Health Bills That Died in the Legislature's Second Half
June 14, 2011—Insurance rate review, allowing psychologists to have prescribing privileges and expanding scope of practice all met a fateful ending when the Legislature adjourned recently. But most of these bills are expected to resurface when lawmakers reconvene next February.
Because of the $3.5 billion budget gap, many bills that had a financial impact died, regardless of their policy merit.
Insurance Rate Review
Sen. Chip Shields (D-Portland) introduced three bills (Senate Bills 717, 718, 719) to make the insurance rate review process more transparent and open to the public, particularly for small businesses and individuals.
Throughout the session, Shields argued that increased insurance rates strangled small businesses, which had to choose between providing coverage to their employees and losing profits.
“They need bigger scrutiny,” Shields said of the rate review process.
All three bills had “staunch opposition from the health insurance lobby,” he added, which contended that the Insurance Division would no longer be able to have candid conversations about rate increases with insurance companies. During public testimony, Theresa Miller, administrator of the Insurance Division, also said the bills would pose logistical challenges for the Division.
Shields, who intends to reintroduce the legislation next February, said a work group has been put together to reach consensus.
Psychologist Prescribing Bill
For the fifth session, psychologists sought the ability to prescribe drugs to treat anxiety, depression, attention deficit disorder and other mental and emotional illnesses, but not narcotics.
If House Bill 3523 had passed, Oregon would have become the third state, after New Mexico and Louisiana, to give psychologists this privilege. A psychologist would have been required to have a master’s degree in clinical psychopharmacology, clinical training in physical assessments, pathophysiology, psychopharmacology and clinical management, and at least one year of experience in a mental health setting.
Questioning whether psychologists had the proper scientific training in the practice of medicine, and subsequent concerns about patient safety became the main points of opposition.
John McCulley, the lobbyist for the Oregon Psychiatric Association, said those concerns won the day. “There were a number of legislators who were concerned about the measure,” he said. “The bill didn’t have enough votes to move forward.”
It’s unknown whether the Oregon Psychological Association will reintroduce this measure next February since they did not return a call for comment.
ZoomCare Bill Didn’t Pass
Scope of practice bills received a fair amount of contentious debate this session (one scope of practice bill relating to dental hygienists, in particular).
Senate Bill 952 was one such bill that didn’t make it out of the Ways and Means Committee. It would have allowed supervising physicians to petition to the Oregon Medical Board to let their assistants dispense medications. It also would have removed a provision requiring the Oregon State Board of Nursing to grant dispensing authority to nurse practitioners only in circumstances where there’s a lack of pharmacy services.
ZoomCare, which operates eight health clinics in the Portland metropolitan area, was the major proponent. Dr. David Sanders, its CEO, believed the legislation would make it easier for patients to receive medications, including antibiotics, ear drops and muscle relaxants rather than have to stop by a pharmacy.
“We were under the impression up to the day before the end of the session that it was going to move,” said Len Bergstein, ZoomCare’s lobbyist.
Bergstein had expected the bill to pass with broad bipartisan support, but was stopped by Rep. Jim Thompson (R-Dallas), who a former executive director of the Oregon Pharmacists Association.
The bill will be back in February. “Sometimes, a good idea takes to sessions,” Bergstein said.
Drug Purchasing Consolidation Fails
The Oregon Prescription Drug Program (OPDP), created in 2003, consolidates the purchasing power of the Oregon Educators Benefit Board, SAIF, and Oregon Health & Science University, serving more than 350,000 people.
Such a program has resulted in cost savings, according to Tom Burns, director of pharmaceutical programs for the Oregon Health Authority. “We think there’ll be savings for many agencies around the state that buy drugs,” he told the Senate Health Care, Human Services and Rural Health Policy Committee.
The bill was expected to have a fiscal impact, but such a statement was never prepared because the Ways and Means Committee never gave the bill a hearing.
No Expansion of Autism Coverage
Senate Bill 555 sought to make significant changes to coverage of screening for, diagnosis of, and treatment for autism spectrum disorders, which include a range of developmental disabilities affecting a person’s communicative, cognitive and physical capabilities.
Insurance companies would have been prohibiting from terminating a child’s health coverage solely because the child had been diagnosed with such a disorder. Additionally, health plans would have been required to cover a type of treatment called ‘applied behavioral analysis.’
“This is a huge step forward” in how autism is treated, said Sen. Alan Bates (D-Ashland) during a Senate hearing.
But with a $13.3 million fiscal impact, the bill never moved out of the Ways and Means Committee.