The Honorable Jeff Merkley 313 Hart Senate Office Building Washington, D.C. 20510

The Honorable United States Senate 223 Dirksen Senate Office Building Washington, D.C. 20510

Congressional District 1 U.S. House of Representatives 2338 Rayburn House Office Building Washington, D.C. 20515

The Honorable Congressional District 2 U.S. House of Representatives 2182 Rayburn House Office Building Washington, D.C. 20515

The Honorable Congressional District 3 U.S. House of Representatives 1502 Longworth House Office Building Washington, D.C. 20515

The Honorable Peter DeFazio Congressional District 4 U.S. House of Representatives 2134 Rayburn House Office Building Washington, D.C. 20515

The Honorable Congressional District 5 U.S. House of Representatives 314 Cannon House Office Building Washington, D.C. 20515

Dear Federal Delegation,

On behalf of nearly 125,000 employees represented by the signatories of this letter, the Oregon Association of Hospitals and Health Systems (OAHHS), Service Employees International Union Local 49 (SEIU), and the Oregon Nurses Association (ONA) urge you to carefully consider the impact of the difficult budget decisions you will be asked to make as the result of the work of the Joint Select Committee on Deficit Reductions. In particular, we are very concerned about the deleterious effects of additional Medicare and Medicaid cuts on health care jobs here in Oregon. As you know, health care is one of the few bright spots in our otherwise dismal employment landscape.

In Oregon, community hospitals and health systems are the largest employer in the health care sector, providing jobs for more than 59,000 employeesi, including more than 20,000 registered nurses and physicians. For every 10 jobs created in an Oregon hospital, an additional 12 jobs are created in an industry that supports and supplies these organizations. All told, Oregon’s hospitals created more than 125,000 jobsii in 2009.

We want to be sure that you are aware of the deep cuts already slated for Oregon's Medicaid program, in light of the significant state budget challenges we are facing. In the second year of this biennium, starting on July 1, 2012, there is a scheduled cut of more than $239 million in State Funds to this program – on top of the significant cuts already enacted this year. These additional deep reductions will result in the loss of over $400 million in federal matching funds, bringing the total cut in the second year of this biennium to Oregon's Medicaid providers to $640 million (State and Federal Funds). This is before any required reductions arising from the recommendations of the Joint Select Committee on Deficit Reductions. This planned budget action will put more than 6,500 hospital-based jobs and, 12,000 home care and nursing home jobs in jeopardy.

As you know, Oregon is a high-quality low-cost state; any additional cuts would jeopardize the viability of community hospitals and the accessibility of providers. Now is not the time to make the situation worse by further cutting payments to such critical community resources. Thousands of community-based jobs are already at stake as the result of the state’s unfortunate budget circumstances. Let’s not make the situation worse.

Oregon's health care delivery system and the people that make it work are recognized as one of the best in the nation. We stand together in our commitment to continue to improve outcomes for our patients and to take unnecessary costs out of the system. Now we seek your commitment to protecting and strengthening fragile funding streams in place today.

Join us in protecting Oregon health care jobs.

Sincerely,

Andy Davidson Meg Neimi Susan King President & CEO President Executive Director OAHHS SEIU Local ONA

i American Hospital Association Annual Survey, 2010 ii EcoNW, Economic Impact of Oregon’s 58 Community Hospitals, April 2011