Ron's Rural Oregon Health Care Report

Ron knows full well that a fundamental foundation to sustain quality rural life in Oregon always has been -- and always will be -- quality rural healthcare.

That essential goal of quality healthcare in rural Oregon poses special challenges when hospitals and doctors may be long drives or helicopter flights away, challenges made even harder by uncertain winter weather.

But he knows the challenge must be met to protect the health of rural seniors, children and families. And it must be met because healthcare generates good jobs at good wages as well as significant financial resources for smaller communities throughout Oregon.

Because the objective of quality rural healthcare stands out as so essential, the senator has conducted a rural healthcare listening tour this year that’s enabled him to hear from doctors, nurses, patients, advocates and many others about what’s working and what needs improving to stay on the path toward quality care for all.

The senator’s most recent roundtables in John Day and Pendleton were the latest stops on his tour that’s included similar discussions with providers from the Oregon Coast, the Willamette Valley, central Oregon and southern Oregon.

He plans additional rural healthcare meetings this year in Oregon but so far can report these five key takeaways:

1)  The Affordable Care Act (ACA) has produced real benefits for rural Oregonians

The state’s rural healthcare providers at his seven roundtables to date overwhelmingly told Ron that most Oregonians have benefited from the ACA.

A consistent theme voiced at Ron’s roundtables has been the demonstrable gain achieved by the ACA for rural Oregonians.

Ron heard powerful personal stories at his roundtables of Oregonians whose lack of insurance before the ACA had forced them to put off essential medical treatment because the resulting mammoth health care expenses would have bankrupted them.  

Thanks to coverage under the ACA, those same people can now receive vital care.  Access to care when needed helps them stay on the job, provide for their families and serve their communities.

He also heard how the ACA helped to provide more cost-saving and life-saving preventive care, as well as caseworkers and behavioral health workers who helped patients get access to resources and make lifestyle changes. And providers told Ron about the crucial connections they have been able to make - because of the ACA in coordinating services to link quality mental health treatment, community resources and good physical health care. 

States like Oregon that are pioneering innovative and successful healthcare must continue to have the flexibility and the resources they need to provide better care at lower costs,” Ron said.

2)  Expansion of Medicaid in rural Oregon has been especially helpful

More than 1 in 4 Oregonians are enrolled in Medicaid -- and the share of Oregon Health Plan (OHP) members is even higher in some rural counties, exceeding one in three in some of those counties.

Ron heard repeatedly how lower coverage rates and increases in uncompensated care from repealing the ACA’s Medicaid expansion could force the shutdown of rural hospitals and clinics, many of which have slim financial margins.

Cuts to Medicaid would worsen the often-tough job of recruiting providers to rural Oregon, with the ultimate victims being rural residents needing quality health care.

“Significant cuts to Medicaid expansion would threaten the progress to patient well-being that rural healthcare providers and community leaders praised during our discussions,” Wyden said. “Simply put, rural hospitals and clinics would risk not being able to provide the care and services their communities count on.

3)  Some of the heaviest impacts from repealing the ACA and slashing Medicaid funding would land on rural seniors and children; and people battling opioid addiction

Ron’s roundtables featured conversations about the vulnerable populations in rural Oregon who would suffer the most.

For example, repealing the ACA and slashing Medicaid funding would threaten rural seniors, who tend to have higher rates of chronic conditions, disabilities, and need more support in nursing homes and other services than their urban counterparts.

Ron also heard how rural children could suffer because youngsters are disproportionately served through the Oregon Health Plan. Nearly half of Medicaid enrollees nationwide are children.

And providers also spoke of how the fight to combat opioid addiction would become tougher if the expanded addiction treatment coverage under the ACA is lost.

4)  Soaring prescription drug prices continue to undermine lasting healthcare solutions

Ron heard harrowing tales at his rural healthcare roundtables about Oregonians continuing to face prescription drug costs that place the treatment they need far out of financial reach.

He spoke with providers and patients alike about his work to lift the veil of secrecy covering the opaque system of pricing prescription drug costs.

Included in his conversation was his recent bill that would require pharmacy benefit managers in Medicare to disclose their total rebates provided by drug manufacturers. The legislation also would disclose how much those rebates are passed on to health plans so that prices are lowered for people needing prescription drugs.

Oregonians are increasingly worried whether prescription medicine will be available and affordable for their families,” he said. “My bill will shine a spotlight on why these drugs are so expensive, and uncover the best ways to make prescription drugs affordable.”

5)  Rural Oregon is hungry for solutions

Oregonians attending Ron’s meetings shared a message of preserving what’s been demonstrated to work toward achieving good health care throughout the entire state.

Simply put, they emphasized proven solutions they have pioneered in rural Oregon over partisan standoffs that could reverse those gains. 

That message resonated with Ron. He said it re-confirms his long-held belief that ideas are most likely to succeed when they emerge from the “Oregon Way” putting the priority on what works rather than partisan gain.

To be sustainable, any healthcare proposal needs to be bipartisan,” he said. “I want to come up with sensible policies that contain costs and improve outcomes."

As the ranking Democrat on the committee that pays for health care in the Senate,” he said, “I will not support changes that go back to the dark days when health care was only for the healthy and wealthy.”

We’ll keep you posted on Ron’s upcoming stops on his rural healthcare listening tour.