* Hospitals in Oregon would lose an estimated $60 million in net income if the current provider tax expires and a new revenue source is not found to fund coverage for low income Oregonians.

* All of the 32 small and rural hospitals would come out ahead under any provider tax scenario, with net benefits totaling almost $9 million a year;

* Of the 25 larger hospitals that would pay the tax, eight would get back more than they pay in taxes from increased revenue from new paying patients and reduced uncompensated care;

* The majority of the remaining hospitals would recover more than 70% of the taxes they pay from increased patient revenue

Health care advocates livened up the halls of the Anne Basker Auditorium in Grants Pass last Monday as they welcomed the House Health Care Committee in hosting their hearing hours south of its normal location in Salem. Members of Oregon Action gathered to sing their creatively retooled versions of such songs as John Lennon’s “Give Peace a Chance”. A rarity to have the committee meet in rural Southern Oregon, the event drew a crowd of over 75 people, the great majority of them there to testify in support of HB 2009 and to ask legislators to “give health a chance”.

Accessing health care has always been a challenge for rural communities like Grants Pass. However, as the statewide unemployment rate taunts the 10 percent mark, these communities are feeling even more of the strain. Last December, the unemployment rate in Josephine County clocked in at 11.7 % while in neighboring Douglas County, the rate was approaching 13%. In our current system, access to health care is most often dependent on employment.

Angelica Ruppe, finance director of a low income community health clinic in Jackson County, testifies that clinics in southern Oregon are seeing a sharp rise in the number of newly uninsured patients seeking services. Some of the clinics she reported are now seeing 90% uninsured patients. Ms. Ruppe expressed her strong support of expanding access through a provider tax. Without this investment, Medicaid revenue received by her network's six sites would be reduced by 20%, the equivalent of $100,000 or 2 full time providers. An additional 3,000 patients would be turned away annually, likely landing in the emergency room.

Other local health networks would benefit from an increased investment via the provider tax. According to a study released last month by Dr. John McConnell, Three Rivers Community Hospital in Grants Pass like nearly all rural hospitals, would benefit greatly from an investment in expanding access and an increase in the Medicare reimbursement rate to 88%. In the case of Three Rivers, with the federal matching dollars that the hospital investment would draw down, they could expect an increase of a little over 2 million dollars in net income to flow through their doors.

Roy Vinyard, President and CEO of Asante Health Systems, which Three Rivers is a part, also addressed the committee. Asante is one of the largest employers in Southern Oregon, home to a trauma referral hospital for 9 counties and the only provider of inpatient mental health services in the area. Mr. Vinyard sought assurance that any increased investment would prove sustainable for Asante's vital network. He ultimately supported the provider tax with the understanding that increased Medicaid reimbursement and reduced uncompensated care would balance any effect increased taxes might have on Asante’s bottom line.

Other supporters for HB 2009 testified in favor of guaranteeing the inclusion of a public plan option, expanding prevention and education programs, and reigning in costs to make health care more accessible to individuals and small businesses.

Last Friday, state economist Tom Potiowsky released a grim fiscal forecast for the 2009-11 biennium. Many options for cutting costs were explored as the Oregon legislature struggles to balance the state’s most unwieldy deficit since 2002. While painful cuts will likely be unavoidable, the legislature must also work to ensure that our tax dollars are used wisely.

The current crisis is particularly relevant in light of the fact that health care costs have been spiraling out of control for years. Premium costs alone rose 4.7 times faster than average family incomes from 2000 to 2007. A study conducted by Families USA found that in that period, Oregon premiums rose by 85.2 percent, while earnings rose by only 18 percent. With more Oregonians losing their jobs and wages stagnant, Oregon families and small businesses cannot continue to throw their money away into a wasteful system.

One of several proposed cost cutting mechanisms recommended by the Oregon health fund board and included in HB 2009 makes the insurance market place more transparent and accountable to consumers by lowering premium costs through the unified purchasing power of an “Insurance Exchange”. Separate from the “public employers health cooperative” which would allow state and local governments to use fortified purchasing power to save taxpayer dollars, the Health Insurance Exchange would give individuals and potentially small businesses the power to negotiate lower rates and better coverage.

A purchasing pool like this one would help small business owners like Becky Jarvis afford quality health care for her family and her employees. Right now, the computer service and repair business that Becky and her husband run out of their home in Aloha is too small of a company for them to qualify for group insurance. The premium costs for Becky and her husband to cover themselves and their son rose 46 % last year to a hefty $495 a month. Both she and her husband have $2500 deductibles, while their son’s plan has a $500 deductible. They are unable to afford the cost of health care for their one part time employee.

Without health reform, a recent OSPIRG study found that the average family insurance premium will more than double by 2016, to over $27,000 per year. Similarly, the Oregon health plan will be faced with unsustainable cost increases. In the face of such dire economic times, Oregonians are in no position to meet the exorbitant costs of rising insurance premiums. We must use our ingenuity and combined power to combat these costs and secure quality, affordable health care for us all.

It is important to remember that the provider tax is not a new idea. Oregon’s 25 largest hospitals and Medicaid managed care organizations have been paying these taxes since 2004. The proposal of a new provider tax stems from the fact that the current tax, which currently funds the Oregon Health Plan is in peril. The state’s provider tax law expires October 1, 2009. At the same time, the federal government is ready to enforce new rules that will deny matching funds for provider taxes like the ones paid by Medicaid managed care organizations. If we do not renew and restructure our provider taxes, we stand to lose vital federal matching dollars that would guarantee coverage to Oregon’s children and low-income adults. In this economy, we cannot afford to leave our federal tax dollars back in Washington D.C.

Let's step back and look at what it would mean for our state if hospitals were asked to provide the dollars needed for Oregon to match the federal dollars available to cover low income Oregonians. Over $1 billion in new federal dollars would flow into our state and our economy and we could provide health coverage to 100,000 low income Oregonians. The majority of hospitals will experience net revenue increases after the new federal dollars are included, so that the bottom line costs to hospitals in the aggregate is estimated to be about $50 per person for each of those 100,000 Oregonians who would now have access to health care.

Oregon hospitals have the chance to boost the economy across the state, by creating new jobs and improving health through primary care and prevention. This is a heroic investment by Oregon's hospitals to boost Oregon's economy and health.

As a consumer of health care and as a health care activist, you have a dual role. Your first role and responsibility is to yourself: be your own best advocate for ensuring you get quality health care.

1. Ask questions. You need to understand the advice and information you are being given
2. Do your part to stay healthy. Including staying up to date on your screening tests and other preventive care, as well as doing your best to manage chronic conditions, eat healthy foods, stay active, and keep to a healthy weight.
3. Be involved in making decisions that affect your health. Ask why tests are needed and how the results will be used or whether any research has been done to find out which treatments work best.
4. Learn more. From your doctor, other health professionals, health plans, hospitals, public libraries, and non-profit organizations that focus on particular health conditions.

Your second role as a health care activist is to advocate for access to quality health care for all. Poor quality health care robs the system of precious resources - in dollars and services - that could be used to expand access.

• In 2004, hospital costs for potentially preventable chronic conditions totaled nearly $29 billion. As many as 4.4 million hospital stays could possibly be prevented by taking better care of people outside the hospital and improving access to effective treatment.
• Researchers estimate that a whopping 30% of health care spending - nearly $700 billion a year - is for services that may not improve people's health.
• Improving the quality of care for patients with chronic illness would go a long way toward freeing up dollars for expanding coverage. 74% of private health insurance spending is spent on care for people with chronic conditions.

Be an advocate for quality health care for yourself and your community.

Last Wednesday, a panel of citizens urged members of the House Health Care Committee to take thoughtful yet quick action on HB 2009. The committee heard testimony on expanding access to health services for Oregonians struggling in our broken health care system. The importance of targeting outreach to vulnerable populations and simplifying the application process was the main focus of the hearing.

Tessa Veenker (right) with her sisterMichele Veenker shared the story of her daughter Tessa who suffers from mental illness. Through much determination Michele has been able to help Tessa. Unfortunately Tessa's father - Michele's ex-husband - is homeless and too sick to complete the complicated process of getting the SSD and Medicare he earned through almost 20 years of service as a postman. Michele expressed her concern for the "thousands on the streets of Oregon with no address to send health cards to, no one to help them navigate a complex system, no one to care." Michele testified because she realizes that some day she might not be there to advocate for her daughter. "That person on the street that everyone turns away from could one day be my beautiful Tessa. And I don't know if I could live with myself without knowing that I am fighting to keep that from ever happening."

Also testifying in favor of the bill was Amanda Stoltz, a senior at Falls City High school. As part of her senior research project, she set out to help uninsured Oregonians in her community apply for OHP. Valedictorian of her class, she was shocked to find herself so confused by all the paperwork. "These forms and applications are for basic services. Why are they so convoluted?" she asked the committee. Encompassed in HB 200909 are provides for the creation of an online application and forms readable at a 6th grade level. Minimal amounts of information would be required to begin processing applications and assistance would be available from qualified staff. "I would like to see more of my fellow students and community members have health care they can depend on," Amanda stated.

The committee also heard testimony highlighting the current gap in coverage for those with low incomes. Currently only those who make 100% or less of the Federal Poverty Level (Income of $10,830/yr for a single person or $ 22,050/year for a family of four) qualify for OHP. HB 2009 would set up a subsidy system to provide premium assistance on a sliding scale to individuals with incomes at or below 300 % of the FPL.

Amy AndersonAmy Anderson of Portland urged the committee to support this provision. A diabetic suffering from untreated Hepatitis C and a host of other conditions, Amy recently lost her OHP coverage because her Social Security Disability Benefits threw her over the current income limits. She does not have the extra $1000.00 per month required to purchase her daily medications and diabetic supplies that sustain her life. "My life depends on you passing this bill. My life is in your hands", Amy told the committee.

The committee was deeply moved by the words of these three women. We want to thank Michele, Amanda and Amy on behalf of all Oregonians for their willingness and courage to share their personal stories.

Legislators want to hear from you too!!

If you have similar stories or concerns as the three women highlighted in this week's monitor, there are two opportunities this week!

The House Health Care Committee will be hearing testimony on all parts of HB 2009 this Monday and Wednesday from 3-5 in Hearing Room D. We would love to help you develop testimony and we do have limited availability to assist with transportation. Call 503-239-8800.

Can't make it, but still want to listen in? Click here for audio or here for streaming video.

Weekly Dose

Rising health care premiums and out-of-pocket costs are hammering Oregon families and businesses. A recent OSPIRG study found that without health reform, the average family insurance premium will more than double by 2016, to exceed $27,000 per year.

The Oregon Health Fund Board recommendations have the potential to cut $10 billion in health care costs over 10 years.

As HB 2009 makes its way through committee hearings, we would like to commend our elected leaders for working to see that meaningful change for health care is enacted in the first 100 days of session. We take this opportunity to introduce the chairs of the House and Senate health care committees.

Senate Committee on Health Care and Veterans' Affairs: Senator Laurie Monnes Anderson (D-Gresham), Chair

As a public health nurse for many years, Laurie lists health care as her number one priority. She understands the necessity of passing a comprehensive plan that will guarantee affordable and accessible health care. "We will have failed if we don’t get this done this session," she said at the launch of the "100 Days: Countdown to Health" campaign in the first week of session. A mother of two children, Laurie believes that every child in Oregon deserves proper medical care, and no parent should have to worry that paying for a child’s health care will push them to the brink of bankruptcy. Having previously served as chair for the Health Policy Committee in 2005 and the Healthy Kids Learn Better Coalition, we are excited to have her taking a leadership role again in 2009. We know we can count on her to champion the fight for quality solutions to our current health care crisis. You may see the full list of committee members at the legislature’s website.

House Health Care Committee: Representative Mitch Greenlick (D- Portland), Chair

Mitch has held the position as chair of the House Health Care Committee since 2007 and has worked in the health care field for over 50 years. He is professor emeritus and past chair of the Department of Public Health and Preventive Medicine at OHSU. He has served as director of the Kaiser Permanente Center for Health Research, Vice President for Research, Kaiser Foundation Hospitals and as a trustee of the Northwest Health Foundation. Mitch has fought for health care since joining the House in 2002, leading the fight for bulk prescription purchasing (SB 875), patient safety (HB 2340) and the HOPE for Oregon Families Initiative. Though the HOPE campaign was ultimately unsuccessful, it would have put the right to health care into the Oregon constitution. Mitch carried this vision forward in facilitating the design of SB 329, the bill which created the Oregon Health Fund Board. He is the author of HB 2009, encompassing many of the recommendations made by the board and currently being heard in committee. See the legislative website for the full list of members.

Make Your Voice Heard! Talk With Your Legislators

Help support the work of these committees by talking with the legislators in your district. To find your legislator, click here. Use these talking points to express your support for HB 2009:

• The best way to help the economy is to reduce health care costs and provide everyone with access to health care. The recommendations of the Oregon Health Fund Board must be enacted and major reforms initiated within the first 100 days of legislative session.
• State efforts to coordinate the purchasing of public plans must be simplified. The creation of an Oregon Health Authority with the capability to take action would pull fragmented pieces together and ensure transparency and accountability in the system.
• We must not let federal matching dollars go to waste. Every dollar of revenue generated by increasing the provider taxes of hospitals and managed care plans would bring in $1.66 of additional Medicaid funds. This stimulus would allow more coverage of uninsured Oregonians, generate more revenue for doctors and hospitals, allow for the hiring and training of more health care workers and control costs for those people who have insurance.

Weekly Dose

Join us for a hearing of portions of HB 2009 in the House Health Care Committee on Wednesday, Feb 4th, from 3-5 pm in Hearing Room D. To listen live to Hearing Room D, click here.

If you would like to attend, please call 503-239-8800.

Following this potent historical speech set to revitalize our Nation, President Obama released "The American Reinvestment and Recovery Plan" later last week. Among the top three actions addressed in the plan was the importance of lowering health care costs and ensuring broader health care coverage. In Oregon, we recognize the vital role that reforming health care will play in retooling our economy.

This is why, at a press conference launching legislative session on January 15, Oregonians for Health Security joined leaders from 20 other organizations representing health care advocates, small business, community, consumer, labor, children and seniors in launching our "100 Days: Count Down to Health" campaign, holding legislators accountable for passing comprehensive health care reform in the first 100 days of session. With job loss reaching record highs and the number of uninsured growing daily, immediate action is paramount.

Sen. Laurie Monnes Anderson (D-Gresham), chair of the Health Care and Veterans? Affairs Committee, understood the responsibility. "We will have failed if we don?t get this done this session," she said. Also speaking in support were legislative health reform champions Sen. Dr. Alan Bates (D- Ashland) and Rep. Mitch Greenlick (D- Portland), who spoke in favor of HB 2009, a health care reform measure that encompasses many of the recommendations put forth by the Oregon Health Fund Board.

A consumer panel of advocates were invited to testify on HB 2009 the following day when the bill had its first hearing in the House Health Care Committee. The coalition focused on the effect health care reform would have on our state economy. Some of the reform packages before the legislature could provide an almost two to one return from the federal government for every state dollar and quoting the 2,859 jobs that will be created by every $100 million dollars in federal matching funds that Oregon currently leaves on the table in Washington. The importance of containing costs, improving quality and shoring up prevention services were among other shared priorities the coalition identified. To read the full list of the coalition's priorities, see here.

Make Your Voice Heard! Health Care Committee Meetings

Committee meetings are open to the public. Below is a schedule for health related committee meetings in Salem. View the legislative website to find up to date information about what is on the agenda. We are looking for volunteers to attend and monitor discussions in each committee meeting. Call 503-239-8800 or email Bethany Wofford. If you are unable to attend a meeting, but would still like to listen in, you can find live and archived audio recordings of all meetings here.

Senate Health Care & Veteran?s Affairs
8-10 AM Tuesday and Thursday
Hearing Room B

Senate Human Services & Rural Health Policy
8-10 AM Monday and Wednesday
Hearing Room B

House Health Care Committee
3-5 PM Monday, Wednesday and Friday
Hearing Room D

Human Services Committee
8-10 AM Monday and Wednesday
Hearing Room D