Salem, OR—Oregon’s citizen legislature, composed of part-time lawmakers, frequently enough brings valuable real-world expertise to the state’s legislative process. However, this system also introduces the potential for conflicts of interest, as lawmakers may have personal financial stakes in the policies they create.

Senate Bill 28: A Closer Look

Senate Bill 28 (SB 28) has ignited debate due to its potential impact on independent primary care providers. The bill proposes that private insurers be mandated to reimburse thes providers, such as pediatricians and internists, at the same, often higher, rate as their counterparts employed by hospitals. This could result in a significant, though currently unquantified, increase in revenue for independent practices.

Who Stands to Gain?

• Independent Primary Care Providers: State Sen. Lisa Reynolds (D-Oak Hills), the bill’s chief sponsor and a pediatrician with a stake in The Children’s Clinic in Southwest Portland, estimates that approximately 1,500 independent primary care providers across Oregon could see a 20% to 30% increase in revenue for routine office visits from privately insured patients.

Amendments and Exclusions

Following its introduction, SB 28 was amended to exclude members of the Oregon Educators Benefit Board (OEBB) and the Public Employees’ Benefit Board (PEBB). This amendment effectively removes approximately 300,000 individuals from the bill’s scope, meaning they would not be subject to possibly higher premiums.

Ethical Concerns Raised

Oregon’s government ethics law explicitly prohibits public officials from leveraging their positions for personal financial gain. The law states that officials cannot use their position “from using or attempting to use the position held as a public official to obtain a financial benefit.” As a practicing pediatrician and part-owner of her clinic, Sen. Reynolds’ involvement in SB 28 raises questions about potential conflicts of interest.

During an April 8 hearing, Sen. Reynolds stated,I’m trying to save my practice and othre independent practices,which we know are cost-effective ways to provide primary care. In a later interview, she acknowledged that her statement might have been hyperbolic, but added, if [SB 28] passes, it will be enormously helpful to my partners.

Sen. Reynolds admitted that she did not seek guidance from the Oregon Government Ethics Commission (OGEC) before introducing the bill, nor did she disclose a potential conflict of interest afterward. Senate rules typically require members to disclose potential conflicts and than proceed with their vote.Reynolds has since stated her willingness to seek OGEC advice and declare a potential conflict.

Regarding the exclusion of OEBB and PEBB members, Sen. Reynolds explained that including them would have required a significant expenditure from the state budget, potentially hindering the bill’s passage and drawing opposition from public employee unions. I don’t have the appetite to ask the state to do this, she stated.

Industry Opposition and Option Perspectives

SB 28 has faced limited public scrutiny, emerging relatively late in the legislative session, according to reports from Oregon Public Broadcasting.Several health insurers, including Moda, Regence Blue cross, and PacificSource, have voiced opposition to the amended bill, arguing that it could lead to higher costs for individuals with commercial insurance (excluding public employees). they also question the appropriateness of using hospital prices as a benchmark for independent providers.

One insurer stated, We have significant concerns with paying [independent providers] based on hospital prices, which are frequently enough inflated and well above market rates for other providers.

Sen. Cedric Hayden (R-Roseburg), a dentist and member of the Senate Health Care Committee, expressed surprise at sen.Reynolds’ decision to introduce a bill that could directly benefit her financially. I thought the optics were pretty bold, he commented.

While Sen.Hayden acknowledged the challenges faced by independent providers, he also pointed out that hospitals are obligated to serve all patients, including those on Medicaid or without insurance, whereas independent providers have the option to decline such patients. This practice, according to Hayden, could be seen as cherry picking. He voted against the bill,which still advanced to the Joint Committee on Ways and Means.

Sen. Reynolds acknowledged the validity of Sen. Hayden’s concerns about cherry picking. I’d love to add a requirement that to qualify, practitioners have to take at least 10% Medicaid patients, she said.