440,000 Oregonians stand to lose health coverage under federal proposal

Diane Dietz | Statesman Journal

Show Caption Hide Caption CBO: 22 million people could lose health care coverage The Congressional Budget Office estimates twenty-two million fewer people would be insured by 2026 under the GOP's proposed health care plan.

If U.S. Senate Majority Leader Mitch McConnell's health care bill becomes law as currently written, about 440,000 Oregonians will lose health insurance over the next decade, according to a report released Wednesday by state health and insurance officials.

The loss includes 350,000 current Oregon Health Plan recipients, 80,000 people now buying coverage in the individual marketplace and 10,000 with employees with group coverage.

“The bottom line is the Legislation is cruel,” Gov. Kate Brown said Wednesday. “It forces Americans to pay more for inferior care. It will slash funding for public health emergencies, epidemics and opioid abuse treatment.”

Changes to the Medicaid plan won't take place until after 2019.

The nonpartisan Congressional Budget Office earlier this week estimated that the Senate bill would increase the number of people without health insurance nationally by 22 million by 2026.

McConnell unveiled the proposed Better Care Reconciliation Act of 2017 on June 22. He said the Senate would vote on the matter by July 4 -- but most recently said the vote would be delayed until after the holiday.

If the bill passes, the state exchange set up under the Affordable Care Act (ACA) that serves as an insurance marketplace for 215,000 Oregonians would lose about 10,000 customers each year, according to the state report.

The first round would be young people who bought insurance because of the ACA’s individual mandate, said Patrick Allen, director of the state Department of Consumer and Business Services. The bill would eliminate the mandate.

As the pool narrowed the cost would increase, he said. As the cost increased more insurance purchasers would drop out. Older people with more expensive illnesses would be more likely to remain.

“They (said) the markets are in a death spiral today and these steps will somehow stop that. We actually think the exact opposite is true: the market is relatively stable. ... Withdrawing this many potentially health people from the market could cause a death spiral.”

State officials were especially concerned by the federal bill’s pruning of the Community First Choice option that supports people with severe disabilities so they can stay in their homes. The option is frequently called the K Plan. In Oregon, about 25,000 people are supported by the plan.

The ACA added a 6-percentage-point increase in a federal the federal match (which pays for a total of 64 percent of Oregon’s program). The Senate bill would eliminate the extra match, leaving Oregon to come up with an additional $150 million or trim K Plan enrollment.

The trimmed recipients, however, would still qualify for mandatory nursing home services that would cost two-thirds more, state officials said.

Oregon is a national leader in the delivery of health care, Lynne Saxon, director of the Oregon Health Authority, said. The state developed its prioritized list of medical services that forms the basis of the Oregon Health Plan in the early 1990s. The state created coordinated care organizations to deliver cost controlled benefits under the Affordable Care Act Medicaid expansion. The state will act to preserve its gains, Saxon said.

“This (Senate) proposal would take us backwards,” she said. “We’ve already begun doing everything possible to insure that our system continues to move toward health transformation, better care, lower cost, better quality.”

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