Rep. Knute Buehler, the Republican nominee for governor, outlined a six-point health care plan Wednesday that would build on the state’s current Medicaid framework, expand access to mental health and substance abuse treatment and maintain access to reproductive health services.
Speaking in front of the orthopedic and neurological clinic he helped found in Bend, Buehler proposed a number of measures he said would cut costs or raise new revenues in order to pay for his plan.
“I’ve learned that health care is not a luxury, it’s a basic human need,” Buehler said. “As governor, this principle will guide me in making decisions to ensure that every Oregonian, no matter your age, income or health, has access to quality and affordable care.”
His plan for Medicaid envisions maintaining the regional coordinated care organizations that receive a set dollar amount for each Oregon Health Plan member enrolled, funded with both federal and state dollars. Plans must provide all the care their members require with that fixed amount, and payments to plans are currently limited to a 3.4 percent increase per year.
Buehler said he would fight cuts in federal Medicaid funding that threaten that program, while ensuring stable state funding by committing more general fund dollars, raising the cigarette tax, creating a vape tax and making permanent a hospital tax. The hospital tax helped the state expand Medicaid coverage several years ago, and Oregon hospitals generally recoup those dollars because they see fewer uninsured patients as a result.
“I think there’s still a lot of headroom to bring some cost savings out of the system, to integrate physical and mental health services, and get people off the streets and into shelters,” Buehler said.
The plan would also invest in nonmedical services that address issues such as housing, workforce training, employment and other community services. Often called the social determinants of health, those issues have been shown to have a major impact on people’s health and health care costs.
Buehler expressed a commitment to reproductive health services and pledged to support access to abortion regardless of what happens at the federal level.
“Oregon has been a pro-choice state before Trump, and we’ll be a pro-choice state after Trump as far as I’m concerned,” he said. “We need to have a commitment to reproductive health and access to those services.”
Buehler also plans to reintroduce legislation to allow Oregon’s attorney general to go after “bad actor drug companies” engaged in price gouging, and would create a preferred medication list for state-funded drug purchases. Several states have used such lists, known as formularies, to cut better deals with competing drug manufacturers.
Buehler spelled out specific targets for many of his proposals. He wants to reverse the rising suicide rates to post an actual decline, cut opioid overdose deaths by 50 percent and reduce the number of unintended pregnancies by 25 percent within five years. He pledged to move the state from its bottom 10 ranking on child wellness and dental checkups into the top 5 percent.
He called for all public schools to have an on-site behavioral health specialist and peer support hot lines, all managed by the coordinated care organizations. Nearly half of all children in Oregon are enrolled in Medicaid.
The plan proposes expanding walk-in and community-based mental health facilities throughout the state.
“We need to make sure that every Oregonian who needs mental health care gets mental health care,” Buehler said. “Under Gov. Brown, way too many people are slipping through the cracks.”
Buehler took the opportunity to take several shots at his opponent in the gubernatorial race, accusing Gov. Kate Brown of mismanaging the state’s Medicaid program.
He blamed Brown for the failure of the Legislature to craft a bipartisan approach on health care.
“That was always done in the past,’ Buehler said. “We haven’t had those partisan fights about Medicaid like in other states. That has unfortunately all disappeared now.”
Brown’s campaign fired back criticizing Buehler’s votes on health care bills in the last legislative session.
“He can’t walk away from his record as easily as he walked away from Oregon families who need health,” Christian Gaston, communications director for Brown’s campaign, said in an emailed statement.
Despite their differences, the two candidates share many of the same ideas for the Oregon Health Plan. Last year, Brown set out four priorities for the next round of contracts with coordinated care organizations: social determinants of health, paying for value instead of volume, improving behavioral health and maintaining sustainable cost growth.
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