Oregon nurses are urging state lawmakers to make hospitals better and safer places to work.

With the 2023 legislative session just around the corner, the Oregon Nurses Association is calling for changes to ensure minimum staffing standards based on patient numbers and accountability for hospitals so there are enough nurses on the floor.

Matt Calzia, director of nursing practice and professional development for the Oregon Nurses Association, said the lack of staffing has real implications for patients. For instance, if a nurse goes on break for lunch, another nurse assumes care of their patients, doubling the other nurse's workload during that time.

"So when you've just had knee surgery and if that period of time falls when you need your next pain medication dose, it may be delayed because right now your nurse actually has eight patients instead of four," Calzia explained.

Calzia pointed out turnover is higher now than during the Delta wave of the pandemic because nurses are burned out. According to the union, turnover was 2% in 2021.

Sean Kolmer, senior vice president of policy and strategy for the Oregon Association of Hospitals and Health Systems, countered under the union's proposal, "community hospitals will have no choice but to reduce access to services if they are unable to hire enough staff" and argued there is a staffing shortage in the state.

Paige Spence, director of government relations for the Oregon Nurses Association, said along with minimum safe staffing requirements, the union proposal would ensure Oregon's current staffing law is enforceable and provide accountability when nurses make complaints. In addition, Spence emphasized an annual review of the staffing plan would include the number of missed meal and rest breaks over the past year.

"To ensure that the staffing levels going forward are robust enough to accommodate nurses' abilities to take the rest break which they need for sanity and physical well-being, and also are entitled to by law," Spence stated.

Calzia refuted claims the state has a shortage of nurses.

"It's not a pipeline issue; it's a turnover issue," Calzia stressed. "You have more nurses leaving the bedside than you can get in, and then you're just burning through them."

It's been 13 years since more than 156,000 West Virginians gained health insurance coverage through the Affordable Care Act.

As sweeping and sometimes controversial as the ACA has been, its longer-term effects are still being felt today at the state level.

Gary Zuckett, executive director of the West Virginia Citizen Action Group, pointed to a new West Virginia law capping insulin copays at $35 per month. The law goes into effect January 1.

"I think we now have the best insulin copay cap legislation in the country that we just helped get passed in a very 'red' legislature," Zuckett noted. "Which does show you that health care is not partisan."

Federal data shows since the launch of the federal health insurance exchange, enrollment in health insurance plans has doubled from 8 million to more than 16 million nationwide.

According to the West Virginia Center on Budget and Policy, the Medicaid expansion included in the ACA allowed more than 200,000 West Virginians to gain access to health coverage.

Zuckett cautioned when the "continuous coverage" rules enacted during the pandemic expire April 1, the state will begin re-evaluating people's eligibility, which could signal a setback in progress.

"A lot of people won't qualify or won't fill out the paperwork, and they'll lose their health insurance in West Virginia," Zuckett explained. "That could be as many as 50 or 100,000 people. So, that's going to be a step backwards."

According to America's Health Rankings, around 6% of West Virginians were uninsured in 2021, far fewer than the nearly 16% of the state's population who lacked coverage prior to the Affordable Care Act.

Beginning next year, more Kentuckians will have expanded access to biomarker testing - which helps doctors customize cancer treatment. Advocates of the new law say it will save lives and improve patients' quality of life.

Signed into law by Gov. Andy Beshear, House Bill 180 requires both private insurers and Medicaid to cover biomarker testing after a cancer diagnosis.

Doug Hogan - director of government relations for the American Cancer Society Cancer Action Network (ACS CAN) - explained that without biomarker testing, doctors typically try several rounds of chemotherapy or other treatments, without knowing which will work best for the patient.

He said biomarkers increase the odds of matching the right treatment to a specific cancer.

"We will be the fifth state in the country to adopt an enhanced access to biomarker testing law," said Hogan. "And so, we're on the cutting edge. This is the way that we can utilize technology to improve health outcomes."

The bill passed unanimously in both the House and Senate. According to the American Cancer Society, more than 30,000 Kentuckians will be diagnosed with cancer this year.

Hogan added that the new law will allow care teams to use the latest technology to make the best decisions for their patients.

"It is so important for these patients to get that right treatment at the right time," said Hogan. "It really will improve their health outcomes. It will save lives in many instances, and certainly will improve the quality of life."

Research shows biomarkers can in many cases reduce the cost of therapy, especially for lung cancer and colorectal cancer patients.

Cancer-care costs are expected to top more than $245 billion by 2030, according to the American Association for Cancer Research.





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Oregon's nonprofit hospitals are not doing enough to provide assistance on medical bills for low-income patients, but a bill in Salem aims to change it.

Nonprofit hospitals are required by federal law to alleviate medical costs for patients who cannot afford them.

Matt Swanson, political strategist for the Service Employees International Union Oregon State Council, said investigations have found the institutions are not going far enough to help.

"People really aren't getting the assistance they need," Swanson explained. "Instead, they're getting every last dollar really wrung out of them in order to satisfy a bill that they really can't pay, and it's risking other things in their life, like housing and food and the ability to get over their health issue."

House Bill 3320 is designed to ensure people get the financial assistance they need and hospitals are transparent about their assistance practices. In written testimony on the bill, the Oregon Association of Hospitals and Health Systems said it agrees with parts of the legislation but wants lawmakers to keep in mind insurers are part of the cost picture as well.

Swanson added it is important for people who cannot afford medical bills to know they have assistance available.

"The purpose of this bill is to really tighten up what compliance looks like," Swanson emphasized. "And ensure that everyone gets screened before they are sent a bill, so that the hospital is giving a hand to folks who need the help, instead of letting them get lost in systems that are often confusing and overwhelming at a time when they're really struggling."

The bill received a public hearing last week and is scheduled for a work session Wednesday.


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