Posts published in “Oregon”

I’ll admit to a bias about news of a corporate merger or takeover: It’s often a good thing for a small group of insiders and poor news for employees, customers, vendors and other people.

How that bias relates to the case of a semi-public organization like the Oregon Health & Science University taking over the nonprofit Legacy Health is a little more difficult to say.

But if it goes through, with regulatory approval, it will have a big impact on Oregon.

The context for thinking about this has partly to do with size, which no one is questioning. OHSU said in a statement that, “the combined system – with more than 32,000 employees and 100-plus locations, including 10 hospitals and more than 3 million patient visits a year — will be the largest employer in the Portland metro area.” Though it has seven hospitals, Legacy is by most measures somewhat more than half of OHSU’s size. Nevertheless, Legacy is Portland’s second-largest health system, the acquisition would be a billion-dollar deal and the two together would be a massive organization.

That becomes all the more impressive when you consider that OHSU, which has Oregon’s largest hospital and 18,000 employees, is one of the top employers in Portland.

Up to this point, the Portland area’s health provider community has split among a number of organizations. Providence is also among the largest health providers in the Portland area and has operations extending from Medford to Hood River to Seaside and is among the state’s top employers. Kaiser Permanente and a number of smaller organizations also account for a significant share. With the merger, one actor in regional health care would become a clear leader.

Something like this may have become inevitable, but the motivation behind this buyout to create a regionally comprehensive health care organization is different from the strictly financial impetus that drives most large-scale commercial mergers.

OHSU would be taking over a Legacy Health that has had some aches and pains in recent years. It has had serious budget and finance problems, reporting a loss of $172 million in the most recent fiscal year, enough for concerns about outright failure – which would be catastrophic for health care in Oregon.

Those financial problems apparently have been related to a series of other problems, such as a much-criticized closing of a birthing center at the Legacy Mount Hood Medical Center. The criticism even went further over the top when a visitor at another facility shot to death a security guard.

The Oregon Nurses Association said on Aug. 17 that it “does not have any faith in Legacy’s management, so a merger with a public institution like OHSU – which will come with more requirements related to transparency and accountability – is likely to be in the best interests of Legacy’s patients and their 13,000 staff members.”

At least some positive effects would be likely. OHSU is a public institution and has a mandate for public service as it says on its website: “OHSU is Oregon’s only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning, with schools of medicine, nursing, pharmacy, dentistry and public health – and with a network of campuses and partners throughout Oregon. We are a national research hub, with thousands of scientists developing lifesaving therapies and deeper understanding.”

But the nurses union also points out, “This merger brings up more questions than answers, and ONA is committed to being a thoughtful partner with nurses and health care workers across OHSU and Legacy while the details of this agreement are hammered out.”

Details to consider will be plentiful. Besides going on the hook for a billion-dollar acquisition, OHSU would have to deal with Legacy’s existing financial problems.

Patients and medical professionals would want to know how the merger would affect access to doctors and insurance. The early responses seem to suggest those wouldn’t change much, but watch closely. We’re talking about health care here, where complexity is baked in. Don’t be sure that all would remain exactly the same, even if that’s the intent right now. The jostling of organizations, finances and contractual agreements would likely cause some kind of shifting.

How would the Portland-area medical provider picture look afterward?

Different.

To go through, the takeover would need approval from a batch of regulators, including the Federal Trade Commission, the Oregon Health Authority and the Washington Health Department. Oregonians would be wise to watch those developments closely. This major proposal could reshape health care in Oregon for a long time to come.

This column originally appeared in the Oregon Capital Chronicle.

 

Several times a year for many years, I have crossed the Oregon-Idaho line in each direction, usually on Interstate 84 over the Snake River bridge. In all these years, I’ve never been slowed or stopped at the border, and the only thing that might have caused such an event is the speed limit.

These days, the notion of a checkpoint is becoming increasingly probable, prompted recently by a lawsuit, involving the state of Idaho on the one side and Oregon – plus a batch of other states, including Washington – on the other.

The lawsuit by abortion rights advocates is aimed at Idaho’s law against “abortion trafficking,” or transporting a minor across state lines to obtain an abortion. Theoretically, an Idaho law should only affect people in that state. But in the opinion of a long list of state attorneys general, including Oregon’s, it’s not that simple. Oregon’s health care finances and professional and legal liability could be endangered due to the wording of the Idaho bill and its interpretation by that state’s attorney general.

In the last two years, Idaho abortion law has been changing and tightening, and on March 27  Attorney General Raul Labrador answered an inquiry about its scope, implicating state borders in the new legal order: “Idaho law prohibits an Idaho medical provider from either referring a woman across state lines to access abortion services or prescribing abortion pills for the woman to pick up across state lines,” he wrote. There are more restrictions, including for any adult (other than parents) to help a minor cross state lines to obtain an abortion.

Labrador later withdrew the letter but hasn’t reversed any of his legal analysis.

This drew, days later, a lawsuit from a Planned Parenthood organization and a group of physicians argued that, “the logic of Attorney General Labrador’s opinion would mean that a health care provider who provides an abortion to an Idaho resident in another state violates Idaho’s abortion ban. The lawsuit asserts that such an interpretation of a state abortion ban is both unprecedented and unconstitutional.”

That implication of other states being held accountable to Idaho’s law drew the attention of attorneys general around the country. On Aug. 2, an amicus brief drafted by Washington Attorney General Rob Ferguson, and co-signed by 19 other attorney’s general including Oregon’s Ellen Rosenblum, took aim at the Idaho law and specified harms it could do to other states, potentially affecting Oregon the most. Those could directly on Oregon.

Rosenblum’s office has specified some of them. Her office said the Idaho abortion laws have led to a drastic increase of abortion patients in nearby states. Washington state saw a 75% increase of Idaho patients obtaining an abortion during a 12-month stretch ending earlier this year. During the first six months after the U.S. Supreme Court’s reversal of Roe. v. Wade – during a time when some but not all of Idaho’s restrictive laws were in place – the number of abortions performed in Oregon for out-of-state residents rose nearly 50% over the same six-month period a year earlier, according to Oregon Health Authority statistics, Rosenblum said.

She said this has hurt Oregon health providers’ ability to provide normal timely health care. Washington Gov. Jay Inslee in a letter to his Idaho counterpart, Brad Little, warned that Idaho’s law would likely result in an “increased mortality rate of Idahoan women and girls.”

And the attorney generals’ brief went well beyond health care impact.

A resident of an abortion-rights state, such as Oregon or Washington, would be directly affected once they cross the border, and their health insurers would be affected too: “As the provider of health insurance for state employees and their children, who may be temporarily visiting or residing in Idaho, amici states have a direct financial interest in preventing increased risk to patients and cost of medical care resulting from undue delays or impeded continuity of care.”

Providers of health care cross-licensed across states – as many are – “would reasonably fear Idaho’s apparent reading of its laws, producing a chilling effect on the lawful provision of health care in other states. For example, a health care provider licensed in both Idaho and a neighboring state, such as Washington or Oregon, might be reluctant to provide abortion services in Washington or Oregon for fear of being subjected to licensing enforcement action in Idaho, potentially resulting in the restriction of their Idaho license or the imposition of fines.”

That, in turn, could lead to health care issues, or gaps in health care, for patients even in abortion-rights states.

These ideas and concerns aren’t brand new. Oregon’s Legislature recognized them earlier this year when it passed the recent and highly contentious House Bill 2002 – which is aimed specifically at protecting people in Oregon from the reach of laws from other states. That legislation like Idaho’s has yet to be fully tested in court, however. When two states collide, their cases typically go to the U.S. Supreme Court, where the results can be unpredictable.

People in many states like to think of themselves as siloed, shielded from what another state might do. But what we do tends to affect people beyond us.

Idaho’s new abortions laws ring not only for Idahoans, but for Oregonians as well.

This column originally appeared in the Oregon Capital Chronicle. Photo Paul Morigi/Getty Images for Doctors for Abortion Action.

One of the most distinctive policy ideas in the 2023 Oregon legislative session – creating a state bank – drew a veto from Gov. Tina Kotek.

The proposal proposed a study. But Kotek indicated that requiring the Oregon Business Development Department to study, in a short period of time, a potentially sweeping proposal would be difficult to carry out.

Setting up an Oregon State Bank would make Oregon distinct from every other state save one, and it’s an idea that Kotek said she supports. But what it would be used for?

Oregon has, of course, lots of private banks and other financial organizations, from branches of national giants like U.S. Bank (the largest in Oregon), Wells Fargo and Chase through small community banks and payday and title lenders. They undertake many kinds of transactions, including holding state funds. But some of the larger banks have been moving away from traditional community banking, and the commercial incentives of many lenders and money managers might not mesh with what are seen as public priorities.

House Bill 2763 aimed to explore, though not specifically establish, a state-run bank. State Rep. Khanh Pham, D-Portland, a sponsor, said in testimony that the idea was to help the money flow that involves local governments and provide some backup assistance to credit unions and community banks, but not to compete with them. “Think of it as a ‘banker’s bank’,” Pham suggested. As described, it might resemble something like a central bank, such as the Federal Reserve in the United States, but on a less-ambitious and state level.

(The bill’s main sponsors were Reps. Mark Gamba, D-Milwaukie, and Jules Walters, D-West Linn, and Sen. Jeff Golden, D-Ashland.)

There also are other ways of looking at the idea.

At least 10 states – Oregon was not one of them – have created state banks since shortly after the demise of the federal Second Bank of the United States in 1836, but by the end of the century nearly all were defunct, partly a result of changing economies and forms of banking. In the last century only one state, North Dakota, has had a state bank, and it is highly active.

The Bank of North Dakota was founded in an environment early in the 20th century of extreme economic hardship among the state’s farmers, who had a hard time getting loans and a harder time finding them at a moderate rate. When the populist farm-based Nonpartisan League took power in the state in 1918, it created the bank to help farmers.

Over the years, it also did much more, the bank’s web site says: “BND has responded to the state’s needs since inception. For example, when teachers were paid with warrants rather than cash during the Great Depression, BND paid them in full rather than with the 15% loss they would take when trying to cash it elsewhere. In the 1940s, BND sold back farmland which had been foreclosed during the ’30s, usually to the original families who owned it and had been allowed to remain on the land and farm it.” It accepts deposits from individuals and businesses, and makes a wide variety of loans, but doesn’t see itself in competition with private banks.

In 2010 Vermont officials explored the idea of a state bank, and reviewed the North Dakota experience. Venture capitalist Cairn Cross commented that, “the Bank of North Dakota appears to use a greater percentage of its deposits to fund loans than does the Vermont banking system. Perhaps this has to do with the Bank of North Dakota’s economic development mission.”

Likely, that comparison would hold in Oregon as well. That could provide an extra, no-cost-, boost for economic development in Oregon – a business support feature other nearby states do not have.

That may be worth considering at a time when many larger banks are moving away from community service and more in the direction of large-scale financial management and investments.

Pham and other advocates may find useful the idea of building a coalition of state bank supporters from around private interests. If the research for such an effort is done outside a state agency, with a built-in external lobby support, it might gain enough traction to see more daylight next time.

(image/Getty Images)

 

When performance politics goes to court, seldom do we get many helpful answers, and no one wins, in a practical sense.

Unless you consider a $1 award to be a win.

The recently settled legal squabble between state Sen. Brian Boquist, I-Dalles, and the state Senate leadership was an opportunity for a federal court to set useful guidelines about what is and isn’t acceptable political speech. But that didn’t happen.

No one got much out of the lawsuit that has bounced around courtrooms for four years, reaching what may have been a final decision on July 17.

The core of it stems from a couple of viral quotes from Boquist, spawned from an incident that resembled performance politics: During a walkout of Republican senators in 2019, Boquist warned then-Senate President Peter Courtney not to try to arrest absent lawmakers: “Mr. President, and if you send that state police to get me, Hell’s coming to visit you personally.”

Soon after that he told a reporter: “This is what I told the (state police) superintendent: ‘Send bachelors and come heavily armed. I’m not going to be a political prisoner in the state of Oregon. It’s just that simple.’”

Eventually, he and the other senators returned, but before he did a Senate committee on conduct said it would require him to give 12 hours notice before he showed up at the statehouse, on grounds that … he was dangerous? That seemed to be the implication.

Boquist sued Senate Democratic leaders over the requirement, arguing accurately that it impinged on his ability to do his work in the Senate. The legal wrangling lasted three years.

U.S. District Court Judge Michael McShane on Jan. 20, 2020 dismissed Boquist’s suit, saying “while both sides can point fingers and complain that the other is overreacting to a political situation, (Boquist’s) chosen words on the Senate floor were those of a bully on the playground. As such, they are unprotected fighting words.” Quoting a 1942 New Hampshire case, he said such words “by their very utterance inflict injury or tend to incite an immediate breach of the peace.”

And he added, “remarkably, (Boquist) argues that his statement to defendant Courtney – ‘if you send the state police to get me, Hell’s going to visit you personally’ – was a statement of religious expression.” The Senate, he said, did not violate Boquist’s speech rights.

In April 2022 the Ninth Circuit Court of Appeals reinstated the case, however, saying Boquist had “adequately alleged that he, in fact, had engaged in constitutionally protected speech and was subject to a retaliatory adverse action on account of that speech. The Senate majority members, however, will have an opportunity to raise affirmative defenses, including that their actions were motivated by legitimate security concerns.”

The case went back to McShane, who ruled under the terms of the higher court’s decision in Boquist’s favor, but awarded him just one dollar.

In all, this river of court activity seems to have reached a nebulous conclusion.

The courts could have gone further and should have.

“Political speech” has been stretched in recent years to sometimes absurd points. The violent Jan. 6, 2021 riot at the U.S. Capitol, for example, has been described by the national Republican Party as “legitimate political discourse.”

Political speech traditionally has been given more judicial leeway than most other forms, but how does our current overheated political speech fit into that framework? What are unprotected fighting words or panic words in today’s environment? A serious answer coming from the courts would be useful.

But courts have placed limits on speech in the past. Famously, Justice Oliver Windell Holmes in 1919, writing for a unanimous U.S. Supreme Court, said, “The most stringent protection of free speech would not protect a man falsely shouting fire in a theatre and causing a panic… The question in every case is whether the words used are used in such circumstances and are of such a nature as to create a clear and present danger that they will bring about the substantive evils that Congress has a right to prevent.”

Fighting words and direct threats have been limited, too.

This becomes salient in a day when emotions can get out of hand in political situations. Decisions in cases like the Boquist suit could help in drawing the lines between what we should find acceptable and what we shouldn’t.

That said, our best approach would be to cool ourselves down instead of letting it get that far.

Here’s something pointing to a positive answer. In an email to with the Capital Chronicle in April 2022, just after the appellate court reversal, Boquist said, “I will ask if Peter Courtney wants to sit down to mediate with the goal of setting in place a method to ensure this never happens again. That was my original goal.”

Maybe they should have taken him up on it.

This column first appeared in the Oregon Capital Chronicle.

 

Oregon’s 5th Congressional District is looking to be a closely-fought contest next year – both in the general election and its primary.

And the Democratic primary election looks to be the least predictable of the two.

Voter registration in this district, anchored by Clackamas and Deschutes counties (home to about two-thirds of its voters) with slices of four others, leans Democratic by 5 percentage points. That’s enough to create a challenging environment for a Republican candidate.

Incumbent Lori Chavez-DeRemer, is a Republican, a narrow winner in 2022, and she appears to have borne in mind since her swearing-in the problems emerging in the next campaign. She is preparing thoroughly for her 2024 campaign for re-election, so far raising a solid $636,051. National Republicans, too, see this as an important battleground seat.

Independent national prognosticators have noted the race as a partisan toss-up, provided Democrats can come up with a candidate who can mount a competitive campaign – and the party so far has produced three.

That in turn means the primary election next spring also will be competitive.

Lesser-known candidates have and may continue to enter the contest; the filing period doesn’t open until Sept. 14. But the main contours of the Democratic field seem to be settling into place, with a potentially tight battle between three leading contenders. No massive philosophical differences seem to separate them; the differences involve geography, backing and types of support.

The most recent entrant is the candidate who lost to Chavez-DeRemer by just 2 percentage points, the 2022 Democratic nominee Jamie McLeod-Skinner, a Terrebonne attorney; that loss came months after she won a tough primary campaign, dispatching Democratic incumbent Kurt Schrader. Through that cycle she built a strong campaign organization and was a strong fundraiser as well, outpacing DeRemer’s $2.6 million by a million more. (DeRemer did receive heavy outside support from Republican groups, however, which likely contributed to her win.) Worth noting: This is not McLeod-Skinner’s first loss: She came in third in the Democratic primary for secretary of state in 2020. Will Democrats want to give her another try when they have as options two other contenders who have repeatedly won offices in the area?

The Democrat with the longest political reach, is Lynn Peterson, now a major office-holder as chair of the Metro Council, elected by voters through the Multnomah-Washington-Clackamas county area. Her most recent races, in 2022 and 2018, both of which she won, were nonpartisan. Previously, she was an elected commission chair in Clackamas County, the 5th District’s largest, and she was elected to the Lake Oswego City Council. She entered politics through working with conservation groups, and retains strong ties there – as well as strong Democratic establishment ties. She likely will have strong fundraising abilities for the new campaign.

A question, however: Will the candidate most identified with the Portland metro area find acceptance in farther reaches of the district, notably Deschutes County, which has become a key element of Democratic base for the district?

The third candidate brings to the table strengths that collectively closely match those of her contenders. Janelle Bynum is a third-term state representative with a statewide profile – she was for a time a prospect for House speaker – and strong connections in Oregon politics, and to an extent beyond.

She also brings an unusually pertinent credential: In two of her three races for the House, her Republican opposition was Chavez-DeRemer, and Bynum defeated her both times. Those races were competitive in a competitive district, and that history will be one of Bynum’s top talking points. Bynum seems well established in her home legislative district, but so far less known than the other two contenders outside of it.

Like the other two contenders, she’s well connected in Democratic circles, and also like them is unlikely to fall short of needed campaign funding.

Taken as a whole, the three candidates have strengths and weaknesses that almost perfectly balance each other.

MacLeod-Skinner won both of the big counties, Clackams and Deschutes, in 2022, though not by large margins. Chevez-DeRemer prevailed by keeping her losses there small enough and by winning very strongly in the district’s slices of Marion and Linn counties. A Democratic nominee will have to contend with that math.

Prognosticators for the Oregon 5th will need some new emerging facts or conditions to budge the races here from toss-up for months to come. For now, this looks like the least predictable Democratic major office primary contest in years.

 

The 2023 Oregon legislative session was dominated by a six-week strike, the longest by legislators in the state’s history.

Did it matter?

Yes, but not as much as many people would have expected, and we may need a while to figure out exactly how much.

The impact of the walkout and this year’s session fall into three categories.

The simplest is that the 10 Republican senators who exceeded the constitutional limits for unexcused absences cannot serve the next term after this one, disrupting their party’s ability to try to gain control of the chamber. That’s a major price for a political party to pay, since open seats – as theirs will be next time – are easier targets for an opposition party. Because of local political conditions, most probably will remain Republican, but not all.

Yes, there’s a legal action seeking to overturn the limitation, and you can never predict what a court might do. But the rule is now in the Oregon constitution – after voters overwhelmingly endorsed it last year. Since it clearly doesn’t conflict with anything in the federal Constitution, attorneys for the senators will have a hard time finding a lever to overturn it.

The second area of impact involves the Republican demands leading to the walkout. These mainly concerned legislation Democrats had proposed relating to guns, abortion and LGBTQ issues.

The Republican senators held off a proposed law change barring Oregonians under 21 from buying guns, and allowing local governments to ban guns from their buildings. (Expect those subjects to return next year.) But the final version of House Bill 2005 did include a ban on ghost guns – firearms created through 3D printing, for example, and lacking traceable numbers – and required that nearly all existing guns in the state carry a tracking number by September 2024. It also set up an investigation into the sources of gun violence, which may be useful.

Gun safety advocates didn’t get all they wanted, but they got at least half a loaf, maybe more.

The biggest focus of the Republican walkout, House Bill 2002, passed with most of its major elements intact: liability protections for Oregon abortion providers following the U.S. Supreme Court overturning Roe v. Wade, and a requirement that insurance companies cover gender-affirming medical care. The main deletion from the package obtained by Republicans has to do with parental notification of an abortion for a child younger than 15. The bill, which hasn’t been signed by Gov. Tina Kotek yet,  still would allow a provider who obtains a second opinion to bypass parental notification in cases of potential abuse. Abortion rights and transgender rights advocates in Oregon can take that result as a win.

The Republicans didn’t get much for the sacrifice their senators made, and neither did they, in the end, stop the flow of legislation.

Kotek appeared to score only one significant loss (and that at the hands of her fellow Democrats), relating to an adjustment of land-use law to expand housing stock. She got almost everything else she sought.

Attorney General Ellen Rosenbaum said in a press release, “I am thrilled that every major bill on my legislative agenda passed! From banning unserialized ‘ghost guns’, to requiring transparency and limits on the use of our personal data, to moving forward our work preserving access to abortion, and fighting labor trafficking and bias crimes.”

Budgets were approved, as they must be each session, and so were scores of bills on all sorts of topics – including substantive measures on housing and homelessness, boosting support for public defenders and encouraging semiconductor development in the state.

That means the walkout had few legislative aftereffects, though we all may discover glitches in the flood of bills passed in a rush at the session’s end.

Consider this quote from Kotek, delivered shortly before the session’s end, about the supersonic speed at the Legislature: “Once the (walkout) deal was reached, everything went into overdrive, and I have not had a chance to look at all the bills. We will make sure we understand what I’m signing and there might be some things I don’t agree with, but right now I don’t know what those are.”

We may see echoes of that for months as critics of many of the rapidly-processed bills examine them carefully for legal or other flaws – and we’ll probably find more than a few.

The Democrats who were mainly responsible for passing them all so quickly will, of course, have to answer for them.

This column originally appeared in the Oregon Capital Chronicle.