Editorials from around Oregon

November 8, 2017

Selected editorials from Oregon newspapers:


Albany Democrat-Herald, Nov. 8, on taxpayers needing real answers in Medicaid mess

Last week’s news of continued financial woes at the Oregon Health Authority could end up casting a long shadow over January’s election on whether to uphold new state taxes on health insurance and medical services.

In case you missed it, the Health Authority last week reported that Oregon incorrectly paid state health care organizations roughly $74 million in federal Medicaid money from 2014 to 2016.

It could be that the state will need to repay that money, although that question has yet to be answered.

The Oregonian reported last week that top officials at the Health Authority knew about the issue for months; in fact, some had known about the problem for more than a year. But the information was withheld from Gov. Kate Brown and the public. Brown found out about the problem on Oct. 17, when she was briefed by Pat Allen, the new director of the Health Authority. (Allen replaced Lynne Saxton, who was sacked — properly so — for her role in a scheme to publicly bad-mouth a coordinated care organization with which the agency was feuding.)

The governor’s office issued a press release on the issue just a couple of hours after releasing records about the matter to The Oregonian in response to a request from the newspaper; in other words, the administration knew a news story was in the works. The press release traced at least some of the problem to the state’s bungled Cover Oregon insurance exchange, a project launched by Brown’s predecessor, John Kitzhaber. Brown declined the newspaper’s request for an interview.

But Laura Robison, the Health Authority’s new chief financial officer, told the newspaper that the incorrect payments occurred in cases when patients were both poor enough to qualify for Medicaid (known in this state as the Oregon Health Plan) and old enough to qualify for Medicare. Medicare, which pays first, should have been used for the bulk of those patients. But Oregon charged the federal government the incorrect amount, and then paid the extra money to the state’s coordinated care organizations, which manage Medicaid services.

Robison said the agency also paid those coordinated care organizations an undetermined amount to take care of people who were not eligible for Medicaid.

The new brass at the Health Authority told Oregonian reporters that they were working hard to get on top of the problems. We don’t doubt that.

But the state’s citizens deserve answers to some big questions, especially as the January election on Measure 101 draws near. (A “yes” vote on the measure would ratify the Legislature’s decision to create new health care taxes to plug a hole in the state’s Medicaid budget and to stabilize the state’s insurance market. A “no” vote would force the Legislature in its February session to find money to continue to provide health services to Oregon Health Plan patients.)

You can probably add your own questions, but here are some to start: Why didn’t Brown know about this issue until the middle of October? Why wasn’t the issue caught months or years before? What’s the governor’s plan for making sure that something like this doesn’t happen again? Are there systemic issues at the Health Authority that need to be addressed? Will she and her new Health Authority staff pledge to provide transparency at the agency?

And here’s a question that voters will be asking themselves when they receive their ballots for Measure 101 in January: How can taxpayers be sure that these tax dollars will be spent in a proper and prudent fashion?

Let’s start the debate on this measure with answers to these questions. And it falls to the governor to provide the answers; from what we can see, the new staff at the Health Authority has its work cut out for it in the near future.


The Oregonian/OregonLive, Nov. 7, on Gov. Brown needing to appoint independent investigator into $74 million flub

For three weeks, Gov. Kate Brown had the perfect opportunity to play the part of a state executive who demands accountability, protects taxpayer dollars and acts like the governor Oregonians deserve.

But for three weeks, despite knowing that the Oregon Health Authority overpaid its 16 health care partners $74 million in federal dollars from 2014 to 2016, she has failed at basic responsible management. She kept quiet about the misspending, going public only as The Oregonian/OregonLive was preparing a story exposing the overpayments. She glossed over the fact that the federal government, which provided the money that went to health care partners, has already demanded $10 million back from the state and could seek the rest. And she ignored the troubling decision that someone in the state made in 2016 to let the private and nonprofit partners just keep the remaining $64 million in public dollars.

Only on Tuesday, after Republican gubernatorial opponent Knute Buehler urged her to claw back the money and initiate an independent investigation, did Brown finally, sort of, take a stand. In a letter to Oregon Health Authority Director Patrick Allen, she directed him to “seek repayment” of the $64 million from the coordinated care organizations. As belated as the directive is, it’s a good call. As Janet Meyer, the chief executive of Portland-based coordinated care organization Health Share of Oregon noted to The Oregonian/OregonLive Editorial Board, the state has the authority to demand the money back.

It should have done so already.

The governor shouldn’t stop there. As distasteful as it might be to follow the lead of her rival, she should appoint an independent investigator. The mystery surrounding who authorized the care organizations to keep money that didn’t belong to them alone merits an inquiry - particularly considering their prominence as regular campaign contributors to Brown and others. Also puzzling is the fact that Brown said she was never told of the mistake or the requirement to repay the federal government until mid-October, an omission that, one might think, would concern her as the state’s top elected official.

But the overpayments fiasco marks yet another sign of persistent mismanagement in Oregon’s Medicaid expansion. In this instance, the state overbilled the federal government for Medicaid patients who were also eligible for Medicare coverage. An investigation can and should focus on how these errors occurred, why they escaped notice for so long and ways to improve practices or processes.

Unfortunately, the governor’s not interested in an independent investigation. Berri Leslie, Brown’s deputy chief of staff, told The Oregonian/OregonLive Editorial Board that the governor trusts her new director, Patrick Allen, to sort through the problems, understand the scope and identify what needs to be corrected.

“We’re confident that Pat and his leaders at OHA will be able to get to the bottom of these questions,” she said.

It’s great that Brown is confident. The public, on the other hand, has witnessed too many meltdowns at the agency, from the never-launched Cover Oregon fiasco to the inclusion of tens of thousands of people who were no longer eligible for Medicaid to feel that confidence. Even with Allen’s solid reputation. Not to mention, Allen and his team oversee a massive operation that won’t allow them the focused attention they need to pin down the whos, whats and whys of the overpayment flub. And as a political appointee, Allen inherently lacks the independence that’s critical for the credibility of any review, particularly of such a politically sensitive issue as this.

Certainly, Buehler’s making political hay with his call for an investigation. But that doesn’t mean he’s wrong. Brown should cut her losses, confront the controversy and appoint an independent investigator.


East Oregonian, Nov. 7, on tax debate requiring a sharp eye

It’s hard to cover the machinations of Washington, D.C., from the friendly wide open spaces of Eastern Oregon. It’s doubly hard when the issue being discussed in the Capitol is the American tax code, a mess so complicated that most Americans can barely make limited sense of it.

Now how in the world could a reader translate the whispers, rumors and actual reports of possible changes to the system — and not just what effect those changes would have on you and your family — but on millions of other Americans, our national debt, the Federal Reserve and the global economic system?

It’s near impossible, but that doesn’t mean we intend to give tax reform short shrift. Perhaps nothing is as important to our readers, and to the fiscal strength of our country and its inhabitants.

Republicans are in control of all levers of the federal government, having secured the White House and a majority in the Senate and House of Representatives in 2016.

Thus far, that hasn’t translated into any meaningful legislative victories, but tax reform is by far the best chance. Most Americans don’t trust Republicans when it comes to health care, but a majority do when it comes to fiscal policies. And tax reform also unites both the Trumpian and traditional wings of the Republican Party (who were divided on health care) as well as many moderate non-affiliated voters who yearn for simpler and lower taxes.

“Tax reform,” at its core, is supported by a majority of Americans. But how you slice and dice “reform” moves its acceptability ratings. If a majority of the tax cuts and “reform” is perceived to benefit corporations and the rich, its popularity plummets. Therefore, it’s curious to see the first draft tax packages currently being debated in the House, which are centered around cutting taxes for corporations and the rich. That’s especially disappointing due to the fact that low-income Americans were the voters who swept Trump into the presidency.

Republicans argue that those tax breaks will eventually trickle down, but on that fact many economists remain unconvinced and history hasn’t done much to sway them.

The bill currently being debated would increase the standard deduction by about $5,500 for individuals and $11,000 for families. But at the same time, it would eliminate the personal exemption for each taxpayer and dependent, which could actually cause large families to pay more. Removing the medical expense tax deduction, as is proposed, would be good for the deficit but bad for many Americans already struggling with high medical costs. The student loan interest tax deduction is a significant help to many young people who pursue higher education.

There are hundreds — maybe thousands — of nooks and crannies in these proposals, each of which will have real-world effects on the wallets and budgets of all Americans.

And as it wends its way through committees, the bill is sure to change form many times over in ways both obvious and obscure. The Republican party establishment will have their go at it, as will lobbyists and special interest groups, and the Senate and White House hold key powers as well.

Americans should remain positive about the possibility of true reform and its ability to improve our broken tax system. But we should demand fairness, simplicity and reasonableness from the tax code. And we should demand that the needs and desires of taxpayers outweigh the lobbyists and special interests, the corporations and the rich.

It won’t be easy. But if it’s done, the American people and economy — as well as the political party that ushers it into being — stand to benefit.


The Daily Astorian, Nov. 7, on governor ducking responsibility for health authority fiasco

Bad news keeps rolling out from the Oregon Health Authority. But instead of taking responsibility, Gov. Kate Brown not only ducked it but also tried to spin it as positive news.

The issue is that OHA paid too much to regional health-care organizations, collected too much money from the feds as a result, and might have to repay all of it.

Brown announced the issue in a roundabout way last week, issuing a press release headlined, “New OHA Leadership Takes Action to Resolve Overpayments Made in Wake of Cover Oregon Failure.” It praised new OHA director Patrick Allen “and his team for acting quickly to bring stability and transparency to OHA’s work on behalf of Oregonians. After just two months leading OHA, Allen has directed staff to resolve yet another consequence of the Cover Oregon technology failure. Governor Brown appreciates that Allen is making the resolution of these issues the top priority and looks forward to monthly updates on his team’s progress in resolving them.”

The overpayments were made to coordinated care organizations for patients who were eligible for both Medicaid and Medicare. This occurred from 2014 through mid-2016.

Brown is the state’s CEO. She is responsible what happens on her watch after becoming governor in February 2015.

Mistakes happen. Still, it is disappointing that OHA apparently overpaid $74 million to 16 coordinated care organizations. It is disconcerting that, according to the governor’s office, Brown only learned of the problem when Allen took over as OHA director. It is disturbing that Brown, through her press release, tried to spin the snafu instead of accepting her share of the responsibility.

Indeed, this does sound like Cover Oregon, but not in the way Brown suggested. The Cover Oregon fiasco stemmed from Gov. John Kitzhaber appointing the wrong people to key jobs, not keeping close tabs on the project and accepting dubious progress reports. That also sounds like this new OHA fiasco.

As governor, Brown is CEO of a multi-billion-dollar organization with tens of thousands of employees. A good CEO develops a solid record of hiring the right people, giving them freedom to do their jobs while also staying on top of their work. In that regard, Brown has a decidedly mixed record, although she did eventually oust Lynne Saxton as OHA director and bring in the well-regarded Allen.

No one, especially a politician, likes to look bad. But a good CEO builds confidence, trust and respect by taking responsibility when things go awry.


Baker City Herald, Nov. 1, on national park fees rising too quickly

We pine for the halcyon era when America’s national parks were known for the grandiosity of their mountains and cliffs and trees rather than the size of their fee increases.

These days, though, you’re more likely to read about how many bills you’ll have to slide from your wallet to enter a national park, not the elevation of Mount Rainier’s summit, or how many feet there are between El Capitan’s base and its top.

The latest proposal from the National Park Service is to boost the entrance fee during the busiest five-month period at 17 parks, most of them in the West, from $25 or $30 per vehicle to $70.

This comes while the ink is still fresh on the new lifetime passes that people 62 and older can buy to gain admission to national parks and other recreation sites managed by federal agencies. On Aug. 28 the price for those passes rose from $10 to $80.

In both cases the purpose is to give the Park Service more money to maintain its visitor centers, trails and other facilities. The agency, which is part of the Department of the Interior, estimates its deferred maintenance tally was $11.3 billion as of September 2016.

Our chief complaint about both the lifetime pass price hike and the proposed higher entrance fees is the scale of the increases.

Most vacationers, we’d wager, would at most mumble something about “inflation” if they had to pay, say, 5 or 10 bucks more to drive into Yosemite or Grand Canyon or Mount Rainier, which are among the national parks where the entrance fee could jump to $70 next year.

But the prospect of shelling out an additional $40 to $45 likely would prompt some people to turn back at the park entrance.

Which makes Interior Secretary Ryan Zinke’s words, which are intended to justify the fee increases, ring hollow.

“We need to have a vision to look at the future of our parks and take action in order to ensure that our grandkids’ grandkids will have the same if not better experience than we have today,” Zinke said. “Shoring up our parks’ aging infrastructure will do that.”

Trouble is, people who can’t afford or aren’t willing to pay the drastically increased fees won’t have much of an experience at all, since they won’t be seeing anything of the parks except the entrance gates in their rear-view mirrors.

We don’t question the need for more money to maintain national parks. But it’s not the public’s fault that that work has been deferred so long that Parks Service officials have concluded it’s necessary to nearly triple entrance fees at some of the more popular parks.

We think a series of smaller, annual or every-other-year entrance fee increases is a more reasonable approach, and one that doesn’t unduly punish park visitors.

The publicity that the Park Service’s proposal provoked might serve one useful purpose — alerting Americans to the maintenance backlog in some of our more cherished pieces of public land. The prospect of having to pay so much more to visit those places might convince people to lobby their representatives in Congress to allocate more money to the agency.

Because if you follow the money, as the saying goes, you’ll find a lot more of it in Washington, D.C., than in the cars and campers of families wanting to see Half Dome or Old Faithful.

Congressional appropriations make up more than 85 percent of the Parks Service’s budget, while entrance fees constitute less than 5 percent.

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