Oregon’s Health Authority

BACKGROUND1
In 2009, the Oregon legislature passed HB 2009, which created the Oregon Health Authority (OHA) – a
single agency, which would oversee most health-related programs in the state. While the implementation
of the new agency is still in progress, the state has already made steps toward changing the health care
system. The first, most important step was the creation of the Oregon Health Policy Board. This nine-
member citizen-led board is charged with overseeing OHA.
OHA’S MISSION 2
OHA’s Mission is to “[h]elp[] people and communities achieve optimum physical, mental and social well-
being through partnerships, prevention and access to quality, affordable health care.”

“The Health Authority will transform the health care system in Oregon by:
• Improving the lifelong health of Oregonians
• Increasing the quality, reliability, and availability of care for all Oregonians
• Lowering or containing the cost of care so it’s affordable to everyone”

In order to accomplish these goals, OHA will focus on health and preventive care as well as the reduction of
waste in the health care system. OHA acknowledges that work needs to be done in both the public and
private sectors. In the public sector, OHA will consolidate many of its health care programs in order to give
the state greater purchasing and market power; this will help OHA tackle the problems associated with
cost, quality, access, and lack of preventive care. In both the public and private sectors, OHA will work to
improve health care delivery and payment as well as the reduction of health disparities.

OHA’S ROLE ANDNATIONAL HEALTH REFORM 3

HB 2009 set the groundwork for Oregon’s health reform in July 2009. The federal legislation [The Patient
Protection and Affordable Care Act (ACA)] will supplement and support the reforms that are already
underway in Oregon.
Affordability and
Availability Will ACA, like Oregon’s legislation, creates an exchange, which allows people and small
Result from businesses to compare prices and policies of health insurance providers.
Exchanges
OHA planned to expand coverage to low-income working families. The federal
Coverage of Low- legislation will help Oregon fulfill this goal. The federal legislation will also make it
Income, Uninsured more feasible for Oregon to reach its goal of having affordable health care for all
Individuals by 2015.

Issue Area, Oregon Health Authority: Oregon Page 1 of 2

National Coalition on Health Care July 2010
 In order to achieve these goals, the federal legislation will bring $5 billion in new
Medicaid funds to Oregon over the next 10 years.
Oregon’s high-risk pool, which is already up and running, does not allow insurance
companies to refuse to insure people due to the existence of pre-existing
conditions. This high-risk pool will remain active and will insure the previously
uninsurable until 2014, when the legislation begins prohibiting private insurance
Erasing Barriers in carriers from denying coverage to people with pre-existing conditions. In addition,
Health Care Oregon will administer a federally funded high-risk pool alongside the already
Coverage existing Oregon Medical Insurance Pool. The Department of Health and Human
Services will allocate approximately $66 million for Oregon to implement this high-
risk pool, which will comply with ACA’s requirements.4 This money will extend
health care coverage to approximately 6,700 Oregonians while saving the state
$65 million over the next three years. 5
OHA is well positioned to be a national leader in the improvement of care, thanks
Improving Care for to the work that has already been started on everything from electronic health
All records to the establishment of quality standards for health care providers and
hospitals.
Consumers will benefit from health reforms.Benefits will: (1) include the
elimination of lifetime caps on benefits; (2) prohibit insurers from rescinding
coverage for those already enrolled in a plan; and (3) allow unmarried children to
Creating Consumer
remain on their parents’ plans until age 26. In addition, Oregon’s Insurance
Protections
Division now requires all health insurance companies to report administrative
costs, executive salaries, and other information; the information creates
transparency and allows Oregonians to know how their money is being spent.
As Oregon works to improve care, expand coverage, and reform the insurance
system, the state will also make progress in the reduction of health care costs.
Lowering Costs States will compete with one another to adopt better and more affordable ways to
deliver care. Also, investments in public health and wellness will be encouraged.
Finally, ACA will reward states for cost controls that they put in place.

1
What is the Oregon Health Authority (OHA)? (Jun. 30, 2010), available at
http://www.oregon.gov/OHA/features/feature_what_is_oha.shtml (last accessed July 2010).
2
For more information, see: OREGON HEALTH AUTHORITY, available at http://www.oregon.gov/OHA/index.shtml (last accessed July 2010).
3
U.S. House Health Reform Vote – March 21, 2010 (Mar. 24, 2010), available at
http://www.oregon.gov/OHA/features/feature_federal_intersect_ore.shtml (last accessed July 2010).
4
U.S. DEP’T OF HEALTH & HUMAN SVCS., FACT SHEET – TEMPORARY HIGH-RISK POOL PROGRAM, available at
http://www.hhs.gov/ociio/initiative/hi_risk_pool_facts.html (last accessed June 2010).
5
DAVID ROSENFELD, THE LUND REPORT, HIGH RISK POOL TO SAVE INSURERS MILLIONS (2010), available at
http://www.thelundreport.org/resource/high_risk_pool_to_save_insurers_millions (last accessed July 2010).

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National Coalition on Health Care July 2010