OREGON

Overview

Oregon is a leader in efforts to provide affordable, high-quality health care to every state resident. It became the first state in the nation to enshrine the right to cost-effective and affordable health care in its constitution when voters passed the ballot measure for the proposed  constitutional amendment. Lawmakers have also tasked the state health authority and another state department with drafting an implementation plan for a public option for individuals and families who obtain individual or small employer insurance from the state exchange and have separately directed a state task force to explore the feasibility of a universal healthcare plan. Legislators also voted to expand Oregon’s Medicaid program to cover qualifying undocumented adults.

Oregon is one of several states seeking to rein in healthcare costs by establishing cost growth targets. The state committee charged with designing such a program provided its recommendations to lawmakers, and they have since updated the law to implement the program. Oregon is also experimenting with health delivery and payment reform, directing various state agencies to conduct studies on the feasibility of alternative health care delivery financing and coordinated care models that reward quality over volume of patients.

Oregon is also a leader in promoting healthcare price transparency with a state-run APCD and comprehensive mandatory reporting statues for hospitals and other facilities. The state offers its residents strong surprise billing protections, requiring insurers to provide enrollees reasonable cost estimates for most non-emergency care provided both in-network and out-of-network and capping patient costs for out-of-network emergency services at in-network rates. Oregon also requires telehealth coverage for video visits, with fuller coverage required for some diabetes care.

Additionally, to address the rising cost of prescription drugs, under Oregon’s “Prescription Drug Price Transparency Act,” when the price of a medicine rises more than 10 percent, a drug maker must report the reasons to the Oregon Department of Consumer and Business Services, including information about cost of production, marketing and research. Manufacturers face civil penalties of up to $10,000 per day for failure to comply. In addition to mandating new disclosures by drugmakers and insurers, the law creates a task force that will develop a strategy for greater transparency across the entire supply chain of pharmaceutical products.

With respect to competition, the state has long required prior notice of nonprofit healthcare transactions and additionally provides statutory authority for attorney general review and approval of such transactions based on a broad set of criteria that include public interest and antitrust review. In 2021, Oregon state lawmakers passed new legislation that may be the most comprehensive merger review law in the country, requiring state health authority approval of any mergers, acquisitions or affiliations between entities whose patient or premium revenue exceed a certain dollar amount.

See below for an overview of existing Oregon state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).

State Action


Latest Legislative Session: 1/19/2021 - 6/28/2021 (2021 term). *Current session bill updates are ongoing. Check back weekly for updates.

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© 2018-2020 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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© 2018-2020 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Additional Resources

STATE BUDGET

Oregon operates on a biennial budget cycle. The biennium budget begins on July 1 of an odd-numbered year and ends on June 30 of the next odd-numbered year. The Governor submits a proposed budget in December and is expected to sign the budget at the end of June.

ANTITRUST ENFORCEMENT

  • Oregon was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.

KEY RESOURCES