Last week's news of continued financial woes at the Oregon Health Authority could end up casting a long shadow over January's election on whether to uphold new state taxes on health insurance and medical services.
In case you missed it, the Health Authority last week reported that Oregon incorrectly paid state health care organizations roughly $74 million in federal Medicaid money from 2014 to 2016.
It could be that the state will need to repay that money, although that question has yet to be answered.
The Oregonian reported last week that top officials at the Health Authority knew about the issue for months; in fact, some had known about the problem for more than a year. But the information was withheld from Gov. Kate Brown and the public. Brown found out about the problem on Oct. 17, when she was briefed by Pat Allen, the new director of the Health Authority. (Allen replaced Lynne Saxton, who was sacked — properly so — for her role in a scheme to publicly bad-mouth a coordinated care organization with which the agency was feuding.)
The governor's office issued a press release on the issue just a couple of hours after releasing records about the matter to The Oregonian in response to a request from the newspaper; in other words, the administration knew a news story was in the works. The press release traced at least some of the problem to the state's bungled Cover Oregon insurance exchange, a project launched by Brown's predecessor, John Kitzhaber. Brown declined the newspaper's request for an interview.
But Laura Robison, the Health Authority's new chief financial officer, told the newspaper that the incorrect payments occurred in cases when patients were both poor enough to qualify for Medicaid (known in this state as the Oregon Health Plan) and old enough to qualify for Medicare. Medicare, which pays first, should have been used for the bulk of those patients. But Oregon charged the federal government the incorrect amount, and then paid the extra money to the state's coordinated care organizations, which manage Medicaid services.
Robison said the agency also paid those coordinated care organizations an undetermined amount to take care of people who were not eligible for Medicaid.
The new brass at the Health Authority told Oregonian reporters that they were working hard to get on top of the problems. We don't doubt that.
But the state's citizens deserve answers to some big questions, especially as the January election on Measure 101 draws near. (A "yes" vote on the measure would ratify the Legislature's decision to create new health care taxes to plug a hole in the state's Medicaid budget and to stabilize the state's insurance market. A "no" vote would force the Legislature in its February session to find money to continue to provide health services to Oregon Health Plan patients.)
You can probably add your own questions, but here are some to start: Why didn't Brown know about this issue until the middle of October? Why wasn't the issue caught months or years before? What's the governor's plan for making sure that something like this doesn't happen again? Are there systemic issues at the Health Authority that need to be addressed? Will she and her new Health Authority staff pledge to provide transparency at the agency?
And here's a question that voters will be asking themselves when they receive their ballots for Measure 101 in January: How can taxpayers be sure that these tax dollars will be spent in a proper and prudent fashion?
Let's start the debate on this measure with answers to these questions. And it falls to the governor to provide the answers; from what we can see, the new staff at the Health Authority has its work cut out for it in the near future. (mm)