Top Oregon legislators ask for your help with health care bills in 2025

Two of Oregon’s top legislators, Julie Fahey and Nancy Nathanson, returned to the Churchill neighborhood Sept. 26 for a citywide health care forum sponsored by the Churchill Area Neighbors.

Rep. Nancy Nathanson: I’m Nancy Nathanson, state representative representing North Eugene. Formerly I was on the City Council. I lived in and represented this exact neighborhood, Churchill.

Rep. Julie Fahey: I’m Julie Fahey, I am the speaker of the House in Oregon. I’m also the state representative for the House District that we are in right now. So I was elected in 2016, representing West Eugene and the Bethel neighborhood. And I just live a few blocks away. So Churchill Area Neighbors is my neighborhood association.

[00:00:43] We started receiving a flood of input about access to health care—and that is why Rep. Nathanson and I are here today. And you’ve got two very policy-oriented sort of nerdy legislators (sorry, forgive me), nerdy legislators up here at the table who, when that happened and we started to get that input, our brains went to: How do we solve this problem systemically? How can we make sure that we at the legislature, at the state level, we are doing what we need to do, and then: What can we do specifically for our communities?

[00:01:13] We are legislators, we are policy wonks, but we are also patients and we are consumers of the health care system. And I personally, you know, my husband was dropped from his provider—PCB at Oregon Medical Group. I had to wait, I’ve had to wait weeks for care, follow-up care from a regular mammogram, physical therapy. My dad had major spinal surgery and his surgeon left his practice because it was purchased by an outside entity and had to move many miles away because of a noncompete agreement. So these personal—and I have my own horror story about prior authorizations, happy to share that anytime anyone wants to hear it.

[00:01:54] John Q: The provider crisis followed the loss of the University District hospital.

[00:02:01] Rep. Nancy Nathanson: Last year I worked with local stakeholders to develop realistic responses to the hospital closure and loss of an emergency department. I drafted and passed legislation in March that does three things. It speeds up hiring nurses already licensed in another state. It pays for an additional crew since ambulances will be traveling farther and longer to get to the remaining two hospitals. And over $3 million goes to an innovation fund to reshape urgent care in our area, to relieve pressure on emergency departments and to get care to people where they are, not just only how to get ambulances to people and take them to hospitals.

[00:02:43] As soon as I got home from the legislative session in Salem, I started looking into panicked social media posts from people who couldn’t get an appointment with someone at Oregon Medical Group. I made calls, like, to the Lane County Medical Society, even the State Department of Justice.

[00:03:01] People were self-rationing prescriptions, reducing the dose or frequency to stretch medication as long as they could because they didn’t know when they’d be able to get a refill. Medications for things like lupus, diabetes, and Parkinson’s disease.

[00:03:15] Annual wellness checks for children were being canceled and they missed their routine and required immunizations. The wait time for appointments grew from two to three weeks to two to three months. Many clinics and doctors were not accepting Medicare patients. People were anxious, scared, angry. One pointed message said, ‘My cat has better healthcare.’

[00:03:39] So there was a noticeable and costly impact on the rest of the health care community as people without doctors leaned on calling 911 or showing up at the hospital emergency department for what otherwise should be primary care.

[00:03:55] Doctors too were under stress. Those who wanted to leave Oregon Medical Group wouldn’t be able to continue seeing patients locally and feared action for violating something called a noncompete agreement in legacy contracts that Optum had inherited from Oregon Medical Group.

[00:04:14] We had doctors in our community who had signed agreements some years ago that Optum had inherited. When they decided to leave practice for one of many reasons, COVID, stress, it was time to retire, or they were uncomfortable with the workplace as the workplace was changing, the requirements on how they delivered and practiced health care with their patients.

[00:04:42] If they were going to leave, it means they couldn’t practice. They couldn’t see patients for 12 months. Some of them moved out of the area, some moved out of state, some started commuting 45 minutes to an hour everyday so that they could work and see patients in another county.

[00:04:59] I talked to at least a couple of physicians that felt that they couldn’t leave, and they were quite worried about that.

[00:05:06] After my colleagues and I sent a letter to Optum—and then I talked personally with Dr. Capp and other Optum representatives, Sen. Prozanski joined me for the second in-person meeting—Optum agreed fairly quickly to not enforce noncompete language and they also committed to continue processing prescription refill requests.

[00:05:29] Rep. Julie Fahey: Oregon has long had a prohibition on the corporate practice of medicine. Basically clinics need to be majority-owned by providers. That’s because of weighing ethical concerns about patient care versus financial considerations.

[00:05:44] But there are a lot of loopholes to that law right now. And so we considered a bill in the short session in February that would have closed some of those loopholes and really but that healthcare is provided by entities that are majority owned by providers.

[00:05:59] That bill passed through the House, Rep. Nathanson and I both voted yes for it, but it died in the Senate. Our friends at Optum did not really like that bill because they would have had to undergo some pretty significant restructuring to comply with the requirements, nor did any of the other many corporate lobbyists that showed up at the Capitol to lobby against it. That bill is going to be brought back next year.

[00:06:24] And so I, and I hope to see it pass. We need to address the root causes of why we are seeing independent physician practices being bought up by outside entities, and we are doing that. And we also need to make sure that it is physicians that are owning the practices that are providing care here in this state.

[00:06:42] The legislature goes back into session in January of 2025, so we are both hard at work about what are the health-care related topics that we are going to take up in the legislature next year. The first one is supporting the Oregon Health Plan.

[00:06:55] One in four Oregonians get their health care through the Oregon Health Plan. So it’s very important that we support that program and that we make sure it’s successful. We are also going to continue the work on workforce. We’ve made some big investments in recent years on that. There’s more to do.

[00:07:09] And then pharmaceutical prices, drug prices. We have done interesting things at the state level in recent years.

[00:07:15] We’ve capped the price of insulin at $35. We’ve tackled the regulation of pharmacy benefit managers. There’s still more to do on that front. Pharmacy benefit managers are the middlemen of the pharmaceutical industry that drive up prices.

[00:07:28] Oregon Health Plan is also doing some really interesting work that I don’t have time to go into detail about, about social determinants of health. So using Medicaid to pay for things like housing for folks who need that to get well. It’s really interesting, creative stuff that we are doing here in Oregon.

[00:07:44] And there’s a program that many low-income Oregonians get pharmaceuticals through called the 340B (Drug Pricing) program. It’s a federal program and we will be taking on legislation to try and protect that program next year.

[00:08:01] Rep. Nancy Nathanson: In broad terms, I’m tackling corporate practice of medicine, access to healthcare and urgent care and access to affordable prescription medications at local pharmacies.

[00:08:13] One, there will be a bill to prohibit noncompete agreements and contracts for staff physicians.

[00:08:19] Two, working with local advisors and Lane Community College, OHSU, Bushnell University and others, I’m preparing a bill to loosen the student-faculty ratio for nursing students. By the way I’m also working with the Oregon Nursing Board on this.

[00:08:34] The idea is to graduate more nurses and get more working in Oregon. The limit right now is no more than eight nurses in a class. We believe we can safely increase that by one or two for every class, every term, every school and get more nurses to work in Oregon.

[00:08:52] Number three: Define urgent care clinics and require registration so that we can have a basic standard of care that you can depend on if you show up at an urgent care clinic. Hospitals are highly regulated. doctors are licensed, nurses are licensed, plumbers, truck drivers, people who do a manicure. But urgent care clinics, nothing.

[00:09:16] Most of these experiences at urgent care clinics are fine, but not all clinics operate alike. Some have doctors, some don’t, some have X-ray, some don’t. Only one will see someone whose insurance is from Medicaid, and that’s thanks to PeaceHealth.

[00:09:34] Finally, I am working with congressional offices to find ways for state and federal collaboration to crack down on anti-competitive business practices, keep community pharmacies open, ensure prescription drugs are accessible and affordable locally and put patient care before profits.

[00:09:52] John Q: Speaker Fahey said now is the time to get involved.

[00:09:55] Rep. Julie Fahey: So the call to action part is we’re going into session, Rep. Nathanson and I. You should email us, call us, tell us what you’re thinking about health care. The session starts in January, but now is the time to engage if there’s things that you want us to put forward.

[00:10:12] We are working on those things right now. So please do get in touch with us. We both read our emails. We will both respond to your emails. And so the input from the community about what’s going on in this health care space is really, really important to us. So please do reach out. And when the session starts, submit testimony, come up to Salem, or do it virtually. You can testify virtually as well.

[00:10:36] John Q: Two top Oregon legislators stop in at the neighborhood association, asking for your help in the upcoming session.