SPIRITED, a CareOregon eNewsletter

Federal policy update:
Another important year for health care

Jeremiah Rigsby, JD

CareOregon remains engaged with federal policy makers as both Congress and various federal agencies work to shape the future of the Medicare and Medicaid programs. This could be a very busy year for federal health care policy, considering the changing political dynamics within our three branches of government.

Here are some of the developments and issues that CareOregon will be monitoring throughout the year:

1. Republican Control of Congress

The midterm elections turned over control of the United States Senate to the Republican Party, which means that Republicans now control both chambers of Congress – and therefore the whole federal legislative agenda.

Party leaders from both chambers are meeting this week to develop what certainly will be a coordinated legislative agenda that often works against the policy objectives of the Obama Administration. We expect there to be a number of attacks on further implementation of the Affordable Care Act (also known as the ACA, or “Obamacare”) including efforts to repeal the law. Many believe the ACA will not be repealed, as President Obama would veto such legislation and Republicans do not have the required number of votes to overturn a presidential veto alone. Republicans would need Democrats to help overturn President Obama’s veto, a highly unlikely scenario.

Capitol Hill jobs lead to public policy role at CareOregon

My road to Care Oregon began in 2005, after graduating from Trinity University in San Antonio, Texas, with a degree in Political Science. I moved to Washington, D.C. to do policy work for U.S. Representative Henry Cuellar from South Texas.

Four years later, I began working for Oregon Congressman Kurt Schrader, who represents much of the Willamette Valley and Oregon Coast. One of my legislative responsibilities was health care policy, which is how I first became acquainted with CareOregon. In 2011 I moved to Portland to attend law school at Lewis and Clark, graduating last May – one week after I started at CareOregon. CareOregon runs government-funded health programs, which means that legislation and government regulations have a significant impact on the way we operate our lines of business.

At the state level, our size and success provide CareOregon with the opportunity to help shape the policy and regulations that impact our work. The Public Policy Department works with the Oregon Legislature and the Oregon Health Authority to make sure that CareOregon can continue to innovate and provide quality health outcomes in line with the Triple Aim. At the federal level, the Public Policy Department works with legislators, administration officials and trade associations to help inform federal policies that affect Oregon health care reform, and CareOregon specifically.

ACA repeal is only one example of the possible changes that could result from Republican control of Congress. CareOregon will be working closely with our national trade associations to monitor legislation that may have an impact on CareOregon, and to mitigate the damage caused by potentially harmful policy developments.

2. Medicare Payment Structure

As many of you know, CareOregon’s Medicare Advantage program (CareOregon Advantage or COA) is mostly comprised of people simultaneously eligible for both Medicaid and Medicare. These “dual eligibles” often have complex health issues that are more difficult to address, compared with typical Medicare members. Through legislative advocacy, work within our trade associations, and our recent admission into the Special Needs Plan Alliance, CareOregon will continue to help shape a Medicare payment structure that accounts for the difficulties that accompany providing health care for this vulnerable population.

3. Supreme Court Ruling

On March 4, the Supreme Court will hear arguments for King v. Burwell. This lawsuit challenges the subsidy structure that the ACA established to help people purchase health insurance through the Federal Health Exchange. This ruling would not directly affect CareOregon, as our health care plans are for those who do not make enough money to purchase coverage on the Exchange. However, the lawsuit could have a significant impact on the implementation of the ACA by eliminating affordable plan options for those not eligible for Medicaid (Oregon Health Plan).