Two Democrats object to increased fees in the medical marijuana program
June 15, 2011—The Oregon Legislature is regarded as being sympathetic to health and human services programs when agency budgets must be cut to close the state’s budget hole. The Senate followed through with that mindset this year, passing the Oregon Health Authority’s budget for 2011-2013 by a 19-11 margin yesterday.
The Authority’s total budget is $11.9 billion, 10.7 percent higher than in 2009-2011. Of that, $1.7 billion comes from the state’s general fund, while lottery funds, federal matching dollars, the hospital provider tax and other sources make up the remainder.
Although the Authority’s budget is higher than in 2009-2011, it’s still not expected to meet case load demands. Caseloads are going to have to be watched carefully, legislators say, and the budget readjusted in 2012.
Serious concerns also exist about cuts to the Oregon Health Plan’s prioritized list of services, and whether $239 million in assumed savings during the second half of the biennium as a result of transforming the Oregon Health Plan into coordinated care organizations will actually occur.
The Governor’s budget proposed cutting the funding for 39 prioritized services, which include coverage for everything from incontinence to cochlear implants for children.
The Joint Ways and Means Subcommittee on Human Services, which worked the Authority’s budget, found $22 million to restore funding to all but 13 of those services.
“We heard a lot from individuals being very concerned about some of the treatments that were going to get cut,” said Rep. Tina Kotek (D-Portland), one of the subcommittee’s co-chairs.
The services being cut include coverage for benign cysts, “non-specific disorders of the breast,” anal fistula, hemorrhoids, mutism and potential lost of vision. The state does need approval from the Centers for Medicare and Medicaid Services (CMS) before making those reductions.
“We did not go higher because ones higher than that lead to serious conditions,” said Sen. Alan Bates (D-Portland).
The annual fee for cardholders was increased from $100 to $200. Also, only people receiving Social Security disability qualify for the reduced card fee of $20, unlike previously when those on the Oregon Health Plan or those who received food stamps also received the reduced card.
Funds raised from those increased fees will pay for emergency medical services, the safe drinking water program, school-based health centers and family planning programs.
Two Democratic senators, Floyd Prozanski (D-Eugene) and Sen. Chip Shields (D-Portland) objected to the fee increase, and were the only Democrats to vote against the Authority’s budget.
Both said they had many constituents on the medical marijuana program. “I believe this would be a significant hardship for them,” Shields said.
Republicans took the opportunity to reinforce their assertion that the state’s efforts at healthcare transformation
, which will create coordinated care organizations and combine physical, mental and dental health services in the Oregon Health Plan, will not achieve the $239 million in savings that advocates envision.
“The assumptions made in this budget, in my mind, are absolutely fictitious,” said Sen. Jeff Kruse (R-Roseburg).
“These savings will not and cannot occur until we have medical liability reform and price negotiation in medical care delivery,” said Sen. Doug Whitsett (R-Klamath Falls), who also voted against the bill.
Bates acknowledged that the Authority’s budget will “face significant challenges” without those savings, and said that otherwise people would either have to be dropped from the Oregon Health Plan or reductions made to hospital and provider reimbursement.
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