Health Care Reform for
Employers

For a long time, we have left health coverage up to employers.  For the first time, employers are leading the charge to fix our health care system and lower costs.

Currently small businesses are being crushed by rising healthcare costs.  Many are one major illness away from ending coverage for their employees.  Even large employers are reeling from skyrocketing costs and employees are seeing fewer wage increases because of it.  Fewer employers are offering health benefits at all, or they are offering less.  To fully address this crisis, we all have a role to play.

Sharing Responsibility, Sharing Risks

The Healthy Oregon Act sets up the Oregon Health Fund which, in the future, will allow employers and individuals to join and “pool” their health care dollars to increase their buying power and share the risks across a larger spectrum.  Everyone who joins the pool gets an Oregon Health Card with an affordable benefits package and employers can purchase additional benefits if they choose. 

The Healthy Oregon Act will propose ways to place a renewed focus on preventative and primary care by setting criteria for insurers to become Accountable Health Plans.  It can also encourage wellness with incentives that encourage healthy behaviors. 

Benefits of Fixing Health Care for Employers

• Lower and more predictable costs, economically sustainable
• Healthier workforce, less absenteeism
• Families of employees covered
• Releives businesses who join the Health Fund of time and cost spend to administer health plans to employees
• Large group plan security for small employers
• Improved quality, increased transparency and easier cost comparison

Frequently Asked Questions from 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 also discussed 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.

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.