75% of the state lacks sufficient access to primary care, and this problem may grow worse without intervention.”
WHO OPPOSES IT: PacificSource Community Solutions and the Eastern Oregon Coordinated Care Organization, two of the groups that provide Oregon Health Plan services across the state, testified that the cost of the increase—which has not yet been quantified—would be prohibitive and that federal officials, who provide the majority of Medicaid funding, would be unlikely to approve such an increase. (The amended bill pledges that the reimbursement hike would not require an increase in the state’s general fund allocation to the Oregon Health Plan, but does not specify which services would be cut to accommodate an increase.) PacificSource lobbyist Rick Blackwell said the cost increases would be “unsustainable,” while Eastern Oregon CCO lobbyist Fawn Barrie noted the proposed change would be “really challenging because we’d have to make cuts within the CCO’s budget.”
WHAT HAPPENS NEXT: The bill passed out of the Senate Health Care Committee on April 3 and was referred to the Joint Ways and Means Committee. The Legislative Fiscal Office, which is responsible for projecting how much bills would cost if they pass, will now attach a price tag to SB 609.
This story was produced by the Oregon Journalism Project, a nonprofit newsroom covering the state.