Providence Health & Services, the largest health care system in Oregon with eight hospitals spread throughout the state, as well as a number of special programs for children, families and senior citizens, has a long and intentional mission to serve the less fortunate in the state. It is a commitment that dates back to the founding of the system. For health care in Oregon, this sense of mission means, among other things, serving persons covered by the Oregon Health Plan, which is the state's name for Medicaid.
As the recession choked off the supply of general funds for state programs, legislators turned in 2003, 2007 and 2009 to a desire to enact hospital and health insurance taxes to raise money. Providence had questions about the policy justice of taxing providers, but in each of those years participated in good faith to design the best taxes possible – taxes that would be charged to hospitals and insurers, with assurance that the proceeds would go to fund low income health care.
CFM's role was to advise Providence on the tax policy, plus monitor negotiations in Salem, with an eye toward being able to give executives a clear sense of the political give-and-take, as well as the final outcome. If the health care taxes made policy sense, the money had to go for two purposes – fund low-income health and reduce the cost shift to private health insurance bills as a result of state government underfunding of the Oregon Health Plan (Medicaid).
With CFM's help, Providence, along with other hospitals and insures throughout, produced consensus versions of both the hospital and health insurance tax. On the hospital, the most recent version of the tax, negotiated in the 2009 legislative session, resulted in an increase in reimbursement to hospitals under the state's Medicaid program, thus reducing the cost shift. On the insurance tax, the proceeds were directed to funding increases in children receiving health insurance, perhaps in the range of 80,000 new covered lives.