Frequently Asked Questions

Individuals & Families

We already have private health insurance, do we have to join?

 No.  But you, or your employer, might want to join for the affordable essential benefits package and perhaps "buy up" as an individual or "negotiate up" with your employer for additional benefits.

Will we still be able to see our family physician?

 Yes.  We expect the Oregon Health Card will be widely accepted because at least 600,000 Oregonians will be carrying one and because of the plan's focus on fair and fast reimbursements for providers.

How much will it cost?

The essential benefits package will be established over the next year with public input.  The price will be based on ability to pay with everyone having shared responsibility.

Our child has a pre-existing condition, will she be covered?

 Yes. The legislation creates the Oregon Health Fund to “pool” health dollars to leverage better rates and share the risks of illness and injury.  Because of the projected number of people who would join the pool, pre-existing conditions will be covered.

I am a member of a union that provides health insurance, how does this affect me?

The legislation exempt employers and union trusts that are already providing adequate health coverage unless they choose to join.

Employers

Is this a state or socialized plan?

No. Employers will still be able to purchase plans through the insurer of their choice and people will continue to choose their own health care providers.  The legislation calls for “public and private health care partnerships that integrate public involvement and oversight, consumer choice and competition within the private market.”

What will the essential benefits plan look like?

After the Healthy Oregon Act passes, a citizen board and sub-committees will begin to gather public input and priorities.  One thing is certain: a renewed focus on primary and preventative care is necessary to lower costs.  Dental, vision and mental health are deemed necessary in the bill.

Can all employers join?

Yes, but employers that are already providing adequate health insurance packages can continue their current plan.  Or employers could join the pool for the essential benefits plan and "buy up", or purchase additional benefits for their employers.   The legislation will look at ways of reducing and spreading the costs to share responsibility.  It's an unfair business advantage for one competitor to shift their health costs to the rest of us.

How much will it cost?

We won't know that until later in the planning process after the essential benefits package has been determined.  What we do know is that this won't work unless  we can lower costs, improve quality and insure every Oregonian.  The goal is a long-term reduction in costs.

Seniors

How will reform lower costs?

Health care dollars aren't unlimited, so by requiring transparency of costs and quality Oregonians can make more informed decisions about their personal health.  And, on a larger scale, before expensive medical expansions and equipment are funded, decisions should be based on community needs and should involve the community in planning.  Also, by streamlining claims paperwork every provider can save on administration.

The plan also focuses on electronic health record technology so your primary provider can ship your records to a  hospital or specialist with the click of a button to save you from duplicate tests.  Also, to ensure your end-of-life wishes are honored, the Healthy Oregon Act creates an online Registry where you can record your advance directive in the event you cannot speak for yourself.

Will we be able to afford health reform in the future?

Any health reform plan must be sustainable into the future and the Healthy Oregon Act provides a practical path to success without over-reaching.  The key to sustainability is to lower costs and to improve quality so everyone can afford essential coverage.

As a state there is much we can do locally, but for long-term change, reform must happen in Washington DC too.  The Healthy Oregon Act examines how federal policies are preventing us from improving health care and asks our Congressional delegation to participate in public hearings and introduce legislation.

I receive Medicare, are there plans for the state to start administering my benefits?

Some health reform plans have proposed similar ideas but the Healthy Oregon Act preserves your Medicare benefits as they are.

Providers

Is this a state or socialized plan?

No. Oregonians will still be able to purchase plans through the insurer of their choice and will continue to choose their own health care providers.  The legislation calls for “public and private health care partnerships that integrate public involvement and oversight, consumer choice and competition within the private market.”

Will this plan create more paperwork?

Just the opposite!  The Healthy Oregon Act calls for a streamlining of claims forms to help reduce administrative  costs for every practice and provider across the state.

My patient has a pre-existing condition, will she be covered?

Yes. The legislation creates the Oregon Health Fund to “pool” health dollars to leverage better rates and share the risks of illness and injury.  Because of the projected number of people who would join the pool, pre-existing conditions will be covered.

What will the essential benefits plan look like?

After the Healthy Oregon Act passes, a citizen board and sub-committees will begin to gather public input and priorities.  One thing is certain: a renewed focus on primary and preventative care is necessary to lower costs.  Dental, vision and mental health are also discussed in the bill

As a provider, why will I want to accept the Oregon Health Card?

We expect the Oregon Health Card will be widely accepted because at least 600,000 Oregonians will be carrying one and because of the plan's focus on fair and fast reimbursements for providers.

I'm a specialist, will this plan reduce my reimbursements?

No. We will always need  highly-qualified specialists.  But, the plan does call for focus on primary care to reduce our long-term health costs, especially around preventative care, smoking, and obesity.