Coverage Expansion, Health Reform and Federal Matching Funds – We Need Them All

By Cathy Kaufmann of Portland, Oregon. Cathy is the Policy & Communications Director for Children First for Oregon and a co-chair of the Human Services Coalition for Oregon.

I’m happy to say that despite all of the bad news coming out of Salem lately thanks to Oregon’s troubled economy, there is a bright spot on the horizon: Oregon is poised to expand health coverage to 80,000 more uninsured children as well as 100,000 low-income adults. HB 2116 has been moved out of the Health care committee into the Revenue committee, where it is expected to be passed out quickly once House and Senate leaders work out an agreement with insurers and hospitals about the funding mechanism.

As a child advocate and a mom of two young kids, I couldn’t be happier about the prospect of the expansion. Now, more than ever, as so many families across the state are struggling to make ends meet, providing increased access to affordable, comprehensive health coverage just makes sense.

Today’s Oregonian editorial points out that this expansion won’t just help uninsured Oregonians -- it will also help our state economy. With the passage of the State Children’s Health Insurance Program (SCHIP) at the beginning of February and the increased federal matching dollars for Medicaid as part of the federal stimulus, expanding health coverage for kids and adults will mean Oregon can draw down over $1 billion in federal matching funds. Every million of state funds invested into a federal matching program such as the Oregon Health Plan results in economic activity of, on average, $2.7 million. During these uncertain times, Oregon can’t afford to leave those crucial federal matching dollars on the table.

It’s important that the funding mechanism be sufficient to provide coverage for 80,000 children -- not 60,000 as suggested by the O’s editorial. Not only to all uninsured kids deserve access to health care, but the matching funds provided through SCHIP are in the form of an allotment, which means Oregon needs to use its portion or lose it to other states smart enough to take full advantage of the program. The finish line is within reach -- it’s time to get Oregon’s uninsured kids into coverage programs that have been proven to work -- both for kids and the economy.

However, our health care efforts this session can’t stop at expansion. We also need health reform through the enactment of the Oregon Health Fund Board recommendations. United for a Healthy Oregon, a coalition of organizations representing over 800,000 Oregonians, began the session with a 100 Day Countdown to Health with the goal of passing health reform and expansion by April 22. This week we mark the 100th Day and are pleased to see real progress toward both these goals.

HB2009 passed out of the House Health Care Committee yesterday. This bill went through an extensive amendment process over the last several months and the current version of the bill is very different from where it started. It includes the key elements of the OHFB recommendations including a Health Authority that can consolidate state purchasing of health care services, begin to enact specific cost saving measures and lay the foundation for an Insurance Exchange so that a plan can be brought back to the 2011 Legislature to establish a central marketplace for insurance that provides one-stop shopping for individuals and small businesses, including a public health plan option.

Expansion and real steps toward health reform are important and achievable goals this session. Oregonians and our state’s economic recovery depend upon the achievement of both.

  • Greg D. (unverified)

    Interesting report on OPB/NPR this morning related to health care reform. The thrust of the report was that the average citizen is not willing to pay the monthly cost, even for a health plan that is well designed and reasonably operated. A Kaiser/NPR survey found that households making substantially above the average wage (I think they mentioned 80K) were only willing to pay 100 - 200 per household per month for full coverage, whereas actual costs start out at around 600 per month for a comprehensive plan. The conclusion was that it will take a MAJOR change in public perception / preference in order to get people to willingly start budgeting and paying 600+ per month for medical insurance, particularly when many of us now believe that we get it for "free" or nearly "free" through our employers or through some form of government subsidy.

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    The problem with this plan is that the state matching funds are being taken out of the health care system itself, with a more than tripling of the provider tax on hospitals and a new tax on commercial insurance policies.

    I'd love to see us access the federal SCHIP money and provide universal coverage for all kids. But we have to stop pretending that we can just rearrange the money we're already spending and somehow the same loaves and fishes will feed thousands of more people.

    The argument has been made that the hospitals and insurance companies will make up what they are taxed by a reduction in uncompensated care and additional health care spending generally. But if the proponents really believed that, why are they exempting small community hospitals and self-insured corporate and union insurance plans from paying, too? Aren't they going to get the same relative benefit from reducing uncompensated care and additional health care spending?

    I'll believe we are serious about providing adequate health care, education, public safety or any other vital public services when we decide that we--collectively--are actually going to pay for them.

    As long as we think we can have our cake and pass the bill onto someone else, then I don't think we are really serious about any of these problems.

  • Johnmayer (unverified)

    It is estimated that Obama's plan could benefit 8 to 9 million homeowners from the new modification procedures. So how do you know you qualify for the Mortgage Modification? Check the website to see if you qualify. I was also in trouble and I am glad I did check it before I talk to my mortgage company and it helped - John Mayer, California

  • Kurt Chapman (unverified)

    I have a few questions and can not fully endorse this plan until those in favor adrees them:

    1. How does taxing my healthcare insurance help me?
    2. Raising costs on larger healthcare providers seems like it would be passed on to those health care consumers with insurance, those raising all of our costs. Seems like bombing for peace. How does raising costs on those who are currently paying help the system?
    3. What type of plan that is comprehensive family coverage costs only $600/month? I happen to know quite a bit about healthcare insurance, having designed plans for small - medium sized companies. Even a "good" plan with catastrophic deductibles ($1,000) and a $5,000 out of pocket maximum layered with an HSA or HRA costs in excess of $850/month.

    Anyone basing a report and premise on family affordable health coverage at $600/month has a Medical Marijuana Card and is using it liberally (er "progressively").

    I agree with the post that health care consumers do not understand the true caost because it is subsidized by either the employer, the government or everyone else. However, the true cost of comprehensive family coverage (even with high deductibles and out of pocket annual maximums) approaches $1,000/month.

  • Kurt Chapman (unverified)

    RE: the alleged statement on NPR/OPB that affordable comprehensive family health insurance plans start at around $600/month....

    I did some searching on Google and found ONE plan offered by Regence (our BC/BS carrier for OR, ID, WA and AK). The Blue Selctions Premier 2500 Plan would run about $591/month for family coverage. The Plan highlights are:

    Deductible $2,500/$7,500 Co-insurance 80/20 Out-of-Pocket Maximum $6,500/$19,500 RX coverage generic $10/co-pay all other 50% of cost, no credit to deductible or oop max Regular doctor visits $20 co-pay Test, X-rays, PT All subject to deductible/oop max Lifetime Cap $2 Million

    I am aware of very few families that would be able to "afford" this type of coverage. Putting the house and car on the line every year for a reduction in monthly premiums of about 55% is really a gamble.

  • Greg D. (unverified)

    Re the 600 per month number. I assume the story is still on the NPR web site, so feel free to check my facts. The 600 price was for the Boston area where Mass. mandates health care coverage for everyone under a state statute. The reporter said they searched among the available mandatory coverage plans in Boston, found a dozen or more, and that 600 was the most affordable. No reference to terms of coverage, etc. Coverage and features was not my point. The point is that if private citizens (non-subsidized) are going to be required to pay their own premiums going forward, it may be a shock to learn that your health premium for a family of 4 will be twice as much as the payment on a new BMW 750i. Surely health insurance is more important than German sports cars, but even for those of us with family incomes in the low 6 figures, it is going to take some education and lobbying by the government to get folks to set aside such a large amount for monthly coverage, even if there are some tax credits, etc. That's why I think a single payer system with a tax on payroll to cover the premiums for the employed and govt. subsidy / payment for the unemployed is the way to go. Medicare for everyone, with the right to purchase a private supplement policy to eliminate deductibles, etc., just like my elderly mother does.

  • Kurt Chapman (unverified)

    Greg D: Medicare for everyone, with the right to purchase a private supplement policy to eliminate deductibles, etc., just like my elderly mother does.

    Kurt: Since Mediocare currently re-imburses at about 855 of actual cost how will you keep the system (now enlarged) from imploding upon itself?

    Have you EVER experienced single payer healthcare? I have as a military dependent. If you're willing to wait until every other Thursday to have that severely sprained ankle looked at; stand in line for your diagnistic heart catherization or wait until next month to have that filling replaced it is wonderful.

  • Perpigillium Brown (unverified)

    Have you EVER experienced single payer healthcare? I have as a military dependent. If you're willing to wait until every other Thursday to have that severely sprained ankle looked at;

    There you have it folks. I work with a guy that cut his earlobe off last year, rather than try to access the system to get simple antibiotics, but to some the issue is down to the wait time on a sprained ankle. Definitely everything you need to know about Americans and health care.

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