Oregon has passed several transformative health care measures in recent years. These include the Sustainable Health Care Cost Growth Target Program with a Value Based Payment Compact. Meanwhile, coordinated care organizations (CCOs) continue to evolve, and discussions have begun to expand access to them by means of a bridge plan. The healthcare system needs time to stabilize and evaluate the effects of these measures on cost and health outcomes. Now is not the time for big new programs.


Policy Principles

Address Health Disparities: OBI recognizes that not all Oregonians have been served equally in our state health care system historically. We will continue to support legislative efforts to evaluate and address disparities across the health care system to ensure all Oregonians are receiving the care they need.

Access and Quality of Health Care: OBI will promote efforts to contain health care costs and improve access to high-quality health care by supporting an affordable health care system that improves the overall health of Oregon residents.

Universal Health Care: OBI will oppose proposals that impose taxes, fees and other revenue generation mechanisms on targeted people or businesses to fund changes to Oregon’s health care delivery and insurance systems.

Protect Employers and Employees from Cost-Shifts: OBI will support policies and initiatives that address health care coverage of the underinsured and uninsured without penalizing or shifting costs to employers. OBI will seek to protect ERISA provisions for self-insured plans. OBI will defend employer health plans against efforts to tax premiums or claims. OBI will oppose any efforts that may raise the cost of insurance, prescription drugs or other necessary health care.

Ensure Costs to Employers are Analyzed: Currently, the Legislature reviews the cost of health insurance mandates only on public programs. OBI believes lawmakers should know how legislation will affect insurance rates in the commercial market. For that reason, OBI will support legislation that requires a cost-benefit analysis to determine the effect of proposed legislation that would increase costs across all lines of insurance.

Limit New and Expanded Programs: While the Legislature is considering how to address Medicaid issues, weighing a return to a state-based exchange and evaluating the creation of an essential health benefit or public option, lawmakers should advance only those options that leverage current coverage and delivery systems to expand access. In doing so, however, legislators must not impose additional taxes or fees on employers. OBI will consider supporting proposals that minimally disrupt the group and individual insurance market and incorporate long-term, cost-neutral strategies that improve access to care, drive savings throughout the system, and reduce cost-shifting to employers. OBI also will consider supporting policy proposals that review existing programs and measure their effectiveness.

Support Sustainable Medicaid Spending: Economic uncertainty remains a concern for many Oregonians, and OBI recognizes the need to support CCOs and efforts to ensure the Oregon Health Plan (Medicaid) has adequate, sustainable, broad-based funding. Legislators must acknowledge that OHP funding is tied to the overall health of the economy and that and raising additional revenue from businesses struggling to make ends meet cannot be a solution if state revenues start to decline.

Advanced Value-Based Payment Models: OBI will support policies that continue to move us toward value-based payments and away from fee-for-service payment structures. OBI will prioritize policies that increase transparency around the total cost of care.  Additionally, it is critical that any payment model ensure maximum flexibility, recognizing that a one-size-fits-all approach will not work.

Promote Transparency of Health Care Cost Drivers: OBI has long supported reducing unnecessary costs and increasing transparency of cost-drivers across the system. We continue to monitor the work of the Cost Growth Target Advisory Committee and will work to ensure that implementation includes mechanisms for better transparency, reporting, and accountability.  Enforcement must recognize the challenges our health care system has faced during the pandemic, and enforcement authority must be clear for all stakeholders and approved by the Sustainable Health Care Cost Growth Target Advisory Committee.

Decrease Tobacco Use: OBI supports a comprehensive approach to decreasing the state’s tobacco use, including smoking and chewing tobacco, and vaping/e-cigarette use.

Protect Association Health Plans: OBI provides an association health plan (AHP) through which member businesses may obtain health insurance coverage. AHPs are an important option for small employers that want to provide health insurance, and OBI will work to retain, enhance, and expand employer private market options such as AHPs in order to meet the health insurance needs of employers and their employees.


Gayle Evans, Unitus Community Credit Union

Download OBI’s 2023 Policy Principles

Download PDF