After initial reports that the Oregon Health Authority incorrectly paid state health care organizations $74 million or so in federal Medicaid money from 2014 to 2016, Gov. Kate Brown took action: Among other steps, she told Patrick Allen, the new head of the state agency, to send her an update every two weeks on the latest developments.
Brown got the first update last week. At this point, the state of Oregon might not be able to afford many additional updates: The big headline from last week's report was that the state might have overpaid its contractors or could owe other entities another $78 million. As reported by The Oregonian and the East Oregonian, the issues ranged from the state paying Medicaid benefits for unauthorized immigrants to incorrectly using federal funds to pay for abortions.
The Health Authority also apparently has problems collecting money that it's owed. Allen told the governor that the agency is owed some $34 million that it hasn't been able to collect or that it hasn't been able to access because of various accounting issues.
Allen noted that he and other agency staffers still are working to get their arms around all the issues, so these numbers could change. In an interview last week with Oregon Public Broadcasting, he traced some of the agency's problems back to the state's bungled rollout of the Cover Oregon insurance exchange and also said, more or less, that some of these were the sorts of growing pains that were not atypical in a relatively new agency like the Health Authority.
There's undoubtedly some merit to both of those contentions. But one big problem for the state is that these bombshells, now due to appear every two weeks or so for the foreseeable future, continue to cast a long shadow over the January special election on whether to overturn some $340 million in increased health taxes that legislators approved earlier this year. The taxes are meant to help fill a funding gap in the state's Medicaid program (better known here as the Oregon Health Plan).
Proponents say the increased taxes are necessary to ensure that Oregon residents in need can continue to access important health services. Opponents say it's not their intention to deny that access; they just believe legislators can find other ways to fill that funding gap.
But those arguments likely will be overshadowed in the next few weeks by a different question: Can the Health Authority be trusted to adequately administer the money that would be raised by the taxes? We don't doubt that Allen and his staff are working as hard as they can and as quickly as possible to fix some of these systemic issues in the agency. It's very possible that Allen's next few reports will contain snippets of good news.
But will those snippets, if they emerge, be enough to convince skeptical voters to uphold the new taxes? You never know about these things (and keep in mind that this likely will not be an issue that voters really start to focus on until after the holidays), but that seems like a long shot to us.
There is one additional thing that might help Brown make the case, but it's a step she's resisted: She can appoint an independent investigator to delve into the workings of the Health Authority. Brown has expressed confidence in Allen, but he might welcome an additional set of eyes on the issue. And it would put a concrete action behind the governor's promises about transparency in this matter. It might help ease the concerns of some voters.
An independent investigation would be of benefit in other ways as well: It could help clarify exactly what went wrong and help the Health Authority avoid similar mistakes in the future. The governor should set aside her reservations and give the green light to an independent investigation. (mm)