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HB 4003: Supporting Oregon’s Nurses
I care deeply about our state and the nurses who provide the care we rely on. They’ve experienced a lot of trauma over the last two years and this bill makes important changes to support them.
The current nursing crisis is the result of longstanding workforce issues that have only been exacerbated by the pandemic. Many of you have heard me speak on this floor about my experience as a nurse practitioner. I have seen firsthand the stress this pandemic has placed on our already overburdened healthcare system and I knew the legislature had to take action to avoid further depleting our healthcare workers.
Over the interim, I convened a workgroup to discuss Oregon’s nursing workforce shortage and consider possible solutions. The coalition was purposely broad and consisted of representatives from nursing advocacy groups, nursing education, hospitals and long-term care organizations, as well as policy experts. Over the course of several meetings, we identified multiple challenges contributing to our nursing shortage. Specifically, burnout and wellness; education and faculty support; care models and documentation; and infrastructure.
The workgroup identified potential short-and long-term solutions and the product of those conversations is what you see before you today. HB 4003 was written to address the immediate concerns Oregon’s nurses are facing. It is not the end of the conversation, but provides a bridge to both address some immediate needs and get us to a place where we can do more.
Hear me speak about HB 4003 and how we must support nurses here and read more about this bill here.
HB 4035: Continuing Health Care Coverage for Medicaid Recipients After the Federal Public Health Emergency Ends
At the beginning of the pandemic, the federal government passed the Family First Coronavirus Recovery Act providing additional Medicaid funding to states to ensure beneficiaries would retain their health insurance benefits throughout the emergency regardless of eligibility changes during the PHE. Once the emergency ends, however, states will have 12 months to complete eligibility redeterminations and disenroll members who are no longer eligible.
Many low-income Oregonians struggle to maintain health insurance coverage when their income fluctuates above and below the eligibility level for OHP. During the public health emergency we have seen the uninsured rate drop to a record low of 4.6% with more Oregonians reporting they were enrolled in health insurance than ever before.
OHA must conduct the redetermination process for all 1.4 million Oregonians on the Oregon Health Plan, the state Medicaid program, within twelve months after the federal PHE expires. OHA’s latest projections suggest as many as 300,000 Oregonians could lose OHP eligibility due to income changes.
I ran for office in 2018 to protect Medicaid coverage for the vulnerable populations that depend on it to access care. It did not escape me how poetic it was that HB 4035, which will protect continuity of care for the same vulnerable Oregonians, was the last bill I carried on the House floor.
Being a primary care provider, you learn a lot about what’s important to people - listening to their dreams and fears, sharing their faith, and giving them hope. I see the emotional toll lack of health insurance has on people. They lose sleep. They are constantly stressed. They worry about seeking care because they are terrified of costs. They ration their medication. On any day, our lives can be flipped upside down by a diagnosis or accident, whoever you are, however important you are. Our healthcare system should support us when it does.
I look forward to continuing working to make sure every Oregonian can access healthcare.
See me speak about HB 4035 and the importance of this work here.
Read more:
SB 1529: Increasing Access to Primary Care and Behavioral Healthcare
In 2019, I led on a bold policy to increase access to primary care. As a new legislator, I hadn't yet built the coalition or spent the time needed for such a heavy lift. But I persisted.
In 2020 I Co-Chaired the Universal Access to Primary Care work group, which met monthly at the start of the pandemic. The members were a diverse group of primary care stakeholders, including practitioners, behavioral health providers, specialty providers, health system representatives, payers, health economists, a rural health expert and a consumer advocate. Even though many of the members were healthcare clinicians working on the frontlines, they knew how important this work was.
Together we built a clearer understanding of barriers to accessing comprehensive primary care and brought forward a policy in 2021 representing the work group's top policy recommendations, with broad stakeholder support. HB 3108 passed out of the House Healthcare Committee with bipartisan support, but with so many big bills in the Joint Ways and Means Committee this small but mighty policy died at the close of the 2021 session. But I persisted because research consistently demonstrates that access to primary care reduces disparities in health outcomes, improves health system efficiency, and reduces overall health system costs.
Unfortunately, primary care is incredibly under-utilized in our state. A quarter of Oregonians report not having a personal provider, which is higher than the national average. While the benefits of comprehensive primary care are clear, over a third of Oregonians report being underinsured, foregoing preventive care visits which leads to worsening illness and more severe, expensive treatments.
Oregon also ranks as one of the worst states in the nation for adults who report lack of mental health treatment within the past year. Mental and physical health are inseparable. We must no longer accept behavioral healthcare as anything else but primary care. We must create a system that reflects this reality, and minimizes the many barriers to accessing mental health care.
This short session the policy, HB 4083 once again made it out of the House Healthcare Committee and once again got stuck in Joint Ways and Means. When I learned the policy was dying again, I knew I had to do whatever I could to make sure it got passed this session. I had one more committee meeting that afternoon so I scrambled and worked with legal counsel, the Legislative Fiscal Office and the Legislative Policy and Research office and we were able to amend HB 4083 into SB 1529. It was an amazing moment in our committee and one I’ll remember forever!
The policy will require insurers to provide reimbursement for three primary care visits annually, removing the often prohibitive point-of-service cost-sharing for patients for these three visits. These visits can be with a primary care provider or behavioral health care provider.
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