Oregon Revised Statutes Chapter 751 § 751.002 — Creation of comprehensive plan to finance and administer Universal Health Plan;

Creation of comprehensive plan to finance and administer Universal Health Plan; report to interim committees of Legislative Assembly related to health. (1) As used in this section, “single payer health care financing system” means a universal system used by the state to pay the cost of health care services and goods in which: (a) Institutional providers are paid directly for health care services or goods by the state or paid by an administrator that does not bear risk in contracting with the state; (b) Institutional providers are paid with global budgets that separate capital budgets, established through regional planning, and operational budgets; (c) Group practices are paid directly for health care services or goods by the state, by an administrator that does not bear risk in contracting with the state, by the employer of the group practice or by an institutional provider; and (d) Individual health care providers are paid directly for health care services or goods by the state, by their employers, by an administrator that does not bear risk in contracting with the state, by an institutional provider or by a group practice. (2) The Universal Health Plan Governance Board established in ORS 751.001 shall create a comprehensive plan to finance and administer a Universal Health Plan that is responsive to the needs and expectations of the residents of this state by: (a) Improving the health status of individuals, families and communities; (b) Defending against threats to the health of the residents of this state; (c) Protecting individuals from the financial consequences of ill health; (d) Providing equitable access to person-centered care; (e) Removing cost as a barrier to accessing health care; (f) Removing any financial incentive for a health care practitioner to provide care to one patient rather than another; (g) Making it possible for individuals to participate in decisions affecting their health and the health system; (h) Establishing measurable health care goals and guidelines that align with other state and federal health standards; (i) Promoting continuous quality improvement and fostering interorganizational collaboration; and (j) Focusing on coverage of evidence-based health care and services. (3) In developing the comprehensive plan and the recommendations to the Legislative Assembly under subsection (4) of this section, the board shall: (a) Consider, at a minimum, the following values: (A) Health care, as a fundamental element of a just society, must be secured for all individuals on an equitable basis by public means, similar to public education, public safety and public infrastructure; (B) Race, color, national origin, age, disability, wealth, income, citizenship status, primary language, genetic conditions, previous or existing medical conditions, religion or sex, including sex stereotyping, gender identity, sexual orientation and pregnancy and pregnancy-related medical conditions may not create barriers to health care nor result in disparities in health outcomes due to the lack of access to care; (C) The components of the Universal Health Plan must be accountable and fully transparent to the public regarding information, decision-making and management through meaningful public participation; and (D) Funding for the Universal Health Plan is a public trust and any savings or excess revenue must be returned to the public trust; (b) Consider, at a minimum, the following principles: (A) A participant in the Universal Health Plan may choose any individual provider who is licensed, certified or registered in this state or may choose any group practice; (B) The plan may not discriminate against any individual health care provider who is licensed, certified or registered in this state to provide services covered by the plan and who is acting within the provider’s scope of practice; (C) A participant in the plan and the participant’s health care provider shall determine, within the scope of services covered within each category of care and within the plan’s parameters for standards of care and requirements for prior authorization, whether a service or good is medically necessary or medically appropriate for the participant; and (D) The plan shall cover health care services and goods from birth to death, based on evidence-informed decisions as determined by the board; (c) Assess the readiness of key health care and public institutions to carry out the plan and collaborate with state agencies, including the Oregon Health Authority and the Department of Human Services, to determine how the agencies’ existing systems will integrate with the Universal Health Plan; (d) Consider the recommendations of the Joint Task Force on Universal Health Care in the report approved by the task force on September 29, 2022, including the recommendations to establish a single payer health care financing system that are consistent with subsection (1) of this