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Portland, OR – The new federal health care reform law puts state leaders in the driver’s seat, according to a new report by consumer advocacy group OSPIRG.
Delivering on the Promise: A State Guide to the Next Steps for Health Care Reform shows how state policy makers can implement and improve on the law to ensure it offers the best deal to consumers.
“The new law gives states the tools – and funding – we need to make fundamental improvements in health care,” said Laura Etherton, a health care advocate with OSPIRG and one of the report’s authors. “Will consumers and employers actually see lower costs, higher quality, and more stable coverage? The ball is in Oregon’s court.”
In many ways, Oregon is ahead of other states because the 2009 Legislature directed the Oregon Health Authority and the Oregon Insurance Division to begin work lowering health care costs and improving quality.
Among the central opportunities is the law’s call for each state to create and run an “exchange” – a health insurance purchasing pool for individuals and small businesses. The report lays out key recommendations to make the exchange a powerful force for consumers:
* It should offer a powerful, easy-to-use set of tools that put consumers in charge of their coverage, including clear comparisons between plans and quality and cost ratings, and that ensure there is a range of clear, distinct choices, rather than an endless array of confusing products.
* The exchange can improve care quality and lower costs by encouraging insurers to adopt reforms that deliver better care for consumers. It should also be able to actively negotiate with plans on behalf of consumers and stop excessive premium hikes.
* Oregon must ensure that the exchange’s governance is transparent, accountable, and responsive to consumers’ interests.
The Oregon Health Authority is scheduled to present a draft exchange plan to the August 10th meeting of the Oregon Health Policy Board. A final plan will go to the 2011 Legislative session for approval.
“The exchange can be a real game-changer, giving individual consumers and small businesses the purchasing power to demand better quality, and drive a hard bargain. And by providing clear information and easy-to-use comparisons on insurance plans, it will promote competition,” said Etherton. “But if state policymakers miss the boat, it won’t be much more than ‘Expedia for health insurance.’”
The new law also offers grant funding to help states adopt and strengthen important reforms. Oregon is in a strong position to gain funding for new and ongoing programs to:
* Encourage high-quality, low-cost treatment by investing in primary care, programs to prevent chronic diseases from turning acute, and reforms to improve coordination of care when many doctors treat the same patient.
* Review health insurance premium increases before they go into effect, protecting consumers from unjustified rate hikes and informing them about where their dollars are going.
* Help consumers with pre-existing conditions who otherwise could not get coverage, through temporary purchasing pools such as the Oregon Medical Insurance Pool.
“There are billions of dollars of grant funds available to support stronger consumer protections and invest in innovative approaches to care. Oregon’s agencies are aggressively pursuing federal dollars in each of these areas, and that’s good news for consumers.” continued Etherton.
Oregon leaders also have the chance to improve on the achievements of the federal law. The report outlines approaches that can save money and improve care, such as streamlining administrative paperwork, and investing in ground-breaking health IT systems to give doctors more powerful tools. The Oregon Health Policy Board recently heard presentations by workgroups recommending action in both areas. And while the federal law ultimately did not include a public health insurance option, states have the ability to create one to serve their own residents.
“The bottom line is this: Whether Oregonians see relief from the rising cost of health care depends on what leaders do right here in Oregon,” concluded Etherton, “D.C. had its turn in the sun – now it’s Oregon’s time to shine.”
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