By Jessica Adamson, executive director, state government and public affairs, Providence Oregon
Kristen Downey, director of government affairs, Providence Oregon
The 2021 session will present new challenges during the continuing COVID-19 pandemic. Legislators are facing budget shortages and big policy questions, all while navigating the complexities of meeting virtually and ensuring that they do so with transparency and opportunities for public engagement. Some of the key issues Providence expects the legislature to consider this year include:
State health care funding
The economic impact of COVID is reflected in lower revenue forecasts. Current projections show about $1.5 billion less in general fund revenue than anticipated prior to the onset of the pandemic. The governor’s recommended budget reflects this impact with substantial cuts to provider rates in Medicaid, elimination of Medicaid Graduate Medical Education funding, and cuts to disproportionate share hospitals that provide additional assistance to large hospitals with high Medicaid volumes. Cuts also are present in a variety of the governor’s other budgets, including K-12 education and public safety.
The legislature has accountability for building the final state budget and is expected to prioritize addressing the needs of Oregon families in a more comprehensive way. Providence is working closely with lawmakers and a diverse coalition of health care and community partners to ensure that the Medicaid budget is fully funded. There is renewed hope that President Joe Biden’s administration may be successful in efforts to push for a federal stimulus package that will enhance state and local funding. Such an effort would greatly benefit Oregon’s Medicaid budget.
COVID-19 response and recovery
Strengthening the state’s infrastructure to manage COVID outreach, testing, treatment and immunization will be a widely discussed topic among legislators. Part of this discussion will include addressing whether to make permanent the wide range of policy and payment flexibilities that have come with this public health emergency. Oregon insurers have voluntarily agreed to extend current telehealth flexibilities and payment parity through June 30, 2021. The crux of the debate will focus on whether to make payment parity permanent, or whether to extend it temporarily.
Care delivery and coordination
The Oregon Legislature will consider a range of bills related to delivery of care. The Oregon House has appointed a committee to focus solely on behavioral health this session. Among the many concerns are the impacts of online school on student mental health, substance use treatment, and ongoing issues at the Oregon State Hospital. Addressing provider shortages, diversity in the health care workforce, racial disparities in health outcomes and culturally competent care also will be widely discussed.
Social determinants of health
Providence is working with community partners to advocate for policies that end systemic racism and to address barriers contributing to health disparities. The legislature likely will consider a range of strategies related to education, nutrition, criminal justice reform and the environment. Housing security also will be a critical issue, with a focus on policies that prevent homelessness, increase access to affordable housing and extend eviction moratoriums.
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