A Eugene-area lawmaker wants to give the Oregon attorney general the power to investigate and fine health insurers that engage in anticompetitive practices after a multinational company’s attempt to stifle competition was blamed for causing a physician shortage last year.
House Bill 3234 would be the most sweeping response Oregon has seen to growing consolidation in health care that critics say is undermining physician independence and putting profits before patients.
“Something is seriously broken in health care, and our constituents are demanding that we do something,” state Rep. Nancy Nathanson, a Eugene Democrat and sponsor of HB 3234, told the House Commerce and Consumer Protection Committee Thursday.
Nathanson said that lawmakers have passed bills “around the edges of the problem” that deal with workforce shortages and the cost of prescription drugs.
Last year, Nathanson led a pressure campaign against national clinic giant Optum after it took over Eugene-based Oregon Medical Group. So many doctors left the practice and were subject to contract terms forbidding them from competing that the region became what critics called primary care desert.
“My cat has better health care,” one patient told The Lund Report at the time.
Nathanson’s bill would give the attorney general the authority to investigate and take action against a health insurance company or its affiliate that uses contracts or other action to hinder competition or create a monopoly. The attorney general would also be empowered to take the insurer to court to stop their anticompetitive practices and force it to pay penalties.
“We can’t just employ people and not exercise some control over what that environment looks like."
Nathanson is seeking an amendment to the bill that would expand its scope and allow the attorney general to also target large vertically integrated companies suspected of anti-competitive practices.
The amendment would prohibit insurers, drug supply middlemen companies or employers from exercising control over providers’ clinical decision making. That includes limiting how long providers can spend with patients, setting clinical standards, prescribing medication customer billing and setting prices for services.
It would also limit businesses from hiring or firing health care workers, setting their schedules or their compensation.
However, representatives of health insurers and hospital systems told lawmakers that the amendments would make their business models unworkable.
“We can’t just employ people and not exercise some control over what that environment looks like,” Jessica Adamson, a lobbyist for Providence Health and Services — a hospital chain that sells health insurance plans — told the committee. “So this bill would subject us to being in violation of the law for the very work that we are here to do and have been doing for a very, very long time.”
Mary Anne Cooper, director of government relations for Regence BlueCross BlueShield of Oregon, told the committee that the amendments would ban actions common to “health insurance contracting.” She said insurers could not direct members to more affordable care or manage prescription drug costs.
Oregon Attorney General Dan Rayfield supports the bill, according to his advisor, Leslie Wu. If accompanied by funding for new consumer protection attorneys, it would allow more aggressive health care oversight similar to the authority wielded by his counterpart in California.
Nathanson said she is working on another amendment to address concerns with the bill.
