COHO Reflects on Successful 2021 Legislative Session

Coalition for a Healthy Oregon had a successful legislative session, passing into law several of its top priorities. COHO secured full funding for the Oregon Health Plan, maintaining current service level for eligibility and benefits as well as rate of growth (i.e., no cuts to providers). COHO was instrumental in passing legislation related health equity investments, expanding Medicaid coverage to undocumented adults, and a budget note to improve future contracting processes for coordinated care organizations (CCOs).

Sustainable Investments in the Social Determinants of Health and Equity

COHO’s main priority bill, HB 3353, was approved with bipartisan majorities in the House and Senate. HB 3353 asks Oregon Health Authority (OHA) to negotiate with the federal government for certain specific changes to the state’s 1115 Medicaid Waiver, which enables Oregon’s local care delivery model.

Specifically, the requested changes would make 3% of CCOs’ budgets more flexible and increase the proportion of federal match for those dollars, amounting to a $250 million increase of federal funds for local health investments over the next five years.

  • Investments must be made in the social determinants of health and equity or provider reimbursement
  • Strategies must tie into CCOs’ Healthy Equity Plan or Community Health Improvement Plan (thereby interlinking with community input processes)
  • Dedicated portions must go to health equity and behavioral health

The effort was driven by health equity advocates, Community Advisory Councils, and provider groups who came together to make a strong case before the House Committee on Health Care. There is no guarantee the federal government will approve the proposal, but the bipartisan backing of the legislature gives Oregon a stronger bargaining position. The initiative also ties in with the Biden Administration’s goals of building upon the Affordable Care Act and reducing health disparities.

Providing Health Coverage to Undocumented Adults

The major focus on equity and racial justice this session extended deeply into health care policies. The legislature approved $100 million to expand the Cover All Kids program to provide Medicaid-like coverage to undocumented adults. As the need will likely outstrip available funds in this phase, the OHA is charged with allocating benefits.

Dan Cushing testified on behalf of COHO in support of HB 3352 and said when parents are healthy, kids get healthier too. COHO participated in weekly coalition meetings, lobbied in support of the bill, and promoted the bill on its social media channels.

Improving the CCO Contracting Process

COHO moved forward on one of its biggest priorities by securing a budget note on the OHA budget relating to CCO contracts:

The Oregon Health Authority shall report to the Legislature on its plans for the next round of coordinated care organization contracting. The report shall include: 1) anticipated milestones and deadline dates; 2) an outline of how the process will provide public transparency and communication; and 3) the anticipated resources the agency will need to perform the next round of CCO contracting. The report shall be delivered to the Joint Committee on Ways and Means by January 1, 2023.

This gives legislators and the public an opportunity to collaborate with OHA and prevent some of the problems that emerged in the CCO 2.0 procurement process of 2019. This will go hand in hand with the Secretary of State’s Audit Plan to ensure responsible use of funds and maximizing federal matching dollars for Oregon’s Medicaid program.

Looking Ahead

Unfinished business from the session includes securing a technical fix on a new demographic data collection bill, enacting legislation to provide transparency on the cost of health care administration, and clarifying in law that CCOs may continue to manage local drug formularies.

Throughout the interim and next legislative session, COHO will continue to advocate strongly for policies that advance health equity and transformation. We offer our support to the Executive Branch and the Legislative Assembly; if we can be of assistance, please do not hesitate to reach out.