Legislation to stem the opioid crisis, boost Oregon鈥檚 health care workforce, set minimum hospital staffing levels, overhaul the state鈥檚 controversial drug decriminalization law and others hang in the balance as the Republican walkout halts legislative work.
Democratic lawmakers say that months of work on health care legislation could unravel after a group of Senate Republicans and Independents announced Tuesday they鈥檒l deny the chamber a quorum until June 25, the session鈥檚 last day. That鈥檒l leave one day for lawmakers to pass a two-year budget as well as other legislation. Hundreds of bills have piled up since the walkout to protest abortion, gun and transgender health care bills began on May 3.
鈥楢n investment in their wellness, their health鈥�
State Rep. Maxine Dexter, D-Portland, told The Lund Report, she is worried about and a pair of bipartisan bills intended to make naloxone, an overdose reversal medication more available as the state sees surging deaths from synthetic opioids.
Dexter said she鈥檚 also concerned about what it will mean for Oregonians if the session ends without health care legislation being passed. She said in an email that the Senate impasse is 鈥渞isking peoples鈥� lives and ability to access treatment.鈥�
鈥淚 just feel like we are undermining what Oregonians need and deserve, which is an investment in their wellness, their health, their safety,鈥� she said.
Another bill that鈥檚 in limbo would affect Oregon鈥檚 coordinated care organizations, 16 regional insurers contracted with the state to provide services under the Medicaid-funded Oregon Health Plan. extends the expiration of the contracts from 2024 to 2026, essentially postponing a procurement process in which the contracts would be renewed and potentially changed to address any concerns over the program鈥檚 spending and care.
The extension is intended to buy time while the state and coordinated care organizations implement to spend Medicaid funds on services affecting health such as food, housing and climate-related programs. It also would give the state and coordinated care organizations a reprieve from the complicated contracting process to allow them to focus on the after a three-year pause that began during the pandemic.
Josh Balloch, vice president of government affairs and health policy for southern Oregon-based coordinated care organization AllCare Health, called the contract extension 鈥渧itally important.鈥� He said the Oregon Health Authority and coordinated care organizations risk being 鈥渂uried鈥� in work instead of focusing on patients if the bill doesn鈥檛 pass.
Oregon Health Authority spokesperson Robb Cowie told The Lund Report in an email that the agency is concerned about multiple bills. Those include legislation intended to provide more money for tribal health programs, increase access to vaccines for children, tighten monitoring of prescription drug prescriptions and others.
The budget and beyond
State government won鈥檛 shut down if the Legislature adjourns without passing a budget because lawmakers earlier passed a resolution funding state agencies at their current levels until September.
State Sen. Elizabeth Steiner, a Portland Democrat who co-chairs the Joint Ways and Means Committee, told The Lund Report that state agencies would keep their doors open but new funding for program expansions won鈥檛 take effect if lawmakers don鈥檛 pass a budget.
The Oregon Health Authority is planning to expand Healthier Oregon, a program that extends the Medicaid-funded Oregon Health Plan to people of all ages regardless of their immigration status. Currently, undocumented children younger than 18 and adults ages 19 to 25 years old or 55 years and older are eligible. Steiner said the state鈥檚 upcoming budget funds expanding the program to all adults by July, but that won鈥檛 happen if it stalls.
Additionally, she said the upcoming budget includes new funding to keep low-income Oregonians insured while the state works through a federally mandated review of Medicaid roles as part of an unwinding of pandemic measures. The health authority is asking the federal government to allow people who would lose their Oregon Health Plan coverage to remain covered while the state develops a new .
Steiner said the upcoming budget includes funding to keep this group insured and will include a federal contribution. She didn鈥檛 know exactly how many Oregonians could be affected but said an estimated 60,000 could be eligible.
鈥淚f people churn off health insurance, it鈥檚 hard to get them back on,鈥� she said. Interruptions to people鈥檚 health care means they stop getting care to manage chronic disease or health screenings, she said.
If the budget doesn鈥檛 pass, the state won鈥檛 receive federal matching funds to help hospitals that care for large populations of indigent patients, Steiner said.
Cowie said that if the Legislature doesn鈥檛 pass a budget, Oregon will lose out on 鈥渉undreds of millions of dollars in potential federal matching funds, at a time when Oregon鈥檚 health care system is already strained and providers are grappling with the loss of federal COVID-19 relief funds.鈥�
鈥淚f the session ends without a state budget or passage of key legislation, tens of thousands of people 鈥� especially in rural counties 鈥� could lose healthcare coverage,鈥� he said.
Cowie said that state health officials are closely watching the situation and are preparing to 鈥渉elp partners in local communities sustain their programs through this period of uncertainty.鈥�
He also said the walkout imperils , a bill requested by Gov. Tina Kotek that allocates $70 million for behavioral health spending.
State Sen. Cedric Hayden, a Fall Creek Republican and vice chair of the Senate Health Care Committee, told The Lund Report the session has been put on 鈥減ause鈥� and Republicans will come back when Democrats negotiate in good faith.
Hayden said there are many budget items that Republicans support as well as policy bills. He said Republicans could support and funding for crisis-intervention line 988. He added that the Legislature could pass roughly a hundred bills in a day if each chamber suspended its rules.
鈥淚鈥檓 not saying it will turn out that way but it is possible,鈥� he said.
Nosse said that if the Legislature adjourns without approving a budget the state will 鈥渓imp along鈥� until Gov. Tina Kotek calls for a special session for lawmakers to pass a sweeping budget bill that includes provisions from leftover bills.
He said he hopes that the bill would incorporate hospital staffing legislation between labor and health systems. He also said he hopes it includes to Measure 110, a drug decriminalization and treatment law widely criticized for its inept rollout.
But he said it鈥檚 possible that in a shorter special session, lawmakers won鈥檛 have an appetite for more controversial bills, such as to reproductive and transgender health care, that could help spur another walkout.
鈥淎m I worried about a bunch of bills that we worked on in the House that are going to die?鈥� he said. 鈥淵es, I am.鈥�
Hoping for a breakthrough
Democratic lawmakers told The Lund Report they are hoping for a breakthrough and are proceeding with legislative business to get bills ready for a Senate vote if the chamber resumes business.
During the session, bills with funding requests have piled up at the Joint Ways and Means Committee, the principal budget-writing panel. Steiner said her committee and all others are set to finish their work by their June 12 deadline.
Democrats hold a 17-seat majority in the 30-seat Senate. Two Republican senators are not participating in the walkout and Sen. Chris Gorsek, D-Troutdale, is absent recovering from surgery. If Gorsek returns and one Republican or Independent senator comes back, Democrats will have the 20-member quorum needed to resume business.
State Sen. Deb Patterson, a Salem Democrat who chairs the Senate Health Care Committee, told The Lund Report that she鈥檚 not willing to give up on bills that have been carefully considered. She said that some Oregonians took time off from work to drive across the state multiple times to testify before committees.
鈥淚鈥檓 super worried,鈥� she said. 鈥淭here鈥檚 some really important stuff we need to move forward.鈥�
If lawmakers end up with not enough time for every bill, Patterson listed her priority legislation:
requires pharmacy benefit managers, controversial drug supply middlemen, to disclose information on their business practices.
creates services for people with brain injuries.
would create a state-based marketplace that Oregonians could use to buy health insurance.
would set up a governance board to establish and oversee a single-payer health care system in Oregon.
tightens hospital requirements to provide free medical care to low-income patients.
sets up a task force to help hospitals with the costly logjam of not having enough settings to discharge patients who don鈥檛 need hospitalization but still require a lower-level of care.
Expanding the training pipeline for the state鈥檚 pandemic-drained workforce has been a key priority of the sessions that鈥檚 attracted bipartisan support. Earlier this week, 20 bipartisan lawmakers from both chambers sent a letter to the Joint Ways and Means Committee to support $40 million to create more training opportunities for nurses and other heath care workers.
鈥淥ur state investment of $40 million could leverage up to an additional $107.5 million federal dollars for a total investment of $147.5 million dollars 鈥� a game changing investment to grow the health care workforce Oregon needs,鈥� reads the letter.
State Rep. Ben Bowman, D-Tigard, told The Lund Report that the requests in the letter grew out of conversations between labor unions and hospitals over the staffing bill. He said the health care workforce shortage is a 鈥済enuine crisis鈥� that will get worse if the Legislature doesn鈥檛 act.
鈥淗ospitals are bowing under the strain of workforce and capacity challenges that are not going to end when session does,鈥� Lisa Goodman, vice president of communications for the Oregon Association of Hospitals & Health Systems, told The Lund Report in an email.
She said her group would continue working with labor unions and lawmakers to address the labor shortage and hospital capacity.
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