SB 862 is an innovative, community based initiative directed at some of Oregon’s most overlooked citizens—health-care wise, that is.  As the economy continues to weaken, many small employers find themselves unable to pay for health insurance benefits for employees.  Most of these employees make too much money to qualify for the Oregon Health Plan, but not enough to be able to afford private health insurance.  SB 862 aims to bridge that gap.

Community based initiatives such as that envisioned by SB 862 provide access to health services through modest contributions from the employer, employee, and community. Each stakeholder pays reasonable dues, in exchange for access to the collaborative’s health services.  Funding gaps between these dues payments and the actual cost of care have been filled in other states through philanthropy, grants from state and federal governments, and through hospitals, as part of their community giving programs.

Services to be provided to members of a collaborative are determined by each community—small employers and uninsured employees work together to identify and prioritize the services they need and the amount they can pay.  In turn, health care providers determine which services they can provide.  Parties then negotiate prices and agree on a maximum total payment and levels of charity care. 

Generally speaking, services offered through community based initiatives are less comprehensive than those in traditional commercial products; however, for most purposes, they are entirely adequate.  Examples of services provided through other collaboratives around the country include basic office visits, emergency department care, inpatient hospital care, mental health care, dental care and wellness services.  Many plans have had good results from offering lower dues to members who take advantage of wellness programs.

Since SB 862 has an emergency clause, work on the project can begin as soon as the Governor signs it.  Over the coming summer, stakeholders will work on administrative rules to define the program; actual implementation can begin when rules are completed. Supporting implementation of these programs is clearly in businesses’ best interests—investing in multi-share health insurance programs will allow low-income workers to address health concerns early.  This helps people to reduce the severity of health conditions and avoid serious illness, leading to stronger, healthier communities.