In anticipation of funding cuts and amid general uncertainty about the state of federal health reform, Oregon Health & Science University plans to "significantly reduce" its hiring, university President Dr. Joe Robertson said today.

“It’s almost a freeze,” Robertson said.

The move will save somewhere in the “tens of millions of dollars,” though it’s a little too early to specify how much, as the board won't approve the next fiscal year budget until June.

Robertson emphasized that the move is proactive in light of a macro environment that promises “significant reductions in essential funding streams for OHSU, for Medicaid and potentially, cuts for other funding streams embedded in ways people don’t realize.”

Senate Republicans on Thursday took the first major step in repealing the Affordable Care Act by approving a budget blueprint that essentially guts the law, while sidestepping a filibuster threat from Democrats.

President-elect Donald Trump said Wednesday the law should be repealed and replaced simultaneously. He plans to put forth more details once Rep. Tom Price, a Republican from Georgia, is confirmed as the new secretary of health and human services.

More than 20 million people have obtained coverage under the ACA, including 550,000 in Oregon, mostly from the Medicaid expansion, but also from the health insurance exchange. The reduction in Oregon's uninsured to 5 percent from about 14 percent previously has been a boon to hospitals such as OHSU, which have seen their charity care and bad debt plummet.

The state Medicaid program is looking at a $1 billion gap in the next biennium. Gov. Kate Brown, in her budget proposal, aims to fill the hole with taxes on hospitals and insurers and some belt-tightening on the part of the Coordinated Care Organizations, which deliver Medicaid services.

“While we look forward to working with the Legislature and Congress to protect those patient populations, I cannot imagine a future where times aren’t more lean than they are today,” Robertson said.

Last year, OHSU hired 800 new employees, Robertson said. The university, the No. 3 employer in the metro area, with more than 15,000 employees, has averaged 500 new employees a year since the depths of the recession.

Robertson said OHSU will continue to add employees in “essential positions and replace essential health care workers.” Certain parts of the university, including the Knight Cancer Institute and OHSU Foundation, have their own funding streams and will continue to add or replace employees.

The university also will give extra scrutiny to new service contracts and capital expenditures, Robertson said. It also won't add any new programs.

“We’re trying to act now, even though we don’t have exact numbers so we can best protect patient services and care for the vulnerable and employees,” Robertson said. “Our principles are not going to change.”

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